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Afghanistan: home care for patients with spinal cord injuries

16-05-2002 News Release 02/20

An ICRC physiotherapist visits 12-year-old Ewazali, paralysed from the waist down by a stray bullet in Kabul in 1996.

In 1996, 12-year-old Ewazali was playing in the yard of his home in Kabul when a stray bullet hit him in the back. Since then he has been paralysed from the waist down and he moves around in a wheelchair. Barbara Rau, an ICRC physiotherapist, and her team visit him on a regular basis to see how he is doing and what progress he is making with his rehabilitation exercises. 

Being confined to a wheelchair, especially when you are young and still growing, can impair muscle development and posture. But Ewazali has taken the ICRC team's advice seriously. With makeshift weights built by his father, he works every day on strengthening his arm muscles and, with callipers fitted to his legs, he practises using a walking frame. He is active and in good shape. With a small loan from the ICRC he has set up a street stand where he sells cigarettes and other articles. The money he earns is a welcome contribution to the household budget.

Ewazali is one of 270 patients with spinal cord injuries receiving regular home visits from the ICRC team in Kabul. The programme is run by the ICRC orthopaedic centre in the capital, which cares for amputees and other disabled patients.

" Paralysed patients have special needs, " says Barbara Rau. " They are often better cared for by their families than in institutions, provided they get the support they need in terms of medical care and receive advice regarding psycho-social and physical rehabilitation. We also give them food aid every two months. " Over 60% of the patients were wounded by shells, rockets or bullets.

Mohammed Karim had an accident at work when a heavy load fell on his neck. A father of two, he can no longer hold his children in his arms and he can only look at them from an awkward position in bed. The accident occurred six months ago and Mohammed will never walk again. But he can at least learn to sit in a wheelchair and move his shoulders a bit, once the many pressure wounds he has on his back, knees, legs and arms are healed. The wounds, which were caused by lying too long in the same position in a hospital bed, must be cleaned and disinfected once a day and Mohammed has to have his position changed every three hours to relieve the pressure. The ICRC team has taught his family to do just that and it comes once a week to check. Barbara is also working on improving Mohammed's ability to move his sore muscles by massaging his shoulders, giving him exercises to do and teaching him to use a special device that will eventually enable him to eat by himself.

In Afghanistan, disabled people suffer even more than the rest of the population from limited access to health facilities. Their specific needs are hardly known and they have difficulty reintegrating into society. Thanks to the ICRC's home visits, micro-credit programme and food distributions, patients with spinal cord injuries have a chance to lead lives that are as normal as possible within their home communities.