23rd ASCoN Conference 2024

23rd ASCoN Conference and the theme

The 23rd ASCoN was held in Nepal from 23-25 November 2024. This was the fourth time Nepal hosted the conference. The conference was co-hosted by Epidemiology and Disease Control Division (EDCD)/ Department of Health Services (DoHS)/ Ministry of Health and Population (MOHP) and the ASCoN founding member Spinal Injury Sangh Nepal (SISN). The conference had multidisciplinary workshops, scientific sessions, paper and poster presentations, exhibitions, and sport events. The theme of this conference was “Knowledge, Exchange and Technologies for Decentralized SCI Care”.

The conference especially focused on strengthening:

  • Specialized SCI services
  • Primary health SCI services
  • Rehabilitation nursing
  • Community outreach and long-term health maintenance support
  • Innovative technologies
  • Wheelchair sports

Participants

We had around 311 participants from 18 countries this year. The participants consisted of PMR doctors, spine surgeons, neuro doctors, ortho doctors, nurses, physiotherapists, occupational therapists, psychologists, social workers, persons with spinal cord injury, prosthetists and orthotist, vocational trainers,  researchers, evaluators, policymakers, representatives of international organizations, Disabled People’s Organizations, development practitioners, officials from local, provincial and federal governments.

Partnership

SISN and EDCD held four preparatory meetings prior to the conference to organize the program. The meetings were led by Dr. Yadu Chandra Ghimire, Director of EDCD and was coordinated by Ms. Nistha Shrestha from LCDMS. During these discussions, it was agreed that the inaugural ceremony would be overseen by EDCD. It was agreed that the team would approach Honorable Minister Pradip Paudel and other senior representatives from the Ministry of Health and Population (MoHP) for the inaugural ceremony.

Key sessions, including “Rehabilitation 2030” and “Challenges and Opportunities to Establish Comprehensive Rehabilitation Services in Asia,” were planned during the meetings. Additionally, it was decided that SISN would be responsible for managing the technical aspects of the conference and EDCD would take a lead in writing emails/letters and coordinating with the stakeholders working in the rehabilitation sector in Nepal for the program. PRA and USAID joined as supporters, as rehabilitation in Nepal is one of their key activities.

Program Details

Day 1 and 2 of the conference was held in Kamalmani Theatre, Patan Dhoka while the day 3 and post conference workshops were held in Spinal Injury Rehabilitation Centre, Kavre.

Day 1:

The day started with welcome remarks by Ms Esha Thapa, ASCoN Chair 2024 and keynote speech by Stephen Muldoon, the founding member of ASCoN.

The inaugural ceremony was graced by Honorable Minister Pradip Paudel and other senior representatives from the Ministry of Health and Population (MoHP). The Minister highlighted that the Conference will act as a catalyst for change and will strengthen long term collaboration and public-private partnerships aimed at increasing access to quality SCI and rehabilitation services across Nepal. 

A plenary session on “Rehabilitation 2030” happened on day 1 as well.  EDCD along with other distinguished speakers provided an overview of the Rehabilitation Sector in Nepal. Advocacy, planning and implementation using ISCoS and WHO Tools and Resources were also discussed in the session.

Various multidisciplinary sessions like Community integration – Aftercare and Long-term health maintenance for people with SCI, Occupational therapy and Assistive Technology, Physical Medicine and Rehabilitation and Nursing Care enriched the learning and sharing experience of Day 1. The wheelchair basketball game was also the highlight of the day. The day concluded with the meeting of ASCoN Executive Committee members.

Transforming policy into action: Rehabilitation 2030

This session was moderated by Esha Thapa, Executive Director of SISN. Dr. Raju Dhakal, Medical Director of SISN, discussed the needs, opportunities, and challenges regarding rehabilitation in Nepal. He talked about the relevance of WHO Rehabilitation 2030 and in the context of Nepal.

Dr. Rabindra Banskota, Chief of LCDMS presented the policies that have been made and implemented in Nepal. He highlighted that work is ongoing to finalise the National Rehabilitation Strategic plan which will  shape and guide the strengthening of the rehabilitation sector in the coming years. 

Prof. Dr. James Middleton, President Elect of the International Spinal Cord Society (ISCoS), presented on the work of ISCoS in areas such as education, research, publications and injury prevention. He described the ongoing work within ISCoS to develop the ISCoS SCI Standards Toolkit and how this resource could be used for advocacy, planning, and implementation of SCI rehabilitation services.

The last speaker Stephen Muldoon through his 3 decades of experience in the rehabilitation sector shared about the work of the WHO- World Rehabilitation Alliance and its role in advocating   for increased investment in workforce development, research, rehabilitation in Primary Health Care and rehabilitation in emergencies. He spoke about the relevance of WRA within the context of Nepal and other countries in Asia .

Overall the session highlighted how we can strengthen rehabilitation in the health systems with a specific focus on complex conditions like spinal cord injury as per the WHO 2030 agenda. The government of Nepal envisions having provincial level rehabilitation centers in different parts of Nepal and in doing so enabling increased access to essential rehabilitation across Nepal. The session highlighted that expansion and strengthening of rehabilitation services in all parts of Nepal will only be possible through collaboration and partnership with all key stakeholders. Resources such as the ISCoS SCI Standards Toolkit can be utilized to inform the planning of SCI of evidence based services both at an institutional level and at a National  Level.  Centers such as SIRC can provide technical partnerships to support the decentralization of rehabilitation services at the provincial level with support from partners working in this sector.

Day 2:

On the Day 2  of the conference there was a panel discussion on “Challenges and Opportunities to Establish Comprehensive Rehabilitation Services in Asia”. EDCD also participated in the panel discussion representing Nepal. The panelists came from Nepal, Ireland, Malaysia, Bangladesh, Sri Lanka and Australia. 12 national and international delegates presented their paper to compete for ASCoN Best Paper Award. The day was also enriched by the parallel sessions on ISCoS Database Base Project (IDaP), Sexual Health and Reproduction after Spinal cord injury, Neuro-urological Aspect of SCI and Physiotherapy in SCI.

The official closing ceremony was organized towards the end of the day. SISN handed over the baton to India. ASCoN 2025 will be held in Chennai, India. 

The 3 ASCoN awards were also announced during the ceremony. Prakriti Khatri from Nepal won the Best Paper Award for her paper titled “Psychometric properties of the Nepali version of Spinal Cord Independence Measure Self-Report”. Likewise, Thitirat Kusol from Thailand won the Best Poster Award for her paper titled “Inaccuracy of Urine Volume Measurement: A comparison study between urine in urine bag and volumetric flask”. The ASCoN Star Award was presented to Ms Esha Thapa, Executive Director of SISN for her relentless efforts and invaluable contributions toward improving the lives of persons with spinal cord injuries in Nepal and beyond. 

One of the key highlights of Day 2 was the launch of the Nepal PMR Society.

Panel Discussion on Challenges and opportunities to establish comprehensive rehabilitation services in Asia

This panel discussion was moderated by Mr Stephen Muldoon, a consultant who has been working in the rehabilitation sector in Asia for almost 3 decades. The panelists included Prof. Dr. James Middleton from Australia, Dr. Dinesh Kafle from Nepal, Dr. Nazirah Hasnan from Malaysia, Dr. Fazlul Haque from Bangladesh, Dr. Narendra Pinto from Sri-Lanka and Ms. Nistha Shrestha from Nepal, representing the Ministry of Health.

Key points that arose from the interactive discussion among the Panellists and Q&A from the participants included:

  • SCI is a complex condition requiring medical care and rehabilitation across the continuum of care – pre-hospital/acute care/rehabilitation/community integration/long term health maintenance. It was felt imperative that clear referral pathways need to be strengthened between service providers across the SCI care and rehabilitation pathway.
  • It was highlighted that there have been many advances in SCI management in areas of acute care and rehabilitation. However, follow up of patients and long term health maintenance support for people with SCI living in the community needs to be strengthened.
  • The importance of the integration of rehabilitation into government health and social care plans was emphasised. It was highlighted that Nepal has completed a National Rehabilitation Situational Analysis and that work is ongoing to finalise a National Rehabilitation Strategic plan.
  • The importance of awareness and advocacy on the causes of conditions such as SCI was emphasised. It is imperative that service providers are in a position to demonstrate the life changing impact of healthcare and rehabilitation services for people with SCI and other conditions.
  • It was highlighted that conditions such as SCI require specialised multidisciplinary care  and rehab over a 2-3 month period and there is often a lack of rehabilitation beds across the country.
  • Financing SCI care remains a major challenge, and mechanisms need to be found to fund comprehensive rehabilitation services. Key to this in the coming years will be the development of public-private partnerships.
  • It was highlighted that bodies such as ASCoN have an important role to play and provide a platform for cross regional learning, exchange and networking.

Day 3:

Seven multidisciplinary workshops were organized at Spinal Injury Rehabilitation Centre on the third day. Around 150 resource persons and participants were present at the centre for the workshops.

Day 4:

Two main post conference programs were organised on Day 4. One focused on SCI Nursing Management where Dr Apichana from Thailand and a support team from Indonesia trained 36 nurses from various hospitals in Nepal. The other session was on the ISCoS SCI Standards Toolkit. Experts from Ireland, UK, Australia, Nepal, Netherlands and Italy participated in the session. EDCD representatives were also present in the session.

Conclusion

The 23rd Asian Spinal Cord Network (ASCoN) Conference 2024 in Kathmandu, Nepal, successfully provided a platform for knowledge exchange, collaboration, and innovation in decentralized spinal cord injury (SCI) care. Bringing together 311 participants from 18 countries, the event showcased a multidisciplinary approach, addressing crucial aspects such as specialized SCI services, primary health care, rehabilitation nursing, community outreach, and the integration of innovative technologies.  

The conference played a pivotal role in supporting the overall development of Nepal and the broader Asian region by emphasizing the importance of inclusive healthcare systems. By strengthening human resource capacity, promoting innovative practices, and fostering collaboration among stakeholders, the event directly contributes to improving healthcare accessibility and quality. These efforts align with broader development goals, such as reducing health inequities, promoting social inclusion, and enhancing the productivity and well-being of persons with SCI.  

With enriching workshops, impactful presentations, and engaging discussions, the conference highlighted the importance of collaboration between governments, healthcare professionals, and organizations. The active participation of stakeholders, including policymakers, medical professionals, and persons with SCI, highlighted the collective commitment to driving systemic improvements that benefit individuals and communities alike. The knowledge shared, partnerships forged, and policies discussed during the conference will undoubtedly catalyze progress toward an inclusive, accessible, and sustainable future for SCI management, contributing significantly to the holistic development of Nepal and Asia as a whole.

16th International Wheelchair Day

We celebrated the 16th International Wheelchair Day at Bhrikutimandap with immense joy and pride! Present on the occasion were around 350 people which included wheelchair users, caretakers, their families and representatives of various organizations. The theme of this year was “व्हीलचियर पहुँच हाम्रो हक, उपयुक्त व्हीलचियर हाम्रो अधिकार” (Our rights to appropriate wheelchair and wheelchair accessibility).

The presence of the Honourable Minister for Women, Children, and Senior Citizens, Surendra Raj Acharya added invaluable significance to this occasion. In his address to the participants he expressed his genuine concern about the unavailability of appropriate wheelchairs in Nepal. He further expressed his interest to explore the possibilities of manufacturing wheelchairs in Nepal.

The event was also graced by Founder of SISN-SIRC Kanak Mani Dixit and Vice-chair Dr Anil Bahadur Shrestha. Mr. DIxit in this speech thanked everyone for their support for more than a decade to come together at least once on this day to create awareness about inclusive society.

He added that he celebrates everyone who has dared to live an active life in a situation that is not inclusive . We were humbled to have with us our ex-patient and now the parliamentarian of Bagmati Pradesh, Honourable Laxmi Ghimire. She has been an activist to promote accessible government offices and also public spaces. This year too in her short address she once again put forward a strong request to make the public offices and other places accessible to wheelchairs so that persons on wheelchairs can live an independent and active life.

After a short formal program of the event, we marched around Tudikhel, embracing the spirit of inclusion and need for accessibility for all. Later the program was formally closed by Dr. Anil Shrestha, Vice Chairperson, SISN who thanked all the supporters, journalists, NGO/INGOS and all the participants for their solidarity. Towards the end , people on wheelchairs danced and celebrated their togetherness for the cause.

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Mechi Mahakali Bicycle Fundraiser 2024

Spinal Injury Sangh Nepal (SISN) has successfully completed the Mechi-Mahakali Fundraiser Bicycle Rally, a journey of airline pilots Capt. Sunil Pradhan and Capt. Bharat Singh Thapa that started from Mechi Pul, the East of Nepal on 11 February 2024, Sunday.

The Bicycle Rally was organized to raise awareness about spinal injury and to raise funds for wheelchairs for poor patients at the Spinal Injury Rehabilitation Centre (SIRC), a project of SISN. The two bicyclist pilots completed their 1100 KM cycle journey on 18 February at Gaddachauki on the Mahakali as planned.

The Mechi-Mahakali Bicycle Fundraiser 2024 aimed to shine a spotlight on the challenges faced by individuals with spinal injuries, particularly their need for comprehensive rehabilitation and appropriate wheelchairs. Each kilometre of the rally was valued at Rs 5000, and the fundraising goal was set at Rs 55,00,000.

“After my visit to SIRC, I realised the desire of persons with spinal cord injury to live normal and dignified lives. I felt the need to give back to this community of fighters, and decided to use my passion of cycling for fundraising,” says Captain Sunil Pradhan.

SISN collaborated with Rotary International for the rally. During the days that the cyclists traverse the country, events were organised at 14 locations where SIRC advocated spinal injury awareness and the need of spinal rehabilitation services in various parts. Different cyclist groups, Rotary Clubs and wheelchairs users joined the rally at different places.

In addition to our national and international individual contributors, this event was also supported by Syakar Trading Company, Summit Air, Buddha Air, Himalayan Bank and Thee Go. We would like to thank them and all our other supporters.

SIRC’s 21st Anniversary

On April 7th, 2023, SIRC marked its 21 years of dedicated service for spinal injury patients. A formal event was conducted at the center in the presence of the Mayor of Banepa, Mr. Shanti Ratna Shakya, our BOD members, and several distinguished guests and well-wishers.

A wheelchair-accessible ATM was inaugurated on the occasion of SIRC’s 21st Anniversary by the mayor of Banepa municipality, the Chairperson of Himalayan Bank Limited, and the Chairperson of SISN. Syakar Trading Company Limited donated a modified scooter to SIRC during the 21st Anniversary Celebration. The scooter was handed over by Mr. Saurabh Jyoti. It will be used at SIRC for wheelchair transfer training for our patients.

“Wheeltrek Trail” at Kavre: A initiation for Accessible Tourism

The Sixth Accessible Tourism Day of Nepal was celebrated on 30 March 2023 with travel along the ‘wheeltrek trail’ at Basuki Thumka, a hill flank at Sanga Village, Kavre District. More than 40 wheelchair users partiicpated, together with scores of well-wishers, people’s representatives, accessibility experts, community leaders and government officials.

The winding wheeltrek trail, as planned, will take wheelchair users over two kilometers of mild gradient to the top of the Basuki Thumka. A 400 metre section of the trail through pristine pine forest has been complete with the help of the Bagmati Provincial Government and local community. When the full trail is complete, from the top of the hill visitors will be able to take in a broad panorama of the Himalayan chain to the north as well as views of Kathamandu Valley and the surrounding hillsides.

Nepal’s Accessible Tourism Day began to be marked on 30 March 2018, at the initiation of Nepal Tourism Board (NTB), the International Development Institute (IDI) and Four Seasons Travels & Tours. The celebration this year at Basuki Thumka was organised by the Spinal Injury Sangh Nepal (SISN), with the support of the above-mentioned organisations as well as the Miral Welfare Foundation and the Sanga village community.

The ‘Basuki Thumka Wheeltrek Trail’ observation was led by Member of Bagmati Provincial Assembly Hon. Laxmi Ghimire, a person with spinal cord injury and a wheelchair user, as well as Dr. Shanta Dixit, Chair of the SISN which runs the Spinal Injury Rehabilitation Centre (SIRC). Community leader Uddhav KC thanked all wheelchair users and supporters for attending, and expressed the hope that besides being a destination for domestic and international tourists, the wheeltrek trail would help support the local economy.

The wheeltrek tour was followed by a panel discussion on ‘Tourism for All’, held at the Spinal Injury Rehabiliation Centre (SIRC), which is located at the base of the Basuki Thumka hillside. The discussion was moderated by Dr. Raju Dhakal, Medical Director of SIRC, who highlighted the importance of wheelchair tourism for physical and mental wellbeing of the spinally injured.

Kanak Mani Dixit, founder chairperson of SIRC who envisioned the project, led the discussion by explaining his coinage of the term ‘wheeltrek’, whose goal was to allow wheelchair users to enjoy the hills and mountains trails of Nepal as do other trekkers. He suggested that wheeltreks in Nepal can be a source of enjoyment for domestic as well as international wheelchair users, and also contribute to the national economy as accessible tourism progresses.

Among the panelists, Suman Ghimire, senior manager of Nepal Tourism Board, expressed the commitment of his organisation to support the goals of ‘Tourism for All’ through promotion of accessibility. Suman Raj Timsina, Director of IDI, highlighted efforts thus far to promote wheelchair trails in Nepal, including in Dhulikhel and Pokhara. Pankaj Pradhananga, Director of Four Seasons Travel & Tours, said the commitment of the Government and dynamism of the private sector would go a long way in ensuring success of the campaign for barrier-free accessible tourism.

Hands-on training on post acute care and rehabilitation of patients with spinal cord injury

“Hands-on training on post acute care and rehabilitation of patients with spinal cord injury“ was conducted at SIRC on the 9th and 10th of March 2023 for healthcare professionals. The training was organized jointly by Spinal Injury Rehabilitation Centre and National Trauma Centre. The participants were doctors, physiotherapists and nurses from National Trauma Centre and Tribhuvan University Teaching Hospital.
We extend our sincere gratitude to all the participants, training facilitators, management staff, and guests. Our special thank you to our guests of the opening and closing ceremony for their valuable time and support. We look forward to organizing such training sessions all over Nepal.

15th International Wheelchair Day

The 15th International Wheelchair Day Celebration was organized at Bhrikutimandap on the 1st of March 2023. With the main objective of making individuals and organizations aware of equity, accessibility, and employment for People with Disabilities (PWDs), this annual event has now been established as a day of celebration and reflection for wheelchair users, their families, friends, and supporters, all over the world.

This year’s celebration theme was “Appropriate wheelchair, safe and accessible mobility; our right”. The celebration included participation from over 100 wheelchair users, SIRC and VOICE staff, distinguished guests, and well-wishers who joined hands together to show solidarity towards accessibility. The main event; the Wheelchair Rally was conducted successfully that started from Bhrikutimandap premises, passed through Bhadrakali temple, the Newroad gate, Rani Pokhari, and ended at Bhrikutimandap eventually. This was SISN’s 12th year of conducting a successful celebration

21st AGM

Spinal Injury Sangh Nepal (SISN) family welcomed Dr. Shanta Dixit as the newly elected chairperson along with her team on 15th November 2022. During the handover ceremony, we thanked the immediate past chairperson Mr. Prachanda Bahadur Shrestha for his invaluable contribution to SISN for a decade. We congratulate and wish Dr. Dixit and her team a successful tenure at SISN.

Dhumdham ko Ghumgham-Charity event for SIRC

A special charity event was organized on the 26th of August 2022 with the premiere of the play Dhumdham ko Ghumgham (Adventures of a Nepali Frog); adapted from the popular children’s book, written by Kanak Mani Dixit.

The play was produced by Rato Bangala Kitab in collaboration with Katha Ghera. This one show out of the many was presented as a fundraiser for Spinal Injury Rehabilitation Center run by Spinal Injury Sangh Nepal.

We acknowledge Rato Bangala Kitab for their thoughtful initiative to support our organization. A heartfelt thank you to the audience for being a part of this noble cause.

20 years of service

7th April 2022 marked the 20th anniversary of Spinal Injury Rehabilitation Centre (SIRC, a project by SISN). There was a grand celebration event at SIRC premises on 18th April where the visionary Board, hardworking staff, generous national and international donors, partners, local and central government bodies, patients and caretakers were present physically or virtually.