Recent Developments
Rokpa Kids Tour | Woza Moya AIDS Project
Charitable Project Updates | Kala Raksha

CHARITABLE PROJECT UPDATES

Hospital and Rehabilitation Centre for Disabled Children - HRDC Spine Program
All Together Now International has been helping for several years to fund Nepal's first and only spinal surgical center for children, the Hospital and Rehabilitation Centre for Disabled Children (HRDC), located near Kathmandu in Banepa, Kavre, Nepal. Through the generosity of many ATNI donors, HRDC has been able to meet its projected costs for 2004, and to continue the spine program activities into 2005.

HRDC's objective is to identify spine problems early during childhood, and to institute effective management plans for these young patients. The Centre's efforts are focused on very poor children, most of whom are less than 16 years old. In addition to dealing with the spinal disease processes occurring in their bodies, these children also deal with severe socioeconomic disadvantages and the social stigma that accompanies all of this.

The HRDC spine program involves center based screening, case selection, patient management including operative and non-operative treatment, a special spine clinic for surgical intervention when necessary, and requisite patient follow-up. Additionally, HRDC operates 50 mobile clinics each year that travel to remote parts of Nepal.   Also, a school screening program has been implemented to look for cases for early intervention and to explore the epidemiology of spine problems in Nepal.

HRDC has made great strides in the recognition and intervention of spinal disorders in Nepal. During the last four years, more than 100 children have been treated with spine problems, ten schools have been screened, with a total of 9.397 students being evaluated. Some specific patient examples are the following. Tsering, a four-year old boy who stood only two feet tall due to kyphosis, was treated with surgical intervention which stopped the progression of the disease which would have lead to paralysis. Kamal Jit Tamang, a twelve-year old suffering from tuberculosis of the spine causing paraplegia, was also treated with surgical intervention and is expected to be walking normally soon. Eleven-year old Priyanka Thakur from India had surgery to correct congenital scoliosis of the thoracic-lumbar region. Her postoperative and recovery periods have gone well. Priyanka's case is an example of HRDC's policy to accept and treat patients irrespective of national boundary.

School screening for scoliosis brings hospital service awareness to new communities, meaning that patients with disabilities other then spinal are now more likely to use HRDC.  The management team at HRDC oversees a continuing program aimed at enhancing the skills of staff members both at the paramedical and surgeon level.  A major challenge at HRDC is to treat in a very cost effective way a highly complex disease process when it has progressed to an advanced stage.  This, of course, is what makes screening and early detection so crucial.

ATNI advisory council member and orthopedic surgeon, Dave Spiegel, MD, also a member of Orthopaedics Overseas, travels to HRDC annually.  He spends several months teaching and enhancing the skills of the excellent and dedicated hospital staff.

The spine program has accomplished many goals and has shown promising results. However, HRDC aspires to reach and treat more children by: developing programs to continue spinal screening, introducing new screening methods, training CBR (community based rehabilitation) workers, recruiting spinal registrars, enhancing the skills of all the staff, and acquiring new equipment and instruments.