Abstract
BackgroundMortality rates from injuries are higher for people from poorer economic backgrounds than those with higher incomes (according to the World Health Organization [WHO]), and health care professionals and organisations dealing with people with disabilities experience that individuals with spinal cord injury (SCI) in low income countries face serious challenges in their daily lives.ObjectivesThe aims of this study were to explore life expectancy (life expectancy is the average remaining years of life of an individual) and the situation of persons living with SCI in low income settings.MethodLiterature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals.ResultsThere are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges.ConclusionThe study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.
Highlights
5.8 million people die each year from injuries (WHO 2010:2)
For high income countries significant improvements in the management of urologic issues and the prevention and treatment of pressure sores have shifted the leading causes of death to heart and cardiovascular diseases and respiratory complications. This shift in leading causes of death was not identified for low income countries, and in Zimbabwe septicaemia because of urinary tract infections and pressure sores and pneumonia had the greatest impact on life expectancy (Levy et al 1998:214)
The findings from this study revealed that urinary tract infections and infectious pressure sores are frequently causing major health problems amongst people with spinal cord injury (SCI), possibly still being the leading cause of death
Summary
5.8 million people die each year from injuries (WHO 2010:2). Injuries kill more people than HIV and AIDS and malaria combined, and road traffic accidents account for about a quarter of deaths from injuries (WHO 2010:2). Many people survive their injuries, and have to live with a permanent disability, often a spinal cord injury (SCI) (WHO 2010:6). More than 90% of deaths that result from injury occur in low and middle income countries, and mortality rates from injuries are higher for people from poorer economic backgrounds than those with a higher income (WHO 2010:10). Poorer people have an increased risk of injuries, and they are hardest hit by the financial pressure resulting from injuries (WHO 2010:10). Mortality rates from injuries are higher for people from poorer economic backgrounds than those with higher incomes (according to the World Health Organization [WHO]), and health care professionals and organisations dealing with people with disabilities experience that individuals with spinal cord injury (SCI) in low income countries face serious challenges in their daily lives
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