Update: Mission 2014

Osteopathy Without Borders (OWB) was created in 2007 to support training in  osteopathy, a form of low-cost, effective medicine for developing countries. We have started first in Pakistan. Every Summer, a small team of volunteers treats patients in Lahore’s hospitals and in Nagar, a remote mountainous valley, to demonstrate osteopathy’s reach and effectiveness.

OWB team with the physiotherapists at Gurki Hospital.

OWB team with the physiotherapists at Gurki Hospital.

Two physical therapists from Lahore were funded to study at SICO (Swiss International College of Osteopathy). They finished the part-time training program in 2012 and are now working on their research project in Lahore to obtain a diploma of osteopathy.

This year marked our 8th annual mission. We were a team of senior osteopaths and volunteers: returning Faisal Naqvi, DO and Sheryl Hoo, DO, from Montreal, and a new volunteer from England, Katy Teasdale, DO, graduate from the European School of Osteopathy (ESO) who has already worked on several international osteopathic missions. You can read her own memoir and see a lot of pictures here.

We arrived on Friday August 15th, just a day after a march demanding the resignation of the Pakistani Prime Minister started from Lahore to Islamabad.  As has happened many times since we started in 2007, we had to decide whether to go ahead with our mission, despite the political turmoil.  Experience has taught us that unrest is usually localized, and all of the people who are working hard at improving the conditions in their country keep working at it, day after day no matter what happens in politics.  We decided to go and were so glad we did.  Our mission was very productive and gratifying.

Faisal in pediatrics at SZH.

Faisal in pediatrics at SZH.

Our priority was to clear the way for an osteopathic school, the ultimate goal of our traveling and treating in Pakistan. Last year we contemplated starting a full-time program, but realized this year, thanks to Prof. Dr. Javaid Asgher, chairman of Lahore Medical and Dental College, that this was not yet realistic.  We returned to our previous idea of a part-time program open to health-care professionals with Bachelors and will continue bringing introductory courses to young physiotherapists and others to pave the way to our first classe in one or two years.

We had hoped to travel to the mountains during our first week in Pakistan, but the weather didn’t allow that. Planes fly only in clear conditions, and with the monsoon season delayed this year, the backlog of passengers made it impossible for us to fly to Gilgit as planned.  Everyone in Pakistan being very adaptable, we switched our plans and worked our first week in Lahore instead. We were happy to return to Fatima Memorial System (FMS), our local partners for the setting up of an osteopathic school.

Shery and Haider working with an orthopedic patient at SZH

Shery and Haider working with an orthopedic patient at SZH

Through generous funding from New York and Lahore, Haider Ali and Usmara Haider, our fundees, have worked a day a week at FMH to treat poor patients from Nainshuk, a suburb of Lahore where FMS has a community health center. Thanks to this Osteopathy Day at FMH, doctors have been able to witness Haider and Usmara’s commitment and the efficacy of osteopathy.  Haider and Usmara have produced a pre-study of 30 patients, showing pain scores going from 7.3 to 5.4 to 2.6 (1 to 10 scale) at weeks 2 and 4.   Their thesis protocol is being approved now for research that will study the evolution of general health for patients being treated with osteopathy. Osteopathy’s side-effects are all positive. Whatever the patient comes for, we treat the whole person, which improves alignment and mobility of the whole structure, allowing better physiological functions.  Someone coming for neck pain can see their digestive issues or sleep disorders get better. Another coming for low back pain can see abdominal symptoms disappear etc.

The road to Nagar is long but beautiful.

The road to Nagar is long but beautiful.

We were very pleased to have senior physiotherapy students assigned to watch our treatments. Their hunger for learning was refreshing. It was another brilliant initiative by Shahima Rehman, head of this worthy institution, whose commitment to the growth of osteopathy in the country we are very grateful for. We thank all the physicians at FMS for taking time to meet with us and for sending us patients. We look forward to deepening our complementarities to bring better health and well-being to the patients.

Thanks to Dr. Pervaiz Iqbal, orthopedic surgeon and pioneer in all things new and worthy, we could spend a day at Sheik Zayed Hospital, (SZH), a large public hospital that receives a lot of patients from rural areas when treatment has failed in smaller facilities. We concentrated this year on pediatrics and orthopedics.  When the team arrived in the pediatrics ward, a resident recognized us from last year and directed us directly to the chronic ward, remembering we had had good results with those patients.

Flattening of the head affects health and posture.

Flattening of the head affects health and posture.

Thanks to Prof. Javaid Asgher,  we visited the modern Lahore College of Physical Therapy and met its Dean, Hafiz Muhammad Asim, DPT.  At the affiliated Gurki hospital, we worked at the outpatient physiotherapy department, with many interested physiotherapists and students witnessing some very good immediate results of osteopathic treatment.  I worked on babies with development issues, and a baby with torticolis who immediately improved his range of motion. These diagnoses, and most issues of children are commonly treated with osteopathy in the West, as osteopathy is able to release tightness and nerve irritation due to birth traumas.

Last year we were happy to meet Zakir Khan and Dr. Sohail Saleem at the Pakistan Cricket Board (PCB).  PCB players were on tour, but we could treat a few younger players and hope to continue our relationship with the medical support team in order to insure the best performance level of the players.

On Saturday ending our first week, we were very lucky to fly to the mountains. Our group of 7 included the 4 foreign volunteers, plus Haider and Usmara who participated for the first time in this part of the mission, accompanied by their 13-year old son Abdullah, who was assigned the role of English teacher in the Nagar schools we were going to work at.

Baby girl with the flattening bandages around her head. For the last time.

In 2008 we met the late Prince Barkat Ali, Mir of Nagar, who offered us hospitality at his palace for our missions. The palace is a simple, rustic accommodation that recently was upgraded with running hot water, with beautiful lawns, situated on a ridge over the village of Nagar, with tremendous views of Golden Peak, a snowcap peak. We were very lucky this year to be hosted by the young Prince Qasim Ali and his mother Princess Rahat. Prince Qasim is bravely following up with the work his father started before his untimely death 2 years ago. Nagar has a  population of almost 150’000 people, mostly farmers, spread over several valleys, living in rustic and challenging conditions. The views are breathtaking and the air very clean, but development has difficulty reaching this remote valley.

Ibrahim Khan and Imdad Hussain, teacher and principal of private English-language schools, facilitated our working with the children and citizen of Nagar. Their now long experience with osteopathy, their dedication to the improvement of the valley, in health and all aspects, made them wonderful organizers so we could treat very appropriate patients.

This lucky baby girl will have her head return to her normal shape thanks to a timely treatment and the education we provided.

For instance, Haider treated a 13-year old boy with cerebral palsy, a smart kid, who was able to walk, though with stiff ankles and dragging his feet. After the treatment, he was able to walk with more confidence, lifting his feet. Smiling, he said: “I’m very happy, I can walk better”.  Haider also treated an 11 year old girl with vertigo for the last 3.5 years, after a head injury. It was gone after the treatment.

Katy had the joy of seeing her 7-year old patient, who seemed to have had polio, with weak legs and pain and rigidity in his knees, who arrived walking assisted by 2 people, leave her treatment-bed on his own two feet for a few steps. With practice, surely he will make great progress.

I received feedback from Imdad that a 13-year old girl I treated who suffered for 3 years of almost daily episodes of fainting, with episodes lasting 20 to 30 minutes, had had only one 5-minute episode in the following 3 weeks. A boy who had been sent to a hospital in Karachi, at great cost, without relief of his severe abdominal pain that interfered with his normal eating also got relief. All other feedback from our patients at the school were positives. With only one session!

When I first trekked through those mountains, in 2005, with Ibrahim as my guide, I treated his daughter, then a few months old. She was weak and failing to thrive. Ibrahim being an educated man, he immediately understood my explanation that the tradition of flattening the head of babies to make them more beautiful was unfortunately so harmful to the heath of the children, forever. Compression of the nerves exiting the head can weaken the free flow of information, especially serious in the case of the vagus nerves that control the autonomic functions of the organs in the chest and abdomen. We see a lot of cases of headaches, abdominal pain and chronic fevers that resolve quickly after treatments.  As Ibrahim’s daughter became better right after the treatment, they gave up the flattening of her head and I was happy to treat her again now a 9-year old, the healthiest of the siblings, with a beautiful round head.

Gabriel Venne, who volunteered in 2009, designed a poster with drawings showing the harm of flattening the head and we have been distributing those posters every trip. We were very pleased to hear that at least around Ibrahim, children are left with the head nature gave them. Because of the interconnectedness of families in those villages, Ibrahim’s family means dozens of families. Prince Qasim is presiding over the construction of new schools and he and his mother can be instrumental in continuing the education of the population. Once given the information, parents are easily convinced to let go of such a tradition, which only started in the 70’s.

Prince Qasim explains the health benefits of leaving the head round using our poster.

Prince Qasim explains the health benefits of leaving the head round using our poster.

With our goal of triggering some osteopathic careers in the Gilgit area, the main town in the mountains, we returned to Sehat Foundation hospital, invited by Dr. Wajahat Hussain, a very dedicated pediatrician we met back in 2007, and Mr. Zulficar Ali, director. We also were introduced to the Agha Khan Medical Center, thanks to Mr. Sifat Ali and Dr. Nadir Shah. Dr. Nadir being a nutritionist he understood easily the basic concepts of osteopathy, that the body’s natural state is of health and that lifestyle choices determine a lot of the way it behaves. At the clinics we screened patients in the waiting rooms and were able to treat many different types of patients with good success: an 8-month pregnant woman, whose severe pain not only went away but who will now have a better chance of normal delivery, as tension produced by pain would interfere with the progression of the baby down the birth canal. Dr. Nadir got patients’ feed-back later-on who were very pleased with the decrease in pain, whether musculo-skeletal or abdominal, and the general feeling of well-being they experienced.  Some felt they needed more treatments, and they were right, rarely does one session completely resolves a problem, but we are always impressed by how well the population in the rural areas responds. They seem to have a strong constitution and get better faster.

These successes and the enthusiasm of the population, whether patients or public health executives, confirm our strategy of returning to the same villages or institutions over the years. With more manpower, we would be happy to spread our reach, but clearly, only a Pakistani school can make serious progress in providing this wonderful, natural, low-cost medicine to the general population. In Pakistan alone, there are 180 million people. It will take a real long time to create enough osteopaths to help the population recover their good health, and so be able to contribute creativity and energies to the development of their families and country.

If you are a trained osteopath interested in humanitarian work, our contacts in Lahore, Gilgit and Nagar would be happy to receive your services for a few weeks.

picIf you are a B.H.Sc in Pakistan and motivated to helping your patients reach greater health and well-being naturally while being part of the modernizing of the Pakistani health-care system, please contact us so we can give you more information about how you can become an osteopath.

If you feel inspired to support our efforts financially, we’ll be very grateful, as for the first several years Western teachers will be sent to Lahore to insure the highest level of training. The high cost of training in complementary medicine is the only reason they haven’t spread to the developing countries, where they could help so many. Our effort is to bypass this injustice. Once there are enough local osteopaths, funding won’t be necessary.

Until the school starts, we need funding for Osteopathy Day, where Haider and Usmara will do a study to evaluate the health evolution of their patients treated with osteopathy. This research will add valuable data to the cause of osteopathy, as patients so often report improvement of issues other than the one they consult us for. It will allow public health officials to estimate how much heath is gained with the investment in osteopathic treatments.

We will also need funds to organize introductory courses to osteopathy for physiotherapists and physiotherapy students to pave the way for the school.

The vision is one of a healthier health-care system. Thank you for your support.

Sylvie Erb, PT, DOMP (Q)
Osteopathy Without Borders

Please contact:
In the West Sylvie Erb at sylvieerbosteo@gmail.com
In Pakistan Haider Ali at osteoapthhaiderali@gmail.com

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