Some experience with paraplegia in a small hospital in Nepal

Paraplegia is a common problem in developing countries. They are the most pitiable group of cases seen, but they can all be offered some help, however limited one's resources. The main causes are Potts Disease, arachnoiditis, tropical spastic paraplegia, trauma, lathyrism and cord compression. The usual trauma is falling from trees and the use of trained monkeys to gather leaves and nuts whilst humorous should not be dismissed. The author saw some 35 cases of paraplegia, of which four are described--two good results and two bad. The physician going to a developing country is advised to prepare himself for the care of these cases and to be prepared to motivate staff, patients and relatives. He will find local medical assistants are kind and enthusiastic and rapidly acquire the necessary skills. Nearly all cases should receive a simple and inexpensive anti-tuberculous regime, vitamins and a very generous diet. Necessary equipment required for the home should be locally made and nothing requiring more than simple maintenance should be used.