As India faces the staggering reality of thousands of fatalities and with 15 lakh people living with spinal cord injuries (SCIs), the call for a robust support system is now more critical than ever. On the occasion of SCI Day (September 5), the healthcare experts and leaders geared up to strongly advocate for a holistic and inclusive solution that includes surgical interventions and comprehensive rehabilitation programs.

According to the WHO reports every year, between 250,000 and 500,000 people suffer a spinal cord injury (SCI). The majority of SCIs are due to preventable causes such as Road Traffic Accidents (RTAs), Falls or Violence.  As many as 1.2 lakh die and another 12 lakhs are seriously injured in road accidents in India.

India has 15 lakh people with SCIs and nearly 20,000 people are added each year.  SCI is devastating, with morbidity not only limited to physical aspects but emotional, social, and vocational life areas too.Violence stands as one of the top three causes of SCIs in India, according to a recent study by the Indian Spinal Injuries Centre (ISIC). Analyzing data from 2012 to 2022, the study revealed that road RTAs accounted for 44% of SCIs, followed closely by falls from heights at 38.3%.

Violent incidents, including stabbings and shootings, also significantly contributed, highlighting the diverse factors leading to these life-altering injuries. The study encompassed 1,537 SCI patients admitted between 2012 and 2022, maintaining consistency with earlier findings from 2002 to 2010, which reported RTAs at 45% and falls at 39.64%. In the last 10 years, the Centre treated nearly 200 SCI patients who were victims of violence.  

This year's theme of SCI Day is "End Violence - Protect Spinal Cord." It is very crucial to intensify awareness and preventive and curative efforts.  Spinal cord injuries are not just physical afflictions; they profoundly alter every aspect of life, including emotional well-being, social interactions, and vocational capabilities. Addressing these issues requires a comprehensive, multifaceted approach that includes policy recognition, accessibility, enhanced safety measures, and robust treatment and rehabilitation services.

Rehabilitation is vital for improving the functional abilities of persons with SCIs. This multifaceted process includes physiotherapy, occupational therapy, peer counselling, plastic surgery, psychological mentorship, nursing care, assistive technology, urological care, and vocational support—often essential following surgical stabilization of the spinal column. 

Rehabilitation, which is critical in teaching patients to adapt to their new normal post-injury, remains inadequately covered under existing government schemes and insurance plans.

Unfortunately, rehabilitation costs are rarely covered by government schemes like CGHS, DGEHS, and ECHS, nor by many insurance companies, posing significant financial challenges for SCI patients. The Delhi High Court's 2023 directive to include disabled persons in insurance schemes is a significant step toward equality, especially for SCI patients facing ongoing medical expenses.

The 2016 Disabilities Act expanded recognized disabilities but excludes spinal cord injury (SCI) as a separate category. Including SCI would grant patients access to key benefits like reservations and vocational support. Despite progress in accessibility under the Accessible India Campaign, universal access and vocational opportunities for SCI patients remain incomplete.On the treatment and care part, all solutions under one roof are needed with highly experienced, internationally trained, and dedicated spine surgeons. The Centre has also established India’s first dedicated neuro-urology department to take care of SCI patients who suffer considerably after spine surgery and are neglected. Institutions like ISIC provide essential surgical, rehabilitation, and vocational training, but gaps remain in broader societal support, particularly in accessibility and long-term healthcare affordability.

It should be a mission to create holistic and inclusive solutions for those battling spinal cord injuries, aiming to build a society that truly values diversity and inclusivity. There is a need to provide more facilities and services for all SCI patients, including those who are victims of violence.

(The writer is chief of Spinal Services, Indian Spinal Injuries Cenre, New Delhi; views are personal)