Epidemiology and impact of early rehabilitation of spinal trauma after the 2005 earthquake in Kashmir, India.

PURPOSE: The Kashmir earthquake, also known as the South Asia earthquake, hit Jammu and Kashmir (India) on 8th October 2005 (registered as 7.6 on Richter scale) and was quite devastating, with the official toll being 1,360 (some estimates being around 1,800). The injured registered around 6,300. In such an enormous disaster, rescue operations, relief and rehabilitation is a great challenge. One week after the Kashmir earthquake (2005), a multidisciplinary rehabilitation team headed by the corresponding author went to Srinagar (Kashmir). The purpose was to tackle the medical rehabilitation issues of the victims of the earthquake and later study the epidemiology of various injuries, especially the spinal injuries, so as to improve the future rehabilitation strategies in similar scenarios.
METHOD: This is a single-phase, hospital-based study of spinal injury patients of the Kashmir earthquake (October 2005) admitted in various hospitals of Srinagar (the capital city of Kashmir, India) and around it. This was conducted one week after the Kashmir earthquake (October 2005). Detailed history of patients, clinical and radiological evaluation was done. In consultation with neurosurgeons and spine surgeons, issues of rehabilitation were noted, and need based on early rehabilitation care was provided by means of rehabilitation orthoses (aids/appliances), physiotherapy, psychotherapy, etc.
RESULTS: Out of 2,621 cases who received various injuries (as per records of different hospitals and health institutions), 1,366 (52.11%) were referred to different health institutions of Kashmir valley, of which 429 (31.40%) cases were admitted for orthopaedic intervention at different referral hospitals of Srinagar and Baramula. Out of 429 admitted patients of different hospitals, we covered 266 patients of four major hospitals, of which 38 (12.33%) cases were spinal injuries, 20 cases (52.7%) had dorsolumber segment involvement with 12 cases (31.5%) having cervical and six cases (15.8%) sacrococcigeal injury.
CONCLUSION: In a massive natural calamity like the Kashmir (India) earthquake of 2005, a collective effort by a rehabilitation team for providing supportive/assistive devices along with physiotherapy and psychotherapy has significantly helped in recovery of functional and psychological status of the spinal trauma victims. No doubt that the life saving operations and definitive surgery are important to combat major catastrophe in such disasters but early medical rehabilitation is equally important to reduce injury-related disability.