Caregiving in India

[Wise Young]

I just came back from a tour of several spinal cord injury centers in India. There is much interest and potential for research, particularly clinical trials. Most of the hospitals that I visited take care of as many as 2000 people with spinal cord injury every year. Just one of these centers alone can carry out the NASCIS 2 trial (500 patients) in less than 6 months.

However, it was the caregiving aspects of India that really caught my attention. In India, the family is involved in the care of the patients in the hospital from day 1. A family member is sitting by the bed in the intensive care unit and all straight through the entire hospitalization. They learn to do the catheterization, the physical therapy, the exercises, the turning, etc.

The contrasts between the centers could not be greater. One center in Bombay had almost no technology but incredible compassion and community. One center in Delhi had state-of-the-art technology with CT/MRI and surgical suites alongside rehabilitation facilities. In the places without all that much high tech, they have invented impressive low tech solutions. Most of the patients are up and are highly motivated to start walking as soon as possible. Most of the rehabilitation is carried out in large room with many people doing the same exercises together. This community approach towards rehabilitation is very impressive. More experienced families teach the new ones on how to handle specific situations. Most of the patients are in open wards where they looked after each other.

Wise.