Injuries In Bangladesh Research Articles

Meaning of Work Participation After Spinal Cord Injury in Bangladesh: A Qualitative Study in a Low- and Middle-Income Country Context.

This study aimed to explore the meaning of work participation for people with spinal cord injury (SCI) in Bangladesh. Narrative inquiry methodological framework was used to explore the meaning of work participation after SCI. Face-to-face interviews with twenty adults with SCI, who were either living in the community or in-patients at a rehabilitation center. The Worker Role Interview questionnaire was used as an interview guide. Participants were descriptively analyzed in two groups, rehabilitation participants and community participants. Their transcripts were analyzed using individual narrative analysis to understand the meaning of their experience at an individual level and then the findings from the individual narrative analyses were summarized using thematic analysis to identify themes that collectively represented the meaning of work after SCI in Bangladesh. Five themes were identified from the interviews: "work life before injury"; "current life in relation to work"; "framing future prospects of work participation"; "motives for working"; and "enablers of work participation." The meaning of work is subjective and is influenced by the participants' pre-existing experiences and other factors related to their work life, such as work preferences, habits, and daily routines. Therefore, creating opportunities to better understand the meaning of work for each individual and incorporating these factors into rehabilitation are keys to sustainable rehabilitation outcomes.

Socio-Economic Impact of Covid-19 on People with Spinal Cord Injury in Bangladesh: A Telephonic Survey

Socio-Economic Impact of Covid-19 on People with Spinal Cord Injury in Bangladesh: A Telephonic Survey

Pattern of Lightning Related Injuries to Human in Bangladesh

Introduction: In recent past, the incident of lightning strikes and related injuries has increased significantly which is the detrimental consequence of climate change. Therefore, it is recognized as one of the cause of weather related death in Bangladesh. Objective: To present the pattern of lightning related injuries in Bangladesh. Materials and Methods: A cross sectional study carried out on September 2021 among 40 people who were victim of lightning on the way to attend a wedding reception in Shibganj upazila of Chapainawabganj on 4 August 2021. Detail information was received from one relative of each 16 deceased family and 24 survivors. Further, data were collected from the doctors and nurses of Chapainawabganj Government Hospital Results: In addition to the two fatalities on the route to the hospital, 14 individuals died on the spot. Further, among 24 survivors, 16 people survived with moderate and rest 8 survivors had mild injuries. 45% lightning victims were dead and 35% were survived with major injuries by lightning and 20% victims survived with minor injuries. Majority (35%) of death were due to direct strike which is followed by ground strike (30%). Injury to nervous and cardiovascular system is the usual site of injury for human organ where percentage of injury is 35% and 30% respectively. The victims remain admitted to hospital in varying range and survivors had multiple symptoms of minor injuries. Among them, majority victims (9 people) 40.91% left hospital after initial observation. Conclusion: Lightning kills few hundred and injures several thousand people in our country every year. However, lightning survivors should be taken to hospital for further investigation and treatment. Field management is very important for a patient to survive. For this, lightning education will immensely help not only to minimize the death cases but also help them to manage the lightning victims on the spot. JAFMC Bangladesh. Vol 19, No 1 (June) 2023:18-21

Paediatric blunt abdominal trauma with organ injury: a comprehensive analysis of cases at a tertiary hospital in Bangladesh

Background: Pediatric blunt abdominal trauma with organ injuries is a critical issue in Bangladesh, lacking sufficient research. This study focuses on managing such cases in a tertiary hospital. Objectives were to assess clinical characteristics, injury patterns, and outcomes of pediatric patients with blunt abdominal trauma and organ injuries. It aims to identify causes, associated injuries, and hospital stay durations. Methods: A prospective study of 142 pediatric patients aged 1-12 was conducted at Rajshahi medical college hospital study period January 2020 to December 2021. In addition, this study aimed to identify and grade solid organ injuries according to the American association for the surgery of trauma organ injury scale. Results: Prevalence of hepatic injuries (76.8%), solid organ injuries (90.1%), road traffic accidents (71.8%), falls from height (25.4%). Most received conservative treatment, had short hospital stays, and a 7% mortality rate. Gender had no significant impact on organ injuries (p>0.001). Among the causes, 84.5% had hepatic injuries, 15.5% had spleen injuries due to road traffic accidents, and 58.3% had injuries from falls from height, with a highly significant cause-organ injury relationship (p<0.001). Conclusions: pediatric blunt abdominal injuries in Bangladesh affect various organs, primarily in males and school-aged children, primarily due to road accidents. Timely surgical intervention and preventive measures are crucial for improved outcomes.

Demographic and Clinical Characteristics of Persons With Spinal Cord Injury in Bangladesh: Database for the International Spinal Cord Injury Community Survey 2023.

The study aims to explore the demographic and clinical characteristics of persons with spinal cord injury (SCI) in Bangladesh. A total of 3035 persons with SCI spanning from 2018 to 2022 were included in this cross-sectional study. Information about demographic and clinical variables was obtained from the medical records and verified through telephone calls to ensure accuracy and consistency. Approximately half (48.30%) of the study participants were located in Dhaka Division. The average age of persons with SCI was 38.3 years, with a standard deviation of 15.9 years, and the largest proportion (33.4%) fell within the age range of 18-30 years. Males outnumbered females by nearly 2.5 times. In the study, 59.6% had suffered traumatic injuries, whereas 40.4% had SCI attributable to disease-related causes; 58.1% were diagnosed with tetraplegia and 40.1% with paraplegia. Fall from height (42.1%) and road traffic trauma (27%) were the most common causes of traumatic injuries. Degenerative myelopathy (41.1%) was the most frequent cause of non-traumatic SCI, followed by tumors (27.7%) and tuberculosis (TB; 14.8%). Both traumatic (58.3%) and degenerative (56.7%) causes of SCI commonly affected the cervical spine, whereas TB (24.4%) and tumors (47.5%) had a higher incidence of affecting the dorsal spine. In the absence of a registry or national database for patients with SCI in Bangladesh, this study would serve as representative data for future studies.

EPIDEMIOLOGY OF OCCUPATIONAL AND NON-OCCUPATIONAL EYE INJURIES: CASES TREATED IN FOUR EYE HOSPITALS IN BANGLADESH Authors

Introduction: Eye injury is an important cause of preventable vision loss in developing as well as developed countries. There are many risk factors for eye injuries. Eye injuries can occur anywhere at any time to anyone regardless of socio-economic conditions, demographic profile, and situation. The principal objective of our research work was to study the epidemiological profile of occupational and non-occupational ocular injuries in Bangladesh. Methods: This descriptive cross-sectional study was conducted on purposively selected 117 eye injury cases from four eye hospitals situated in Dhaka (2), Tangail (1), and Rajshahi (1), Bangladesh. A structured questionnaire was used to collect data from the study subjects. Results: Respondents’ Mean ± SD age was 29.70± 15.95 years where a maximum (69.2%) of them were male. Secondary-level education was more common among the study subjects (24.8%). A great number of respondents (62.4%) monthly income ranges from 12,000- 30,999 Bangladeshi Taka. Not using/lack of protective measures, carelessness, and road traffic accidents were identified as the leading causes of eye injuries at the workplace, home, and other areas, respectively by most of the participants. On the other hand, maintaining or cleaning instruments at the job place, looking after children at home, and riding vehicles were mentioned as the activities during eye injuries by the highest number of respondents. A statistical significance p < 0.05 was found between eye injuries and participants’ age, gender, occupation, educational qualification, and monthly family income. Conclusion: Eye injuries are more or less common at home, the workplace, and other areas irrespective of epidemiological distribution. Therefore, measures should be taken to eliminate eye injuries at personal, community, and national levels.

Scarf Injury: a qualitative examination of the emergency response and acute care pathway from a unique mechanism of road traffic injury in Bangladesh

BackgroundRoad traffic injuries (RTI) are the leading cause of death worldwide in children over 5 and adults aged 18–29. Nonfatal RTIs result in 20–50 million annual injuries. In Bangladesh, a new mechanism of RTI has emerged over the past decade known as a ‘scarf injury.’ Scarf injuries occur when scarves, part of traditional female dress, are caught in the driveshaft of an autorickshaw. The mechanism of injury results in novel, strangulation-like cervical spine trauma. This study aimed to understand the immediate emergency response, acute care pathway, and subsequent functional and health outcomes for survivors of scarf injuries.MethodsKey informant interviews were conducted with female scarf injury survivors (n = 12), caregivers (n = 6), and health care workers (n = 15). Themes and subthemes were identified via inductive content analysis, then applied to the three-delay model to examine specific breakdowns in pre-hospital care and provide a basis for future interventions.FindingsOver half of the scarf injury patients were between the ages of 10 and 15. All but two were tetraplegic. Participants emphasized less than optimal patient outcomes were due to unawareness of scarf injuries and spinal cord injuries among the general public and health professionals; unsafe and inefficient bystander first aid and transportation; and high cost of acute health care. ConclusionsFemales in Bangladesh are at significant risk of sustaining serious and life-threatening trauma through scarf injuries in autorickshaws, further worsened through inadequate care along the trauma care pathway. Interventions designed to increase awareness and knowledge of basic SCI care at the community and provider level would likely improve health and functional outcomes.

Exploring the intersection of critical disability studies, humanities and global health through a case study of scarf injuries in Bangladesh

This article puts critical disability studies and global health into conversation around the phenomenon of scarf injury in Bangladesh. Scarf injury occurs when a woman wearing a long, traditional scarf...

Incidence, severity and time course of pressure injuries over the first two years following discharge from hospital in people with spinal cord injuries in Bangladesh.

Cohort study embedded in a clinical trial. Community, Bangladesh. To determine the incidence, severity and time course of pressure injuries over the first two years following discharge from hospital in people with spinal cord injuries (SCI) in Bangladesh. Participants (n = 186) were contacted by telephone 39 times and assessed face-to-face4 to 6 times over the two years following discharge. At each point of contact the presence and severity of pressure injuries were determined using the Pressure Ulcer Scale for Healing (PUSH). Survival analyses were conducted to determine the time course of development of pressure injuries and recovery from pressure injuries. Lasso regression was used to construct multivariable prediction models. Seventy-seven participants (41%; 95% CI 34% to 49%) developed at least one pressure injury in the first two years after discharge (incidence rate 0.27 per person-year, 95% CI 0.22 to 0.34). Most pressure injuries were on the sacrum (23%). Pressure injuries took a median (IQR) of 40 (29 to 57) days to heal. The median (IQR) peak PUSH score was 11.0/17 (8.0 to 13.5). The multivariable prediction models had poor predictive properties (maximum c-statistic 0.75). Pressure injuries impose a large health burden on people with SCI in Bangladesh. However, they are difficult to predict, treat and prevent. Further research is needed to identify who is at most risk and to find solutions for the treatment and prevention of pressure injuries in Bangladesh and other low-middle income countries.

Influence of Environmental Barrier on Participation Among Persons with Spinal Cord Injury in Bangladesh

Introduction: Persons with SCI experience limitations of activity and inabilities in their early age in comparison with non-injured individual and also experience difficulties in participation in personal and social life. The participation has significant relationship with environment that’s why improving participation in the socio-cultural context can advance their personal satisfaction adequately for people with spinal cord injury. Disability, individual and environmental factors are considered as indicators of participation. Objectives: To explore the perceive impact of environmental barriers on participation of community dwelling individuals with spinal cord injury in Bangladesh. Methodology: A qualitative study design was selected by the researcher to carry out the research. All dimensions of each individual were completed at one theme in time. Data were collected within a short period of time. The target population was the persons with spinal cord injury discharged from a rehabilitation center and living in the community and data collected by purposive sampling. Results: From the transcriptions, researcher identified 15 environmental factors that influenced participation among individuals with SCI. Approximately there are some causes which straightly influence the participation and some causes through others. Conclusion: Participation have to ensure throw ensure accessibility and removing barrier. The participation of persons with disabilities in the formulation and application of public strategy is perceived as indispensable in dropping poverty and confirming their rights. Exclusionary guidelines not only put burden on the country socio-economically, but also create psychological barricades for people with disabilities to explore full potential.

732Epidemiology of Geriatric Injury in Bangladesh: Findings from a National Survey

Abstract Background Everyday 2591 elderly people die due to injury worldwide. The complications and consequences of injury is different and worse than that of other age-groups. Yet little is known about the injury scenario of elderly population of Bangladesh. This paper aim to describe the epidemiology of geriatric injury of Bangladesh which will help policy-makers to undertake interventions for this vulnerable-group. Methods Bangladesh Health and Injury Survey 2016, a nationwide cross-sectional survey was carried out among 299,216 residents to identify the injury-related mortality and morbidity. Injury data among the population aged 60-years and above was extracted and analyzed for this study. Results Injury was found to cause 3.9% of the total deaths among elderly population of Bangladesh. Mortality and morbidity rate due to injury was found 157 (95%CI 112- 216) per 100,000 elderly populations and 129 (95%CI 124-133) per 1000 elderly population respectively. Fatality rate was 182.6 among urban population and 147 among rural population. Fall was identified as the leading cause of injury deaths and morbidity. It caused 47.2% of all fatality followed by Transport-injury (19.4%) and Suicide (13.9%). Among all fatally injured, 72.2% victims received treatment from health-service providers and among these 58.3% (n = 21) went to registered doctors. Conclusions Fall is the leading cause of injury related mortality and morbidity among elderly of Bangladesh. A significant amount of deaths also occurred due to RTI and suicide. Further in-depth research and interventions are needed to minimize the preventable burden of fatality and morbidity among this vulnerable-group. Key messages Elderly, Injury, Epidemiology, Bangladesh

Patterns of injuries and injury severity among hospitalized road traffic injury (RTI) patients in Bangladesh

BackgroundRoad traffic injuries (RTIs) are one of the key public health issues worldwide causing 1.3 million deaths every year. This study aimed to determine the patterns of injuries due to road traffic accidents (RTAs), the severity of injuries, and factors associated with injury severity. MethodologyA cross-sectional study was conducted among RTA victims, who attended two large tertiary care hospitals located inside the Dhaka metropolitan area, through structured interview between 28 January and 22 March 2020. ResultsAmong 375 RTI patients, a total of 1390 injuries were recorded among interviewed patients, yielding a mean of 3.7 injuries per patient. The most frequently injured systems were external (n = 351), lower limb (n = 235), head and neck (n = 151), and face (n = 150). The mean ISS were 20.96 ± 12.027 with a maximum of 65 and a minimum of 4. Among patients, 87 (23.20%) had a severe injury, and 37 (9.87%) patients were critically injured. A statistically significant variation in ISS was observed in ANOVA among various categories of age, education, occupation, and purpose of going outside, vehicle type and fitness, accident type, road type, times required in hospitalization, and death history (p < 0.05). ConclusionsOur study has revealed several important findings which will help stakeholders and policymakers devise better policies to reduce RTA and RTA related injuries in Bangladesh.

Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

Epidemiology of pelvic fractures in adult: Our experience at two tertiary care hospital in Dhaka, Bangladesh

PurposeIn Bangladesh the incidence of pelvic fracture is increasing day by day due to suboptimal roads and heavy traffic. However, there is no epidemiological study of these injuries in Bangladesh. Our aim was to study the epidemiology of patients admitted with pelvic fractures at two tertiary care hospital in Dhaka, Bangladesh. MethodsThis was a prospective study carried out on trauma patients with pelvic fracture at two level 1 trauma care center of two tertiary care hospital in Dhaka, Bangladesh. The study period was from July 2015 to June 2019 (48 months). Patient’s data including demography of patients, mechanism of injuries, fracture types, associated injuries, method of treatment, post-operative complications, length of hospital stay were recorded according to a unified protocol. ResultsThe study population was comprised of 696 patients, where 556 (79.88%) were male and 140 (20.12%) were female. Mean age was 37.75 years and road traffic accidents were the most common mode of injuries. Lateral compression fractures were the most common injuries and Urethral injuries were the most common associated injuries. Death was the outcome in 3.5% of the cases due to high energy trauma. ConclusionThis study revealed that pelvic fractures were significantly more frequent in men. Most frequent cause was road traffic accident. The majority of these cases did not required surgery. Mortality was associated with high velocity trauma with severe injuries.

A community-based intervention to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh (CIVIC): a randomised trial

Study designRandomised controlled trial.ObjectivesTo determine the effectiveness of a sustainable community-based intervention designed to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh.SettingBangladesh.MethodsA pragmatic randomised controlled trial was undertaken. People who had sustained a spinal cord injury in the preceding 2 years, were wheelchair-dependent, and were about to be discharged from hospital in Bangladesh were recruited and randomised to an Intervention or Control group using a concealed allocation procedure stratified by level of lesion (tetraplegia/paraplegia). Participants in the Intervention group received 36 phone calls and three home visits over the first 2 years following discharge. All participants received usual post-discharge care. Survival status and date of death were determined by blinded assessors 2 years after randomisation.ResultsBetween July 2015 and March 2018, 410 participants were randomised (204 to Intervention, 206 to Control). There was no loss to follow up. At 2 years, 15 (7.4%) participants in the Intervention group and 16 (7.8%) participants in the Control group had died (hazard ratio from unadjusted Cox model = 0.93 [95% CI, 0.46 to 1.89]; p from log rank test 0.85). There were no clinically important or statistically significant average causal effects of intervention on the incidence or severity of complications.ConclusionA program of community-based care for people with recent spinal cord injury in Bangladesh involving frequent phone contact and occasional in-person contact with a health professional after discharge from hospital is no better at preventing death at 2 years than usual care.

Understanding how a community-based intervention for people with spinal cord injury in Bangladesh was delivered as part of a randomised controlled trial: a process evaluation

DesignMixed methods studySettingCommunity, BangladeshObjectivesTo understand how a community-based intervention for people with spinal cord injury (SCI) in Bangladesh was delivered as part of a randomised controlled trial and to gauge the perceptions of participants and healthcare professionals to the intervention.MethodsA community-based intervention was administered to 204 participants as part of a large randomised controlled trial (called the CIVIC trial). Case-managers followed-up participants with regular telephone calls and home visits over the first 2 years after discharge. The following data were collected alongside the trial: (i) chart audit of telephone calls and home visits (ii) recordings of 20 telephone calls (iii) interviews with 14 Intervention participants and four healthcare professionals including three case-managers.ResultsParticipants received the target number of telephone calls and home visits. Pressure injuries were identified as a problem during at least one telephone call by 43% of participants. Participants and case-managers valued regular telephone calls and home visits, and believed that calls and visits prevented complications and alleviated social isolation. Participants trusted case-managers and were confident in the care and advice provided. Case-managers expressed concerns that people with SCI in Bangladesh face many problems impacting on well-being and motivation stemming from poverty, limited employment opportunities, societal attitudes and inaccessible environments.ConclusionA community-based intervention involving regular telephone calls and home visits was administered as intended and was well received by the recipients of the care. Nonetheless, people with SCI in Bangladesh face economic and social problems which cannot be fully addressed by this type of intervention alone.

Analysis of landslide-induced fatalities and injuries in Bangladesh: 2000-2018

Landslides are one of the most substantial damaging and recurrent disasters in the hilly areas of Bangladesh. In the last decades, devastating landslides have repeatedly hit the hilly regions of the country, typically due to climate change along with other anthropogenic causes such as high population density, unplanned land use, and rampant hill cutting. However, there is a lack of an official database to analyze the trends of the landslide disaster in Bangladesh. In this vein, this paper compiled a catalog of 204 reported landslides in Bangladesh that caused 727 deaths and 1017 injuries during the period 2000–2018. The average number of annual landslides is 19, with a 4% yearly growth rate, which results in 38 fatalities and 54 injuries yearly on average. Using data from three national and two regional newspapers, the study finds that monsoon summer is the most damaging season and 83% of landslides are primarily triggered by heavy rainfall. A Hot Spot Analysis tool (Getis-Ord- Gi* algorithm) was used to identify the spatial concentration of high and low landslide affected areas in Bangladesh. Of 64 districts in the country, eight were exposed by landslide episodes, five were recognized as profoundly affected. Moreover, three sub-districts (Chattogram City Corporation, Ukhiya and Teknaf) have been identified as hot spot areas. Finally, the study will assist academicians for continuing risk studies through understanding the trends of landslide related causalities; policymakers for formulating suitable policies considering the high landslide affected areas; consequently, help local communities to protect their life and properties through raising awareness.

Myths, Safety and Awareness of Lightning Protection in Bangladesh

Bangladesh, being a tropical country, experiences relatively high density of lightning each year. Lightning has been identified as one the major causes of weather-related deaths and injuries in Bangladesh. The government of Bangladesh has declared lightning as natural disaster when 81 people have lost their lives in just two days due to lightning in 2016. Lightning is a source of fearfulness, inquisitiveness, inspiration and panic. As number of death has increased in Bangladesh in lightning, so the safety rules for the installation of lightning prevention system which is a mandatory provision under Bangladesh National Building Code, to be followed for building construction. People of low literacy rate have the tendency to violate more, the basic lightning safety guidelines. Hence, awareness program has started to educate the people especially the rural one. However, a survey has been conducted to find out the common myths, beliefs, misconceptions in Bangladesh and its impact on lightning safety. It summarizes the prevailing lightning safety awareness and education around the world. Finally, it puts forward some ray of light about the suggestions about lightning protection, safety and awareness for Bangladeshi people to curb the myths and misconceptions.

Exploration of gaps and challenges in managing burn injury at district and sub-district government health care facilities in Bangladesh

BackgroundBurn injury is one of the leading cause of mortality and morbidity worldwide. In developing countries like Bangladesh, burn is one of the leading causes of illness, disabilities and deaths. More than 365,000 people are injured every year by electrical, thermal and other causes of burn injuries where 27,000 people needed hospital admission and over 5600 people died. Emergency management of burn at the facility level can reduce the severity of burn injuries and improve overall survival. The study has explored the health care providers’ views on gaps and challenges in management of burn injury at the facilities district and sub district health facilities in Bangladesh. MethodologyA qualitative study was conducted during the period in July 2015. In-depth interviews (n = 19) were performed with the doctors and nurses working in the three district government hospitals and seven sub-district (upazila) government health facilities. Thematic analysis was performed on different themes. ResultsHealth care providers mentioned that the people are coming to the facilities usually, hours after the incidence. Before visiting the facilities, the burn victims mostly seek treatment from the traditional healers or form village doctors (quack) or from the local pharmacy, over the counter. Family waited until they felt that the patient may not survive. It has identified that delaying in decision making and transferring the patient to the health facility are the key challenges identified by the doctors and nurses when they attended any burn patients in their facility. Moreover, use of different traditional infectious agent in burnt areas from their home make the burn surface more damage. While as, deficiency of adequate supplies, logistics and adequate trainings for the health workers in the facility create much more difficulties to treat a burn patient at primary or secondary health care centers. ConclusionBurn patients are maltreated in the community before coming to the healthcare facility in most of the cases. The community has misperceptions on burn management which delay the proper management in the facility. Readiness of the facility on the other hand is a big challenge. In order to consistent in burn care in Bangladesh, its equally important to build knowledge and awareness among the community on burn prevention and their role. Like this, readiness of the facilities in time will build confidence in community, thus in turns, will save thousands of lives from burn injury in Bangladesh.

Endeavouring sustainable participation: Post-discharge adaptation process of occupational participation among persons with spinal cord injury in Bangladesh

ABSTRACTAgainst a background of high levels of morbidity, mortality, and social exclusion among persons with SCI in Bangladesh, the aim of this research was to identify and describe how these persons experienced adaptation of occupations after discharge from an in-patient rehabilitation hospital. Following ethnographic interviewing and observation, the data of 19 adults with SCI were analysed by an iterative process of constant comparative analysis. The research identified three outcomes of adaptation, (1) creating opportunities for daily occupations, (2) reintegrating daily occupations, and (3) striving for sustainability; and seven doing processes of adaptation, (a) solving problems using local materials and knowledge, (b) reframing one’s situation, (c) adapting the environment (d) recreating routines and habits, (e) evolving vocational and social roles, (f) forming reciprocity, and (g) producing additional roles. These results show that sustainable participation in occupation requires support that enhances adaptation and eliminates maladaptation among persons with SCI living in Bangladesh.