2019
2019 was a full year of quiet progress
April 5 – a new disaster
A woman sits in the middle of the debris of a residential house damaged in rainstorm in Bara district, 125 kilometers south of Kathmandu, Nepal, Monday, April 1, 2019. Villages in southern Nepal were damaged by a powerful rainstorm that killed at least 28 people and injured hundreds more. (AP Photo/Niranjan Shrestha)
We had not long been back in Canada when we heard of another disaster in Nepal: a severe weather event in the south of Nepal. The storm, almost certainly a tornado related to climate change, travelled across Bara district about 120 kilometers (75 miles) south of Kathmandu on the border with India. It killed at least 28 people and injured hundreds. High winds during the storm had flipped cars and blew a bus carrying at least 40 people off a highway, killing some. Most of the deaths were caused by collapsing walls, toppled trees and electrical poles. Our first official word came in the form of an appeal from Esha Thapa, SIRC’s Executive Director: Vishnu, a nurse at SIRC, had joined an emergency government team dispatched to screen spinal cord injured people.
“As you must be aware there was a devastating cyclone in the east of Nepal last week injuring more than 700 people and killing around 30 people. Our nursing staff is also deployed at the site now and he is supporting the medical teams and also working on referrals. Currently there are 10 new cases of SCI identified who are being treated in different hospitals in Kathmandu. We have been approached by Ministry of Health to run training for about 50 health workers in this area for emergency management up-to referral. It is a very tense situation there and training needs to be planned well and done within 2 weeks.”
Women grieve the death of their relatives. (AP Photo/Niranjan Shrestha)
SIRC – with the support of Spine Nepal – sent a team to the disaster area including head of rehab Chanda, psychologist Sai Laxmi and nurse Vishnu. They ran a three day training course teaching caregivers the consequences and complications of SCI, the principles and practice of patient care in the first days after injury and beyond. See below – pictures courtesy of Spinal Injury Rehabilitation Centre. By the end of April about 20 people had been screened with the suspicion of spinal injury, and 10 diagnosed. A patient with high tetraplegia had died, 2 patients were referred to a teaching hospital in Kathmandu for acute care. 2 were admitted directly to SIRC. A number of people with more minor spine injuries were treated in local hospitals, with few more expected later from other acute hospitals.
For more general information about this event, go to Wikipedia
April 26 – Good news from the SCI Network!!
The SCI Network was given land on which to build a new hostel, allowing them to increase the number of children with spinal injuries who wish to continue their education. (Spine Nepal provided some funding to SCIN). For more information please read SCIN supporter and cheerleader Kate Coffey’s blog.
May 9-14 – Dr Prakash Paudel returns to Vancouver
Dr. Prakash Paudel visited us in Vancouver from May 9 through May 14, on a stopover to the AO Global Spine annual conference in Toronto, sponsored by SpiNepal. Prakash met a number of specialists within the Vancouver Spine program. He learned more about the management of back pain from local expert Paul Bishop over dinner at the Point Grey Golf and Country Club. (Dr. Bishop is an expert in the physiology and management of spinal disc disease, an area that Prakash had little exposure to during his training.) We breakfasted with Dr Viet Vu, a physiatrist at GF Strong where Claire worked prior to retirement. While in Vancouver, Prakash also met paediatric spine surgeon Dr. Firoz Myanji at the BC Children’s Hospital and paediatric neurosurgeons Dr. Paul Steinbok and 
Dr Patrick McDonald (division head).
We lunched with Karalee and David Greer (left) who Prakash had met in Kathmandu, when he helped David access the medical system because of a respiratory problem in January of this year.
On Bowen Island we visited friends and supporters. Left to right:
Chris Pollard, Ann Ramsay, Darby Honeyman/Prakash, Dave Hess, Claire Weeks, Kate Coffey and Peter Wing. Dave and Darby had visited and stayed with Prakash and his family in Kathmandu.
In Vancouver Prakash met spine surgery staff Drs Nick Dea and Rafaelle Charest-Morin, rehab specialist Dr Rhonda Williams and final year resident Dr. Jordan Farag, who had visited SIRC two years previously. We were also joined by consumers Teri Thorson, John Chernesky and Brad Jacobson (right).
Kate Coffey, a supporter of the Spinal Cord Injury Network (SCIN) in Kathmandu, had a suitcase full of art supplies and toys for the children in the SCIN hostel, which Prakash took when he left for the Global Spine conference May 14. While in Toronto he was able to meet with Vancouver Spine staff Drs Brian Kwon and Charles Fisher, as well as Spine fellow Nathan Evaniew.
August
Extensive discussions with Dr Raju and SIRC Board chairman Prachanda Bahadur Shrestha beginning last December have addressed setting up a rehabilitation medicine training residency in Kathmandu. However, Dr Raju needs expert help at SIRC sooner than the 4 or 5 years that a new program would take to produce its first graduates, so planning began for another Nepali trainee now halfway through his physiatry residency.
September 3
News on this date from Keshav from the Spinal Cord Injury Network, which provides accommodation and support in Kathmandu for spinal cord-injured children:
“Last Friday to Monday Khagendra New Life Special School (where our 7 students are studying in different classes) organized outdoor program and our five students participated for 3 nights 4 days outdoor program. And as a guardian I was invited. Participants included students, teachers, volunteers, guardian and officials – all together we were 52 people. We went to Kakani in Nuwakot district, about 30 km away from Kathmandu. The main objective of outdoor program was to teach students how to work in group, how to help each other and how to face challenges in case of emergency. We had 6 groups and students prepared food in all groups for all days and it was first ever experience of sleeping in tent to us. During outing program our students had experience of zip lining, hiking and rock climbing however rock climbing was much too dangerous for wheelchair users. It was great experience to all. I have attached some photos then you can guess how was our outdoor experience. Thanking you all !! This program was financially supported by Freedom Social Foundation and we got some photos from them.”
September 5
SIRC celebrated SCI Awareness Day complete with a brief speech by Raju summarising the history of SCI care, a cake and dancing.
Sept 13-15 
The annual Asian Spinal Cord Network (ASCON) meeting was held in Kuala Lumpur, hosted by Dr Nazirah Hasnan. SpiNepal provided partial funding for the attendance of six staff members – Executive Director Esha, Medical Director Dr Raju (also attending the IDAPP database planning group), Adminstrator Hari, peer counsellor Sonika and therapists Sanjita and Saraswati. This group was joined in Kuala Lumpur by Dr Jas Gurung (more about Dr Jas on this page). Jas is shown circled in the SCI training workshop held before the conference.
Oct 2
We published an article summarizing the SpiNepal program for members of the Canadian Orthopaedic Association – with only about two pages to summarize ten years work! You may read the full article in the bulletin here. (If you cannot access the journal, the article alone is here.)
Oct 20
Julius Schmid’s 1897 painting of Schubert with a gathering of friends – a ‘Schubertiade”.
We have a large group of musical friends in Vancouver, including Stanis (an architect and an excellent clarinet player) and Joanne (a hand therapist), who kindly hosted a small fundraising concert at home on October 20th. This was in the form of a ‘Schubertiade’ – an evening celebrating the music of composer Franz Schubert (1797–1828). Stanis assembled a talented group of players to perform Schubert’s Octet in F Major, D 803. The musicians decided to support two nonprofits: SpiNepal and a local mental health charity. The audience gave generously and we thank both them and the musicians for their time and skills. While we are not able to bring you a photo of video of the event itself, the reader may wish to enjoy this YouTube recording of the music, which runs for a little over one hour in its entirety.