SPINAL NETWORK NEWS

areas. Then, issues such as wheelchair seating were considered,
and the team would try to organise any equipment they
could, including wheelchairs and shower commodes, from
the donated equipment they had. Annie would then give
physiotherapy advice; for example, describing the benefits of
passive stretching. To help pass on knowledge to local health
professionals, two Samoan health workers travelled with the
New Zealand team to observe and learn also.
Many of the differences observed by the team related to the
lack of a rehabilitation process, a lack of equipment, and a lack
of knowledge around management. For example, mattresses
are uncommon in the traditional Samoan house or fale,
and even in hospitals. Wheelchairs were often ill-suited to
individuals needs and were broken or damaged. Hoists were
uncommon, and while some consumables were available,
stocks were limited, and catheters were often used for long
periods of time. This created terrible skin breakdown in
some males who did not secure their leg bags, which dragged
on the ground. Pressure sores were also common and the
team observed some very advanced skin breakdown. They
also observed that medication for spasm and pain was more
or less non-existent. Marian found the access in the home
environments to be very challenging for those with a SCI.
Showers and toilets were often outside and inaccessible, so
could not be used. Toileting and showering were sometimes
performed outside.
Annie noted a very interesting aspect, reporting that she
saw no neglect of individuals with a SCI in terms of love and
care. Even when people had no wheelchair, often spending
most of their time on the floor, or performing their toileting
and showering outside, not one person the team visited was
lacking a caring, loving family. Any secondary complications
were more a result of a lack of knowledge – not knowing
the correct ways to avoid complications, or how to treat and
manage them.
Reflecting back on their experience, Maria, Marian and Annie,
were all very glad they had made the trip, despite the heat,
12-hour days, and all manner of novel insect life! Although only
so much can be achieved in one week, being in a position to
impart knowledge, and sometimes provide equipment that may
improve the outcomes of those with a SCI in Samoa, was a
very special feeling indeed. It is hoped these trips can continue
as they really do help those living in Samoa with a SCI.
John Bourke
15