SIRC started its journey in 2002 from the 31-bed facility in the Jorpati suburb of Kathmandu city. It is at Jorpati that we learned to serve the spinally injured of Nepal. Over the years, the knowledge of spinal cord injury and the possibilities of rehabilitation have spread, while at the same time there has been a dramatic increase in new sources of injury to the spine. Thus, even as more patients who come for treatment of the 'traditional' forms of spinal injury, the number of victims from road, construction and industrial accidents is on the rise. There was clearly a need to move for a larger purpose-built centre, with more beds, facilities and services, and which was manned by a larger and better-trained staff. It was also clear that SIRC must have its own centre rather than remain indefinitely in rented premises, so a decision was made by the SIRC Board of Directors in mid-2004 to move out of the modest facility at Jorpati. We would look for a larger site in order to build a purpose-built centre to provide comprehensive rehabilitation management for a larger number of patients. The goal was to locate a site and to construct a rehabilitation centre to high standards, whilst remaining close to Nepali needs and realities.

A two-year search in Kathmandu Valley and the neighboring region was conducted to find the right piece of land. It would have to be close to a highway, for ambulance access as well as for family attendants and visitors. It would have to be near hospitals for referrals in both directions. The new place would have to be on a south-facing flank, so that the winter sun would be able to warm sedentary bodies in a country where central heating is not economically feasible. We would also need ample space to expand, and be in a terrain that would be environmentally soothing to our rural body of patients.

All these requirements were fulfilled with a 2.5 acre site located at the western end of Banepa Valley, 20 kilometers east of Kathmandu's city centre and just beyond Bhaktapur town. A transparent competitive process awarded the architectural contract to the Design Cell consultancy, and the building construction was similarly assigned to the Chitawan Construction and Engineering Company. The Kadoorie Charitable Trust provided support to enable completion of most of the first phase of construction, which has to be ready for SIRC to move from Jorpati to Banepa by the end of 2008. Construction commenced in June 2007, and the structure is to be complete by May 2008. As of January 2008, SIRC needed an additional, USD 862,400 to complete the construction and services and open its doors in Banepa. The development of the Banepa facility into the National Spinal Injury Centre, as we envisage it, requires the ability of SIRC to upgrade our level of services. We seek to achieve a high standard of professional competence and an ability for scientific enquiry, in addition to the success already achieved in service delivery. We hope to carry over to the larger facility the same level of humane commitment and sensitivity that we have been able to develop in Jorpati over the last six years.

While we have the human resource, enthusiasm and motivation to move to the purpose-built centre in Banepa, we urgently need further support to complete the new centre. We have developed a multi-phased approach to the construction, implementation and operation of the new facility. There are three phases to our building plans: Phase I including the facilities required to make the move to Banepa by end-2008, Phase II to include completion of the entire building and all services and facilities, and Phase III being the construction of staff quarters and other required expansions. This last phase will be considered only after Phase II is complete and running. An evaluation and review exercise is attached to the completion of each of the two phases.
Construction Plans: In addition to the existing text the following should be added at the beginning: The identification, selection and purchase of real estate for the construction of the new centre was part of the Preliminary Phase (January 2005 - December 2006). All the funds required to complete this phase were provided by the Mountains to Mountains group of Berne, Switzerland. The land is on an elevated site close to the Banepa highway. This was also the time used for planning to upgrade services and human resources in order to make the move.

This phase sees the construction of the ground-floor rehabilitation facility as per agreed project plan, with all required equipment and services in place. Phase I will allow SIRC to move from the Jorpati facility to Banepa, and provide 38 beds for patients. The services in place as part of Phase I will bring comprehensive spinal cord rehabilitation to our patients. These services include: medical and nursing treatment, physiotherapy, occupational therapy, simple laboratory testing and pharmacy services, active rehabilitation skills and intensive education programmes on self-care, outpatient services, x-ray facility, counseling for psychological and emotional issues, vocational training tailored to the patient, assessment of user home environment prior to discharge, sports and leisure facilities, income-generating projects, a service area for maintenance of wheelchairs, as well as equipment and laundry facilities.

relates to the construction of the lower ground floor and the top floors, to be completed as per design and project plan. This will result in SIRC being able to provide services for its full patient-load of 64 residents. In addition to all the facilities mentioned in Phase I going to scale, Phase II will also include a hydrotherapy pool, an indoor sports hall, space for social services and administration, as well as conference facilities. Phase II will also see the completion of three low-cost half-way homes, made to simulate traditional home settings where patients will move to prior to discharge.