Who We Are

Summer 2010

Osteopathy Goes Public in Pakistan

The foundation Osteopathy Without Borders (OWB) was founded in 2007 to raise funds to train Pakistanis as osteopaths.  Haider Ali and Usmara Zafar, physiotherapists in Lahore, have now finished their 3rd year, out of a 5-year part-time study program.

With only 2 years until they are done, and can become assistant-teachers of a Pakistani osteopathic school,  we had to start being known more widely.  Every year for the last 4 years our team members, who volunteered from the CEO in Montreal, worked one week at Shaik Zayed Hospital and one week in the remote mountainous Northern Areas, and presented at different hospitals in the main cities of the country. A drop in the ocean in a country of 180 million people.  To reach a wider audience this year, we focused on media efforts, to introduce the idea of osteopathy to the population, and possibly inspire some of the youth to think of a career in osteopathy.

My first patient of 5 years ago, who couldn’t heal from his fevers because of his head compression

Aleema Khan, founding member of the board, succeeded in arranging for a major tv channel to follow us while we were doing school screenings and treating children in Nagar and Hoper, remote villages in Hunza valley, and also when we worked in refugee camps in Hunza, where people displaced by a newly formed lake are waiting for relocation.  Thanks to some very dedicated people we met in Hunza, Gulam Ali, formerly of the NGO KADO, and Iqbal Muhammad, chairman of Aga Khan Health Board, we had another local channel and a radio and print media follow us and interview us too.

No surprise one of the most common complaint is headache

This year was the biggest group of volunteers so far: Jad Khoury, DO, Sarah Clinton, Guillaume Gagnon and Brian Olney, finishing students.  They were luckily very adaptable, as we had to work on the floor most of the time, sometime on some veranda outdoors with stunning mountain views. Hygiene is often poor, and insides made themselves be noticed by each participant at some point, but luckily no one got seriously sick.

It was a very gratifying experience for all to treat these children, release them of their current symptoms, but mostly knowing we were helping them become stronger for the future. All the boys and some girls have their heads flattened for beauty, a local tradition. The poster designed last year by Gabriel Venne was distributed further, and we were happy to see some newborns who were left with their natural head-shape, thanks to the continuous information provided by Ibrahim, mountain guide and teacher, who has become an invaluable member of our team, helping us every step of the way.

In this valley, there are 2 doctors for 14,000 people. The closest hospital is 6 hours away, and mostly the farmers cannot afford medicine. Easy to see how osteopathy is the perfect form of medicine for remote areas.  In the country as a whole, we were given the numbers of 1 doctors for 4 posts. The  Health Secretary of Punjab said it was even worse.

At Shaik Zayed Hospital in Lahore, Prof. Anwaar Khan, the chairman, and Dr. Pervaiz Iqbal, orthopedic surgeon, again opened widely the doors of their wards for us to treat the severely sick patients that end up in their university hospital. Because the health services offered in the decentralized areas are poor, too often people are rushed to the hospital when they already are at an advanced stage of their disease. Imagine how that could be changed with an osteopath in every village!

We had the opportunity to present osteopathy to the doctors of the hospital on the last day of that week. Brian gave a brilliant report of a patient with hepatitis, a plague to the country, that drew spontaneous applause. His presentation is at the end of this article.

At the end of our presentation, Prof. Anwaar said a few words to the audience, insisting on the fact that in these difficult times for Pakistan, having volunteers from North America come share in new knowledge was to be applauded and supported. He also mentioned how, as a fame gastro-enterologist, he had so many patients filling his waiting room with functional diagnosis that didn’t respond to medical treatment. Opening to complementary forms of medicine could only bring help to over-burdened doctors, and bring necessary relief to patients.

In all of our presentations, I insisted on the fact that in the USA, trillions are spent on allopathic health-care, and in addition, billions are spent on all forms of natural health-care, from supplements and massage to osteopathy, acupuncture or homeopathy. This is not a cost-effective way. By bringing osteopathy at this stage of development of the country, we can insure that those patients who don’t need the high-tech medicine are seen by osteopaths, allowing the allopathic resources to be wisely and effectively spent.

In pediatrics, we treated several children who were not responding to their medical treatments. One of them was of particular concern, with Bartter syndrome, a genetic metabolic disease, whose older sibling had died of the same diagnosis. At 4 months, he had been in and out of the hospital since age 7-days, and had an intractable chest infection. I found his dura mater to be extremely taught, pulling the brain into the spinal canal. I gave him a 2nd treatment 3 days later, but already he was a different child: sleeping well, eating more. The chest cleared during that 2nd session, where he was now calm and smiling. A beautiful moment.

We again did a lot of media during the week in Lahore, with a press conference sponsored by the Imran Khan Foundation, who supports OWB in Pakistan in view of creating a school in 2-3 years. I was also privileged to be invited on a morning show in English. The program touched a doctor from WHO working in Pakistan, who contacted me with the hope that the promises of osteopathy were true. Dr Darwish accompanied us when we spent a morning at the public children’s hospital, where we could present to a group of doctors and physical therapists, welcomed by the dean, Prof. Tahir Masood Ahmad.  Haider and Usmara, keeping in the spirit of osteopathy, are going to start giving a day a month to treat the children at that hospital.

The Children’s Hospital was meant to receive 250 beds. It has 684 beds and 1200 patients. For a ward that should have 10 nurses they have 4. Do you think they could use some help?

The help osteopathy can offer was immediately understood by the Health Secretary of Punjab, Fawad Hasan Fawad. He himself had benefited from manual medicine in the past, and he had shared with his chief-minister (governor) how the efforts had to focus on non-traditional forms of medicine and on prevention because of the lack of resources.

Our vision to create a modern, cost-effective health-care system in Pakistan: As soon as possible once Haider and Usmara finish their studies, we’ll open a new osteopathic school in Lahore, most likely as a public/private partnership. The program and the teachers will come from the CEO in Montreal, with Haider and Usmara acting as assistant-teachers.

At first, we’ll start with the part-time 5-year program open to physiotherapists and doctors. Like it’s been done in the West, that will allow the students to work and earn a living while learning and perfecting their skills as osteopaths. The standard program consists of 6 courses of 4 days per year, plus clinical days. Because of the traveling issue, most likely we’ll group the courses so as to have 4 courses of 6 days. In the future, once we have enough local osteopaths who can do clinical supervision, we’ll open a full-time program, open to motivated graduates of grade 12.  You can check the program at www.osteopathiecollege.com.

Initially, the gap between fees and costs will be covered by fund-raising that OWB and the IK Foundation will sponsor.  OWB also has a commitment to sponsoring students from the remote areas all over the country, so that they can bring osteopathy back to their communities.

Brian’s patient:

A 40-year old woman with hepatitis C, portal hypertension, ascitis (accumulation of water in the abdomen) and jaundice.

Complaints were of extreme weakness, constipation and fatigue.

Gastro-enterology, Jad and Guillaume, +Haider

Treatment involved releasing the dura-mater from the sacrum to the attachments on the ethmoid and cranium. Especially the base of the skull to include the jugular foramen and therefore the pathway for the vagus nerve and also the 3rd, 4th and 5th cervical vertebrae, origins of the phrenic nerve controlling the diaphragm, and the somatic innervations of the capsule of the liver. As well, treatment emphasized release of the attachments of the 4 organs that help control hydrostatic pressure: the heart, liver, kidneys and small intestine. In working to control pressure and release tension of the tissues, to increase flow and normalize sympathetic and para-sympathetic nerve conduction. This allows the body to increase its auto-regulation.

Within minutes of finishing the treatment, the patient went to the bathroom, then sat up and ate her lunch energetically and then rested. By the time we were done with the next treatment, 45 min later, the jaundice in her eyes had significantly improved, her energy was up, and she was interacting with her family with enthusiasm.

Prof. Anwaar and Dr. Pervaiz with the team

A senior doctor in the audience had a very interesting question. He said: “ even when we put a stent in the choledoque (the canal that drains the bile from the gall-bladder into the intestine) it takes 3 days for the color to change. How can you have such an immediate result?”

The answer is that we didn’t work on one canal; we worked on the entire circulation system, allowing a return to balanced homeostasis.