Palmer College

Palmer supports World Spine Care with financial and human resources

The Shoshong valley
Shoshong valley

World Spine Care (WSC) was founded in 2008, the inspiration of Scott Haldeman, D.C., M.D., Ph.D., a 1964 graduate of Palmer College of Chiropractic and world-renowned researcher, academic, author and lecturer, as well as a leading expert in the assessment and treatment of spinal disorders. WSC was founded to “fill the profound gap in the treatment of neuromusculoskeletal conditions found in the developing world,” Dr. Haldeman says.

Palmer College of Chiropractic was the WSC’s earliest supporting organization, with a primary vision of expanding and enhancing the Palmer Clinic Abroad Program. In 2008, Palmer provided Dr. Haldeman with funding to explore the feasibility of establishing a WSC model clinic in the village of Shoshong and Mahalapye District Hospital in Botswana, where officials were asking for a spinal care clinic. Dr. Haldeman’s team was warmly received in Botswana, and government officials there agreed to provide facilities, staffing and housing for the WSC doctors.

After receiving donations from four foundations, Dr. Haldeman was able to set up a non-profit foundation and officially launch World Spine Care in 2010. The Vickie Anne Palmer Foundation also supports the WSC, along with the Bechtel Trusts, a private foundation in Davenport. In early 2011, the Palmer Board of Trustees officially endorsed World Spine Care and its efforts worldwide.

Next came a fortuitous meeting. Dr. Haldeman and his WSC team were introduced to 1984 Nobel Peace Prize Laureate Archbishop Emeritus Desmond Tutu, who agreed to join the WSC advisory committee, providing some much-needed momentum. WSC is focusing its initial efforts on two projects: a spinal care clinic in the rural village of Shoshong, Botswana, and another in Ranthambhore, India. WSC is endorsed by the Steering Committee of the Bone and Joint Decade Initiative, established by the United Nations/World Health Organization.

Palmer College has continued its support of WSC on several levels. In addition to financial support, Palmer is providing expert assistance through its people. Board of Trustees Chairman Trevor Ireland, D.C., serves on the WSC board of directors. Maria Hondras, D.C., M.P.H., a faculty member at the Palmer Center for Chiropractic Research, is a member of the research team and will be conducting research on the WSC project as part of her Ph.D. requirements in epidemiology. The research team will conduct studies in the communities where WSC establishes spinal care clinics before and after treatment begins to determine whether the clinics improve the peoples’ lives. Also, Palmer and Canadian Memorial Chiropractic College officials are considering preliminary discussions about setting up a joint educational program for volunteers or students to rotate through WSC clinics.

The clinical model developed by WSC involves an interprofessional, multidisciplinary approach to spinal disorders that incorporates the best available scientific evidence into the cultural, political, medical and economic values of the targeted communities. WSC is a multinational not-for-profit organization, bringing together the full spectrum of healthcare professionals involved in spinal health—medical physicians, surgeons, chiropractors, physiotherapists and scientists. WSC integrates its approach into existing local healthcare systems and takes steps to ensure that the care provided to people with spinal disorders continues on a permanent basis.

Conducting research in the community before and after establishing a spinal care clinic is an important component of the WSC mission. Palmer researcher Dr. Maria Hondras is spearheading the first research project in Shoshong, Botswana. Botswana is an African country north of South Africa with a population of more than two million people.

Dr. Hondras joined the WSC research team in late 2010, and a year later was on the ground in Botswana, visiting the capitol of Gaborone as well as Mahalapye and Shoshong. “My first trip was focused on making key connections and concrete plans to conduct a fairly large epidemiological study (interviewing at least 3,500 people) and smaller-scale qualitative research projects in a rural community that has few resources for spine care,” she says. “We want to document the spine care behaviors and beliefs of villagers and healers in Shoshong and compare the similarities and differences with other developing and developed countries. My vision is to examine how chiropractic care can integrate with traditional healing practices and other recognized healthcare disciplines in areas of the world where few resources exist.”

In late 2011, Dr. Hondras spent five weeks in Botswana, first meeting in Gaborone with Ministry of Health and World Health Organization officials as well as staff at a consulting agency and the University of Botswana who might be interested in assisting with data collection efforts in Shoshong. Then she worked with WSC lead clinician Geoff Outerbridge, D.C., M.Sc., in Mahalapye and Shoshong to refine WSC protocols that are currently used with patients at the Mahalapye District Hospital and are planned for patients in Shoshong and additional WSC clinics worldwide.

The current clinic in Shoshong, Botswana. The spinal care clinic will be a separate facility.
small wooden building with murals on the walls

“I also conducted informal interviews with Shoshong Clinic patients and staff, where patients spoke about medications prescribed by the clinic nurses and visiting medical doctors for their muscle, bone and joint pain and were not aware of other treatment options unless traveling far distances, which many are unable to do,” Dr. Hondras says. “The Shoshong nurses told me that working with and caring for people with spine pain is challenging. It became clear that we must engage villagers in the process of developing practical and relevant questions in order to determine the true impact and burden of spinal disorders in Shoshong.”

On Nov. 25, 2011, Drs. Hondras and Outerbridge met with the Shoshong village chief and Shoshong Clinic head matron to update them on progress. The plan is for Dr. Outerbridge to continue treating patients in the hospital in Mahalapye until the building and staff are in place in Shoshong in spring 2012, conduct focus groups in mid-2012, and begin household surveys in 2013. “My first trip to Botswana was an amazing experience,” Dr. Hondras adds. “The people of Shoshong have such community spirit. I hope we can capture this spirit in our research efforts and incorporate villagers’ preferences and values into sustainable spine care delivery.”

The efforts of WSC will take volunteers, financial donations and grant funding to carry out the work. If you are interested in contributing, contact Dr. Scott Haldeman at scott.haldeman@ worldspinecare.org. To learn more about WSC, go to www. worldspinecare.org.

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