During 2006 & 2007 activity in Southern Africa has focussed on gearing up to hosting the 47th Annual Scientific Meeting in Durban in 2008, while attempts have been made to make contact with other workers on the African continent.
Preparations for the ISCOs meeting are proceeding well. SASCA has managed to enlist the active support and involvement of the South African National Department of Health - who have undertaken to assist with making contact with other African Health Departments and to contribute to planning the meeting - both financially and with a request for a course in Spinal Cord Injury management for African workers. As a result, the Executive Committee, the Scientific Committee and the Education Committee have agreed to stage a course in SCI care in conjunction with the meeting in September 2008. This promises to be a valuable resource in our efforts to ensure African participation in the meeting and in increased interest in SCI care on the continent. Details about the 47th Annual Scientific Meeting and the course in SCI care will be available on the meeting website by the end of July 2007 - www.iscos2008.org.za.
We have continued to make contact with individual health care workers who have some SCI experience throughout Africa, but this has again been difficult. The ongoing theme that SCI is eclipsed by other health care issues (HIV, TB, Malaria and poverty related illness) still results in little formal government level attention to SCI. There are however individuals and teams in hospitals in Botswana, Namibia, Zambia and Kenya who have expressed great interest in improving the services they are able to provide. Workers in the primary health care setting have stressed the importance of taking SCI care into the community.
Workers on the continent (even in relatively affluent South Africa), while keen to participate in meetings like the ISCOS Annual Scientific Meeting have again complained that attendance is simply out of their financial reach. The cost of attending this year's meeting would cost a physiotherapist 2-4 month's salary, while a nurse would have to budget 4-5 months of her salary to be able to attend. These financial constraints are pushing us towards developing some kind of virtual SCI community. We hope that the 2008 meeting will assist us by identifying those teams, sites & individuals who could form the backbone of this network and then allow time for us to work out a mechanism to facilitate communication.
In South Africa SASCA has held 3 different 3 day courses in SCI care - 2 of these in rural regions - while SASCA members have been actively involved in training in hospitals where no SCI unit exists, but where SCI patients are cared for. SASCA will hold it's Bi-Annual Conference in September this year - and interested individuals can find out more about the meeting on the website www.sasca.org.za.
Since the last meeting in Boston there have not been many dramatical changes to report about the activity of the European SCI community. The representative of the European Affiliated Societies did not send an annual report by my suggestion and invitation. I hope this next year will be better.
In Europe the economical situation is getting worse with regards to the public health systems. The funds are decreasing year by year and this situation makes the comprehensive assistance to the SCI people and their families worse. The length of hospitalisation seems to decrease a little everywhere and the number of specialised beds are not increasing as needed.
With regards to the involvement of the former Eastern European countries in our community, as by my declared Mission after my nomination as Vice President Europe, I have tried to support the Institution of Organizations and Centers for SCI people and increase the contacts between them and the rest of Europe. I have been strongly supported in this mission, by Fin Biering Sorensen and Wagi El Marsy. A meeting has been held in Albania in the presence of Fin Biering Sorensen on behalf of ISCoS on September 15 2006. During that meeting the decision was taken of proposing and supporting the formation of a Balkan Society or network for Spinal Cord. Such a project made the Albanian collegues, like Maksim Bozo and others, very enthusiastic. We are supporting this process by creating connections among collegues from Croatia, Serbia, Bosnia, Montenegro, Slovenia, Macedonia and Albania. We will folllow the future progress.
In Romania, June 7, 8 and 9 2007 the first joint meeting of Romanian Society of Neurosurgery and the newborn ROSCOS ( Romanian Society of Spinal Cord ) was held in Sibiu. Prof Genu Olnose, Director of a Spinal Lesion Rehabilitatioon Center, located in the Emergency Clinic Hospital Bagdasar-Arseni in Bucharest, together with Professor AV Ciurea, President of the Romanian Society of Neurosurgery, who works in the same University Hospital, were the Presidents and Organizers of the meeting. I attended as ISCoS Vice President and gave a lecture on the Models of Care in SCI. The meeting was very interesting and they are very happy to enter the ISCoS circuit. At the next meeting we will discuss ways of developing such a project.
This is my short report for this year, hoping to have interpreted my mission in the right way.
The XI Latin America Paraplegia Society Meeting and III Workshop - Comprehensive Management of Spinal Cord Lesion took place Belo Horizonte City, capital of Minas Gerais State, in Brazil from July 10-14/2006. They are a combined organization with the XX Brazilian Physical Medicine and Rehabilitation Congress. The workshop was a precongress activity and the meeting was a congress activity.
SLAP had the sponsorship from ISCoS and brought Dr Joan Vidal, from Barcelona and director of SCI Program of the Gutman Neurorehabilitation Hospital. He was present during the workshop and meeting and also had a special participation in the congress, itself, where he gave one of the Congress Magnum
Conferences.There were 170 participants in the III Workshop - Comprehensive Management of Spinal Cord Lesion and the public was composed by doctors: physiatrists, orthopedic surgeons, urologists, clinical and neurologists, PT, OT and nurses of many parts of the country. There were two people from Guatemala.
There were 50 participants in the XI Latin America Paraplegia Society Meeting. Most of the people were physiatrists who work with SCI. They came from all parts of the country and also from Guatemala. There was a very interesting session, which some clinical cases are discussed with expressive participation of the public. It was very useful because it was compared some kind of procedure in a developed and development country.
The fact of Dr Joan Vidal is a Spanish speaker was a great thing because there was no need of translator and the sessions were very dynamic. Dr Joan Vidal arrived in Brazil, in July 9th 2006 and stay until July 14th 2006. He flight from Barcelona - Paris- São Paulo - Belo Horizonte.
There were few people from the others South American countries, but it was expected, because SLAP had not organized any meeting since 2003.
My personal evaluation was that both activities (workshop and meeting) were useful, but the SLAP members in the different South America countries could organize the basic workshop, because there is enough expertise about the common SCI / SCL themes and their comprehensive management fir this purpose. However, the advances, meanly in therapeutics and technologies associated with the clinical discussions, that were debated during the meeting, with the participation of one international expert were very use and helpful for the participants.
One of the aims of these meeting was reorganized the SLAP and try to put together the SCI people from Latin America and keep them integrated with ISCoS. The XI Meeting did not get the target, but it is our intention to organize annual meetings and try to bring the South America doctors and other professionals. For that we are planned the next activities.
SLAP received £2.000,00 from ISCoS. The money was sent to Júlia Maria D'Andréa Greve, personal account. It is obligatory that the international currency would be converted in local currency. The £2.000,00 became R$ 7.500,00 (£1,00 = R$ 3,75). The liberation of the money took 3 months time. The great delay to release the money is caused by the wrong name of the destination bank, which was changed by sender. For this specific reason Dr Joan Vidal had to buy his ticket in Spain and he was reimbursed in Brazil. His ticket cost 1.709,00€, that means R$ 5120,00 (1 euro = 2,99 reais). The money was converted two times: from pound to real and again to euro. This double change cost more taxes.
| Credit (pounds) | Credit (reais) | Debt (euros) | Debt (reais) | Subtraction | |
|---|---|---|---|---|---|
| ISCoS income | £2.000,00 | R$ 7.500,00 | |||
| SLAP income | R$ 1.000,00 | ||||
| Air Tickets (international) | 1.709,00 € | R$ 5.120,00 | |||
| Hotel | R$ 1.380,00 | ||||
| Meals | R$ 286,00 | ||||
| Taxi | R$ 235,00 | ||||
| Room rental | R$ 1.200,00 | ||||
| Coffee break | R$ 200,00 | ||||
| Total | R$ 8.500,00 | R$ 8.421,00 | |||
| R$ 79,00 |
It was organized some special sessions about Spinal Cord Injury inside CINDOR - Pain and Functional Rehabilitation Congress of School of Medicine of University of São Paulo, to be organized in 10-12th May, São Paulo - Brazil.
We had 35 participants and the main theme was Neurophatic Pain and three cases were discussed for five different specialists. The meeting was partially successful, because only Brazilian doctors and health professional participated and there was not participation of people of other countries of members of Latin America.
Some special sessions about Spinal Cord Injury inside XXIII AMLAR (Latin America PM & Rehabilitation Society) Congress and XIII Congress of South Cone (Regional PM & Rehabilitation Meeting of Brazil, Uruguay, Paraguay, Chile and Argentina), in November, October 27-30th 2008, in Punta del Este, Uruguay.
Dr William Donovan had been invited and confirmed his participation. To achieve the objectives I would like to have some support from ISCoS. My solicitations are: get sponsorship for Dr William Donovan in the SLAP future activity in Uruguay. The sponsorship will be for air tickets and hotel.
We already have confirmations of many Latin America doctor's participation: Brazil, Uruguay, Paraguay, Colombia, Venezuela and Argentina. SLAP and AMLAR will organize the meeting with Scientific Committee and divulgate in all Latin America countries participants of SLAP.
Now in it 7th year, ASCoN has evolved into an important and well recognized regional learning and sharing forum and a catalyst for change in the field of spinal injury management and rehabilitation. Membership of ASCoN has increased from initially 14 members in 7 countries to more than 50 members in 16 countries of Asia. The Executive Committee has also developed into a cohesive team, with overall responsibility for implementation of the ASCoN Plan of Action.
Locally within Bangladesh, Dr Hoque as been continuing to run the workshop on Spinal Cord Injury on nursing management for the nurses of both government and non government hospitals, with sponsorship for the workshops provided by WHO.
Two nurses from Vietnam provided 1 week training programme to staff of Green Pastures Hospital in Nepal. The main focus of training was on prevention of pressure ulcers, bowel management and urological nursing care.
A 3-week training programme for OT and PT staff was held, with direct inputs from resource persons from Australia, Bangladesh and Poland. The training programme provided the opportunity for a theoretical review of PT and OT management for SCI alongside Active Rehab training.
A doctor from SIRC was seconded for 6-months training at the Amrita Institute of Medical Science in Cochin, Kerela, India. Training and placement will increase his knowledge and skills in Spinal Surgery and Instrumentation; Spine in all its spectrum (Spine related disease, disorders and its treatment); Pre and Post Operative surgery management; Hospital and patient management systems.
Immediately after the 6th ASCoN conference in March 2007 an exchange and training programme was organized at CRP for teams from Sri Lanka and Nepal with inputs from resource persons from CRP, Bangladesh, John Grooms Ireland and ISIC, New Delhi. The objectives of the training programme were to provide participants with an overview and practical knowledge on the aspects of comprehensive rehabilitation relating to their particular profession; and to demonstrate different CRP patient and organizational management systems that have potential for replication within the participant's organization.
ISSICON-2007 was organized from 23-25 February 2007 in Indore India. The theme of the conference was "Past, Present and Future of Spinal Injuries & Spine Disorders". 7 International faculties, 12 National faculties and 282 delegates registered for the conference.
There were 4 pre conference workshops in addition to the main conference - "Surgical Management of Spinal Injury" facilitated by Dr Ashwini Saran, Dr Patrick Kluger and Dr Hans Erli; "Physiotherapy Management of Spinal Cord Injury" facilitated by Dr Vinod Sehgal; "Management of Neurologenic bladder" conducted by Dr Jean Jacques Wyndaele; and a meeting for spinal injury patients was also held wherein 80 spinal injured participated. A patient support group was launched during the meeting. Various spinal injured brought out how they had been able to accept the challenge and come back to a normal life style.
In order to promote research activities among ASCoN activities, greater importance is being levied on this area by the members of ASCoN Executive Committee. A current research project in which ASCoN members are involved include an international research project on ICF data sets being performed by the Swiss Paraplegic Research at the Guido A. Zach Institute in Nottwil, Switzerland in collaboration with the International Classification of Functioning, Disability and Health (ICF) Research Branch in Munich Germany and the WHO.
At future ASCoN conferences it has been agreed that one session will focus on Research (development of new aids/appliances) in order to encourage younger staff in this field.
Joint research projects among centres will also be actively encouraged by the ASCoN Executive Committee.
The Guiding Principles for Management of Spinal Cord Injuries, developed by ASCoN members and first published in March 2006, are clear cut guidelines of comprehensive spinal cord injury management, appropriate to the Asia region. 5,000 copies of the Guiding Principles have been distributed throughout Asia and further afield. Another print run has been ordered. They are particularly useful for professionals who are new to the field and for newly developing centres. They can also assist policy makers in designing rehabilitation services and prevention programmes.
The Guiding Principles have also been translated into Vietnamese, Chinese (with assistance from Prof Dajue Wang and HI China) and French (with assistance from Dr Ventura AFIGAP). Plans are underway to have the Guiding Principles translated into Spanish or Portuguese so they can be used broadly in South America.
The 1st edition will be updated following feedback and suggestions from eminent spinal injury consultants across the globe. Work on the 2nd edition of the Guiding Principles is currently ongoing.
Work has also commenced to develop other aspects of the Guiding Principles as separate guidelines for both Prevention and Development of Model SCI centres.
A 3-year plan of Action for ASCoN is currently being drafted and will be finalized shortly by the ASCoN Executive Committee. The main areas of focus include:
Work is ongoing to support the further development of the ASCoN Secretariat, the ASCoN website and increasing membership.
In order to promote human resource and service developments between personnel working in field of rehab in Asia and to increase access to information/materials relating to comprehensive rehab management, greater emphasis will be placed on education and training through the following ways:
There are plans to strengthen the following centres in Asia as recognized ASCoN regional training centres:
A training resource database of ASCoN and ISCoS members will be compiled and these resource persons will be selected to carry out training for ASCoN members.
A 3-day workshop will be held from 3-5 September 2007 at SIRC, Nepal for staff of SIRC and other institutes working in the field of SCI management in Nepal. The workshop topics will cover comprehensive rehabilitation and include organizational development and design for new centres. A core team of resource persons from within ASCoN/ISCoS will provide their inputs at the Workshop.
Dr Apichana Kovindha will host the Chiang Mai Workshop from 22-24 November 2007. The theme is 'Management of Complicated SCI'. The Workshop will be for doctors and paramedical personnel. It is envisaged that 50-60 participants will attend.
Spinal Cord Society (Indian Chapter) and Indian Spinal Injuries Centre is organizing the International Spine & Spinal Injuries Conference (ISSICON 2008) from 22nd to 24th February 2008. The theme of the Conference is "Recent Advances in Spine Care". At least 650 delegates are expected, not only from all over India and the neighboring countries but also from other distant Countries.
The 8th ASCoN conference will take place in Hanoi, Vietnam and be hosted by HI Vietnam and Ministry of Health in 2008
The 9th ASCoN conference will take place in Katmandu, Nepal and be hosted by SIRC in 2009.
The 10th ASCoN conference will take place in New Delhi in conjunction with the ISCoS annual meeting in 2010.
This area will be further developed.
ASCoN will continue to advance networking between SCI centres and staff across Asia. International links will also be encouraged. ASCoN will advocate to national and international bodies for greater attention to be paid to the needs of those requiring rehabilitation services.
The American Spinal Injury association held their 2006 meeting in Tampa. At this meeting the SCOPE project was discussed and "kicked off". We are hopeful that ISCoS will be significantly involved in this project and it will be discussed further at the Council meeting by Dr J Steeves. The next ASIA meeting will be held next June in San Diego, California. Glen Rechtine has succeeded me as President and the term of our Presidency was decreased to 1 year. Work has also continued in conjunction with ISCoS on the Autonomic standards and it is hoped that an accepted first version of this document will be sent for publication this summer.
An on-line training package for the Neurological Standards has been initiated through ASIA. We would like to continue to work on this project in conjunction with ISCoS. We would like to incorporate training in the Autonomic Standards in this project and will seek corporate sponsorship. We would like this product to be available internationally in a two-tiered system. One might have to pay if they desire CME or a certificate but otherwise a health professional could also access the training free of cost.
The American Paraplegia Society has had some financial challenges due to a change in their funding sponsors. Their meeting has now moved and will be held in Orlando in August 2007.
The Christopher Reeve Paralysis Foundation received a grant from the Department of Defense to expand their US clinical trials network.
The US Model Systems has funded two large studies, one looking at the benefits and costs of rehabilitation in SCI and another related to treating depression after SCI.
ICCP documents have been published and they have partnered with ASIA on SCOPE.