34
CHAPTER 4
at Konstancin, which has greatly improved the standard of the initial treatment of
traumatic paraplegics and tetraplegics. Beds are still reserved for the admission of cases
with complications, but, as a rule, the medical officer in charge of such a case is requested
to stay at Konstancin for at least six weeks to receive training for proper management of
his own case. Acute traumatic paraplegics and tetraplegics are transferred to Konstancin
by helicopters of the Sanitary Ambulance Service or, if this is not possible, by a military
'plane. The Konstancin Centre has good facilities for clinical and social rehabilitation,
including excellent sport facilities, with easy access for paraplegics from the Spinal
Centre. Moreover, with the help of the Co-operative Society for Invalids and Sheltered
Workshop, paraplegics with distal lesions can be trained in special professional schools
as medical laboratory assistants, radio and television technicians and in precision engin–
eering. Dr Weiss, who is now professor at the School of Medicine ofWarsaw University,
and his staff are engaged in research and teaching and recently other Spinal Units have
been set up in Poznan and Upper Silesia. Poland wras the first country behind the 'Iron
Curtain' which for some years has taken part in the Stoke Mandeville Games.
PORTUGAL
There is a General Rehabilitation Centre at Estoril (Centre de Medicina de Reabilitacao)
started by Dr Victor M.Santana Carlos. Paraplegics and tetraplegics were treated amongst
other patients in that Centre as they were in Orthopaedic and Neurosurgical departments
of general hospitals in Lisbon. However, in view of the increased number of paraplegics
and tetraplegics as the result of the combat in Angola, the Ministry of Defence is very
anxious to start a proper spinal injuries centre, and Dr Carlos has segregated a ward for
these casualties and other traumatic injuries of the spinal cord. There is also a well
built hostel in Lisbon for the institutional care of Portuguese ex-servicemen.
SCANDINAVIAN COUNTRIES
There are no proper Spinal Injury units in any of the Scandinavian countries which can
give paraplegics and tetraplegics a comprehensive treatment and rehabilitation from the
start. In these countries there still exists the fragmentation of treatment and the initial
and early treatment is carried out in neurosurgical or orthopaedic departments and
patients are then transferred to General Rehabilitation Centres. Dr Bodil Eskesen of
Orthopaedisk Hospital, Copenhagen, Denmark, has taken particular interest in the long
term management of paraplegics and tetraplegics and has been particularly interested in
the development of sport of these patients who, in recent years, come regularly to the
International Stoke Mandeville Games, as do paraplegics from Finland, Norway and
Sweden.
SOUTH AFRICA
There are now several Spinal Injuries Centres in this large country to cope with the
steadily increasing problem of spinal cord affliction. When I visited South Africa in
