A 6-year-old Palestinian girl may be about to experience at first hand the gulf between care of spinal injuries in the rich world and developing countries.
An Israeli missile strike on a militant leader in the Gaza Strip in May last year killed most of Maria Amin's family and wrecked her spinal cord so high up that she lost not only the use of all limbs, but also the ability to breathe for herself.
Somehow, the Palestinians kept Maria alive long enough to get her to Israel's renowned hospitals.
Israel's defence ministry paid for her treatment there, but now wants to return her to the Palestinian territories -- to medical centres that can only provide a fraction of the care she has received, and may be overwhelmed if her condition worsens.
In a developed country, proper care, equipment and money can make life relatively long and productive, even for someone with such severe disabilities.
Yet in the developing world, even surviving such an injury is practically unheard of. Living with it long-term, with all the expense of permanent care, is all but impossible.
Paraplegics -- those with broken backs who retain full use of their arms and hands -- should be able to live for as long as the able-bodied, provided they have access to the information and equipment they need.
Sometimes this may mean no more than good information and relatively basic equipment such as pressure-relieving wheelchairs and mattresses.
But charities say that in developing countries, most paraplegics are dead in two to three years.
Others linger for years in hospitals or nursing homes, rarely if ever making it out of bed and often suffering repeated pressure sores and resulting infections.
POVERTY THE KILLER
Gladys Charowa broke her back in a car crash in Zimbabwe just before Christmas 2001. She was released from hospital in April 2002 at the same time as 19 other people with spinal cord injuries. By November, she was the only one still alive.
"They died because of poverty and lack of information," she told Reuters by telephone. "If you are paraplegic and you are carried in a wheelbarrow instead of a wheelchair, then of course you will get pressure sores."
Exactly a year ago I broke my neck on assignment for Reuters in Sri Lanka. Unlike Maria, I just about kept the ability to breathe. My arms and legs no longer function.
In the capital Colombo, a doctor told my colleague that people with my level of paralysis were often simply left on side wards to die from pressure sores or pneumonia if there was not enough money to provide proper care.
Maria's Israeli hospital says the Palestinian medical centres similarly lack the capability to cope with her, particularly if her condition deteriorates.
She still cannot breathe for herself or move her limbs, but she can drive an electric wheelchair with built-in ventilator, using a chin-operated joystick. Her father must do everything for her, from washing to feeding.
