1. Disability and environmental factors in spinal cord injured Wenchuan earthquake victims seven years after the disaster Jan D. Reinhardt 1,4,5, Youping Yang 2, Hao Li 1, & Chengqi He 1,3 1 Institute of Disaster Management and Reconstruction, 2 Bayi Rehabilitation Center, 3 West China Hospital, Chengdu, Sichuan, China, 4 Swiss Paraplegic Research, Nottwil, 5 University of Lucerne, Switzerland IntroductionResults, continued Materials and Methods Conclusions We comprehensively describe a series of cases of patients with SCI who have been visited at their home by a rehabilitation team which performed clinical examinations (e.g. AIS), standardized patient-reported outcomes assessment (e.g. PHQ- 9 to screen for depression), qualitative interviews, and environmental assessments. Seven years after the Wenchuan earthquake, victims with SCI still had complex medical and psychosocial needs. Most of those needs could be met with relatively low-cost interventions County level rehabilitation centers seemed underequipped, and staff lacked training. Vocational and educational rehabilitation measures as well as psychological counselling seem of pivotal importance. * Names have been changed to protect patients, anonymity. Patients provided written informed consent including display of photographs for research purposes. severely dependent (MBI: 20). She complained about pain in a lying position (VAS 8/10) and showed signs of a moderate depression. She had been employed as a factory worker before the earthquake providing the main source of family income. At the time of our visit, her husband was her only caregiver and seemed overwhelmed with the situation. The patient was very thin and seemed to suffer from malnutrition. The family complained about insufficient government support, environmental barriers and financial problems. Recommended interventions: Professional nursing support as well as physical and occupational therapy to mobilize the patient. Earthquakes leave many victims with permanent disabilities requiring long-term medical, psychological, and social rehabilitation. Spinal cord injury (SCI) is one of the most severely disabling conditions caused by earthquakes. However, a solid scientific evidence base on long- term medical, psychological, vocational, and educational rehabilitation needs of earthquake victims with SCI and apropriate interventions is lacking to date. Therefore, we aimed to comprehensively understand long-term medical and psychosocial problems and needs of SCI victims from the major 2008 Wenchuan earthquake in Sichuan, China. Results Case 1: Wen, Ling* The patient (female, 25 years) suffered a motor incomplete paraplegia (L2- L3, AIS C) from the 2008 Wenchuan earthquake. With a Modfied Barthel Index score of 80 the patient was only mildly dependent. The patient lived in a rehabilitation center since 6 years. Although able to walk, Wen Ling was afraid of falling and usually operated a wheelchair. We found that her crutches were poorly adjusted so that she would walk in a bent position. Her main problems were psychological in nature with some indication for Postraumatic Stress Disorder. The patient was emotionally unstable during our visit and started crying frequently. She showed a negative body image, signs of isolation and withdrawl. Wen Ling was unemployed at the time of our visit and her main social contacts were relatives and wardmates. She uttered feeling like being a burden to others. Recommended interventions: Psychological counselling, psychotherapy, vocational counselling, exercise to improve body image. Case 2: Liu, Yu* The patient (female, 46 years) had a complete tetraplegia (C4, AIS A). Mrs. Liu was confined to bed at the time of our visit and Case 3: Wu, Daiping* Mr. Wu (male, 25 years) had a complete paraplegia (T10, AIS). Apart from issues with urinary incontinence he was independent (MBI: 90). Mr. Wu recently married a young woman he met through the internet. His wife had a non-traumatic spinal cord injury. The young family lived with the husbands’ parents and the wife’s daughter from a previous marriage. The patient was a very good student before the earthquake but had to discontinue his education because of trouble sitting for a long time. He operated a small online shop at the time of the study. His greatest wish was to offer his wife a better life. Recommended interventions: Educational and vocational support, potentially re-training, online study.