Update from the Field

October 31, 2007

Dr. Zeba Vanek

The Spinal Cord Injury Project for Pakistan Earthquake Rehabilitation (SCIPPER) is an international collaborative effort aimed at facilitating the rehabilitation of survivors who have sustained spinal cord injuries (SCI) from the devastating 2005 South Asian earthquake.

The goal of this project is to promote the health, independence, quality of life, dignity and productivity of these individuals involving local and international cooperation.


Women with Spinal Cord Injuries in an Islamabad facility

On October 8, 2005, South Asia was hit by one of the most catastrophic earthquakes in the last 25 years, only surpassed in devastation by the 2004 Asian tsunami and the 1991 Bangladesh cyclone. The 7.6 magnitude quake killed more than 74,000 and left 3 million people homeless in the treacherous Himalayan terrain. More than 76,000 people were injured, with various forms of crush injuries, including head and spinal cord trauma.The World Health Organization has reported 667 survivors that sought medical care for spinal cord injuries. This is a much larger number than what has been reported from other recent major earthquakes. For example 90 SCI survivors were reported to survive the Turkish quake in 1999; 120 from the 2001 Gujrat, India earthquake and 150 in the 2004 Bam, Iran earthquake.

The majority of these survivors from the Pakistan earthquake are young women and children. They have become paralyzed from their neck (quadriparesis) or waist (paraparesis) down, often with lifelong bladder and bowel dysfunction that requires repeated catheterization and other medical care. In addition, many of them have lost members of their family and their homes and are still lying in shelters and tents with surviving family, in extremely sub-optimal living conditions. These shelters are scattered throughout the valleys and remote mountains of the Western Himalayas, in many cases, located far away from even basic health units, and only accessible, by jeep and a hard mountain trek. A visit by an SCI patient to a health facility usually requires two or three people willing and available to carry the SCI patient to the nearest dirt road from his or her shelter, and then, the resources to pay for a rental jeep, in which he or she must make a journey a few hours long before being evaluated at a poorly equipped rural health unit. Better facilities in distant cities are either too far away or unaffordable for most patients.

A 15-year old boy with a spinal cord injury, with deep and infected pressure sores and urine, carried to a mountain clinic from his shelter in the Balakot Mountains. December 2005

Some patients are still living in distant urban health facilities, like the NIH-D in Islamabad. A few of them have been abandoned by their families and others cannot go back to their family shelters because they are quadriplegics, and too fragile to be able to survive in the wilderness without trained and devoted caregivers. Many such paralyzed women are separated from their children who are cared for by surviving family members in their village of origin. Similarly a child with an SCI may be living at a distant health facility with a grandparent separated from his parents and other community members.The difficult Himalayan terrain and the lack of rehabilitation resources and infrastructure in this region, make the long-term survival of these vulnerable spinal cord injury survivors, very unlikely. If appropriately rehabilitated, however, these individuals can survive and lead meaningful lives. A collective effort made by the local and international community which involves a collaboration and partnership between philanthropists, volunteers, experts, organizations, disciplines, institutions and governments, can make this challenging goal achievable. If this unique endeavor results in a successful outcome, the lessons learnt and the experience gained by everyone involved, will help generate novel ideas, guidelines and a model for the rehabilitation of survivors of disasters in other parts of the world.

Zeba Vanek, MDDirector: SCIPPER

Associate Professor of Neurology
Director: UCLA Spasticity Clinic
Movement Disorders Program
UCLA Neurology


Methods Proposed for Achieving SCIPPER Goals

  • Ongoing Assessment of the Condition and Needs of the SCI Survivors
  • Ongoing Assessment of Rehabilitation Infrastructure in the Affected Region
  • Ongoing Interpretation of Data by Local and International Participants
  • Recommendations and Solutions Proposed by Local Teams and International Input
  • Implementation with Global Cooperation

The Current Immediate and Long-Term Principal Needs of SCI Survivors

  • Basic Support for Survival
  • Medical Rehabilitation and an Ongoing Sustainable System of Medical Care
  • Psycho-Social Rehabilitation
  • Educational and Vocational Rehabilitation
  • Construction of Disabled-Friendly Homes

RMF will process the Zakat donations without charging an overhead and so 100% of the donation can be spent for the medical rehabilitation of SCI patients

Please make your donations to 'Real Medicine Foundation' (In Memo please add 'SCIPPER')