A INTRODUCTION
41
many other medical and social problems for the disabled and able-bodied alike are so
pressing. As a result of the conflict between India and Pakistan a few years ago, a Spinal
Injuries Unit has been set up at the Military Hospital in Poona, which has very good
facilities for vocational training in workshops built primarily for the large number of
amputees. No doubt this unit will have had to admit an increasing number of spinal
cord injuries occurring during the recent conflict with Pakistan in Bangladesh. There are
also small spinal units at the L.I.M.G. Hospital, Sion, and the All India Institute of
Physical Medicine and Rehabilitation in Bombay, and on the occasion of the celebration
of the loth Annual World Day for the Disabled in Bombay I opened the first 10 beds of
a new spinal unit at the orthopaedic department of the J.J. Hospital Group (Dr Massalla-
walla). However, it remains to be seen which of these small units will develop into a well-
established Spinal Injuries Centre provided with all facilities for the acute, subacute
treatment and long-term management of traumatic and non-traumatic spinal cord
afflictions. Perhaps the recently founded Societies for the Rehabilitation of Paraplegics
and Paraplegic Foundation might be able to develop a comprehensive Spinal Injuries
Centre of larger size with its own specialized medical and para-medical staff under the
leadership of one experienced surgeon or physician. In 1967, Professor Sinha, late
Director of the orthopaedic department at the K.G. Medical College in Lucknow estab–
lished a Spinal Injuries Unit, and Dr S.Varma, who for 5 years was a member of my
medical staff at Stoke Mandeville, is in charge of the unit. The accommodation and
facilities are very primitive and one can only hope that the authorities concerned will
provide better facilities.
Sport amongst paraplegics in India has no doubt promoted public interest in these
severely disabled, as it has done in other countries, and India has already been three
times represented in the Olympics for the Paralysed.
INDONESIA
At the 4th Pan Pacific Rehabilitation Conference at Hong Kong in 1958, the late Dr
R.Soeharso gave a report about paraplegic care in Indonesia. Although his Rehabilita–
tion Centre was already set up in 1951, it was not, as he pointed out, until 1963 that the
interest in paraplegia led to the opening of a special ward for paraplegics. However, there
were still great limitations in the services that could be offered. Only selected cases of
paraplegia could be accepted, namely those who still had bladder control and were free
from sores. From Dr Soeharso's report, it is difficult to assess the present standard of
that unit, and it would appear that the management of complete paraplegics, let alone
tetraplegics, is still far from satisfactory. This may apply to the prevention and treatment
of infection of the urinary tract, the problem of pressure sores and the prevention and
treatment of contractures. It is significant of this unsatisfactory situation that Soeharso
did not 'hesitate to advise bilateral above-knee amputation in cases of fixed deformities
of joints and bad health (decubitus etc.)'. At least a special home for paraplegics has
been established, which offers sheltered work and living quarters for those patients who
otherwise would not survive in their village homes.
