CHAPTER 5
DEVELOPMENT OF OTHER SPINAL
INJURIES CENTRES
3. PROBLEMS IN DEVELOPING COUNTRIES
AFRICA
In contrast to the United Kingdom, the European Continent, America, Australia and
South Africa where trauma plays a very essential part causing spinal cord lesions, in
tropical Africa and also Asia infectious conditions such as tuberculosis of the spine,
polio and transverse myelitis represented until recently the major causes. Most sur–
geons took still a very defeatest attitude toward the traumatic paraplegics, let alone
tetraplegics. It was significant that at the first Symposium on Rehabilitation in Africa
at Kampala (Uganda) in March 1964 A.Roper, from Bulawayo, Rhodesia, made the follow–
ing statement: 'The surgeon, faced with the request from another hospital to accept two
patients of the same age, one with Pott's paraplegia, the other with traumatic paraplegia,
must accept the former.' At the same meeting, J.Golding, from Kingston, Jamaica,
pointed out: 'In my view, a complete cervical lesion, showing no signs of improvement
by three weeks, is best sent home.' Both surgeons considered a special centre for the
rehabilitation of these patients unnecessary, Roper even as 'luxury'. However, with the
increase of traumatic spinal cord lesions in African countries, as a result of increase of
industrialization and motorized vehicles, the attitude of members of the medical and
para-medical professions is changing, and the discussions at the second (Addis Ababa,
1966) and third African conferences on rehabilitation (Lusaka, 1968) sponsored, like
the first, by the British National Fund for Research into Crippling Diseases under the
leadership of Mr Duncan Guthrie showed that the establishment of Spinal Units where
patients suffering from traumatic and non-traumatic lesion could be congregated for
comprehensive treatment and social resettlement, far from being a luxury was an
increasing necessity. D.Wilson (1966) reported in Addis Ababa about his experience at
the Institute Medical Evangelique, Kimpisa in Congo Central Province, on 47 spinal
cord lesions, 23 of whom were due to accidents, amongst them 4 cervicals. Five were
casued by road accidents, while in the majority (13) falls from palm trees were the cause.
Two of the non-traumatic and 3 of the traumatic lesions (2 tetraplegics) died. To meet
the needs of these patients who could not return to their own villages the building of a
'Paraplegic Village' in the vicinity of the hospital was planned. At the third African
Conference, held in 1968 in Lusaka (Zambia), the subject of spinal cord injuries was one
of the main topics of the discussions, which revealed the growing interest in this problem.
UGANDA
There is no Spinal Injuries Unit in this country, but the Orthopaedic Surgeon, Professor
Huckstep, has done great pioneer work in the treatment of polio victims, and has con-
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