With the help of three Styrofoam boards, a group of paraplegics went diving in the sea near Kenting beach, like a school of silver fish striving to swim towards the immense ocean.

Under the gray October sky, few boats still sailed on the sea . When the paraplegics and their relatives had put on their swimming gear and snorkels and started to dive, I narrowed my eyes and looked out to sea. With the help of three Styrofoam boards, they were swimming like a school of silver fish striving to swim towards the immense ocean.

A lifeguard observed that they had swum for more than 100 meters [330 ft]. Considering that these people were paralyzed below the waist, and thinking of the potential dangers they might encounter in the water, one realized that this scene had been made possible only through a great deal of effort.

Guests From Far Away

From October 8 to 10, 1996, the Hualien County Association of Spinal-Injury Patients sponsored a tour to Kenting National Park in southern Taiwan for members and their families. During the long drive, their skill with their wheelchairs and their ability to go for a long time without relieving themselves were challenged. But the long journey brought much more excitement than anxiety.

Because it was such a long trip, and because most of the tourists were members of the Tzu Chi Spinal-Injury Patients Club, the association invited Dr. Huang Su-huei and nurse Huang Chin-ying, both from the Tzu Chi Hospital rehabilitation department, to join the team. The Tzu Chi Kaohsiung branch office also sent 15 members to assist the club members and their families during their tour of the park .

The association provided two buses, both specially equipped with lifts to allow handicapped persons in their wheelchairs to get on and off. On the bus, they could either fix their wheelchairs to the floor or sit on the bus seats. Except for those males who were strong enough to move themselves from wheelchair to seat, most of the handicapped had to rely on the driver to carry them on or off the bus.

A major concern in a paraplegic's life is care of the urinary tract. On the way to Pingtung, the buses stopped twice for rest breaks, but few people got off. They had relieved themselves before leaving home, and on the road they used diapers, urine bags or Foley tubes. They also drank as little as possible.

Lodging had been inspected beforehand, with emphasis on freedom of movement. A hotel located near the beach was chosen. The view of the ocean brought a sense of freedom and leisure. Outside the seaward windows, people could be heard talking until late in the evening.

The Bright Side of Life

October 9 was the day for the tour of Kenting National Park. The group visited a forest area in the morning, went snorkel diving in the afternoon, and held a campfire in the evening.

Why did they try diving? "How do we know if we can make it or not until we try?" said Chu Yen-kun, secretary of the association and a paraplegic himself. Besides, some of the association members had already tried it in the sea in northern Taiwan. Lifeguards observed that snorkel diving was not particularly difficult if swimmers maintained their balance.

The swimmers had a great time, and on their return from the ocean, they proudly showed the coral and shells they had found.

At one point in the evening, the campfire was almost extinguished by a shower of rain. "Do we need to move somewhere else?" somebody asked. Nobody answered * they were stubbornly concerned with how to keep the fire burning. Perhaps it was exactly this persistence which helped them deal with their handicap.

The rain stopped, perhaps because nobody cared, and stars spread over the clean-washed sky. This group of paraplegics, who had lost their mobility in their prime years, sang under the starry sky and danced their "single-wheel dance," showing a carefree character.

A Permanent Wound

The fate of spinal injury victims is decided at the moment they are injured. According to statistical data, more than fifty percent of spinal injury victims are totally paralyzed. Those with partial damage to the spinal cord can usually restore only limited functions, with the functions of the lower limbs and urinary system impaired forever. So what is spinal cord injury?

The spinal cord, which is located in the cavity of the vertebral column, supports the central nervous system. It may be called a signal-exchanging station between the brain and limbs. Once the cord is injured, the sensory and motor functions are impaired or lost.

The vertebral column can be divided into four parts: the cervical vertebrae, the thoracic vertebrae, the lumbar vertebrae, and the sacrum. Depending on the location of the injury, function loss varies. If the cervical or thoracic vertebrae, which control the trunk, are injured, the patient has to use a seat belt in the wheelchair. If the sacrum is injured, the patient will probably become impotent and incontinent.

"The treatment of spinal cord injury is not limited to the patient, but covers the whole family," said Dr. Kuo Han-tsung, a urologist at Tzu Chi Hospital. The best treatment consists of a thorough understanding of the patient's condition, prognosis, financial status, and possibility of obtaining home care.

In the past, medical professionals did not offer positive care for the urinary system in paraplegics. Usually they only used a Foley tube. A high percentage of repeated infections occurred when a Foley tube was used on a long-term basis. Furthermore, there were no follow-up or preventive measures against deterioration of kidney functions, which often led to death.

According to Dr. Kuo, Tzu Chi Hospital performs urodynamic studies such as sonography for the genito-urinary system, urine analysis, residual urine determination, plus home visits, in order to lower the incidence of life-threatening urinary tract infections and to help patients with psychological rehabilitation. Tests are carried out continuously for seven years.

Learning to Live Again

"In order to take a bath by myself, I crushed any number of tubs," said Chu Yen-kun. Paraplegics have to readjust to life after they lose their bodily functions. They have to start from such basic details as learning how to turn over in bed, get out of bed, put on clothes, take a shower, etc. In addition, having lost their sensory reaction to cold or heat, they are highly vulnerable to burns.

For the handicapped, both sexes have doubts about their attractiveness to the opposite sex, which means that they still need to love and be loved. Relearning life skills, rebuilding self-image, preparing to land a job, forming interpersonal relationships* Such adjustments are needed on both physical and psychological levels. This takes time, and some may never make it.