Our seventh mission, this late Summer of 2013, was eventful, and different in many ways. Unfortunately, in June there was a terrorist incident in the mountain areas where we have worked every year since 2007. After 10 mountaineering tourists were killed, security measures tightened so we were not able to obtain authorization to travel back to Nagar valley. We were very disappointed as our work there has been gaining a lot of support from the population, but as it turned out, we did need the time in Lahore to pursue our goal of creating a Pakistani school of osteopathy.
Our small team of returning volunteers was the perfect team for this year’s mission: Sheryl Hoo, pDO, always ready for anything, always generous. Faisal Naqvi, DO, the charismatic teacher in our team, with us for the 4th time, with enthusiasm and skills that make everyone love osteopathy. And of course, this time our two fundees, Haider Ali, pDO, and Usmara Zafar, pDO, participated in the mission as full members, as they received their certificate of osteopathy from SICO (Swiss International College of Osteopathy) in July 2012. Thanks to all who have allowed them to complete their courses. They are now working on their research thesis so that they can obtain their DO: diploma of osteopathy.
We started our mission with a meeting with the leadership of Fatima Memorial Hospital System (FMS) to discuss the possibility of opening an osteopathic school within their system. The school would be a partnership between the CEO (College of Osteopathic Studies, in Montreal) and FMS. Never before has anyone tried to introduce the training in complementary medicine in a developing country. Our experiences, and the discussions at that meeting, certainly made us understand all of the challenges that exist in such a different economic and cultural environment.
In the Western world, professionals are keen to further their training in a modality that is popular and known to help patients get better with all aspects of their health. The priorities in a developing country are to secure a safe job. For the profession of osteopath to become attractive to young professionals and high-school graduates in Pakistan, we need to secure the recognition of the profession by the Higher Education Institutions and government bodies of the country.
Shahima Rehman, chairperson of FMS, has already led her institution through numerous partnerships and pioneering endeavors to improve the well-being of her fellow countrypeople. Thanks to her experience and contacts, we were able to present our vision and project to high-level people in the government. Our coming every year for the last 7 years gives us credibility, unfortunately our results have not been evaluated or witnessed enough by doctors. We have collected the direct feed-back of the hospital patients we’ve treated, with a good 80% rate of satisfaction and improvement with osteopathy. We have seen amazing changes in their status: decreased fever, improved energy and color, improved digestive health or sleep, decreased pain, etc… We needed a tool to make our results visible to all.
To this end, we have decided to create an Osteopathy Day at FMH. Every Thursday, Haider and Usmara are now funded to treat patients at Fatima Memorial Hospital. They will collect data on the evolution of their patients’ health score. We are gratefully acknowledging the precious help of Prof. Amanullah Khan, a research expert, dean of the faculty of community health sciences to finalize the design of the study, and all the leadership of FMS who, through brainstorming sessions, helped us come up with this plan that will provide more evidence to help others embrace our vision of a healthier health-care system, able to provide cost-effective, complementary care in the remote communities as well as in the urban hospitals.
technical training school at Naim Shuk
Shahima Rehman, being such a fast thinker, plus understanding the value of osteopathy as community-care, was able to organize our visit to Naim Shuk, FMS’ community health-center on the outskirts of Lahore that first Monday afternoon. We were very impressed by how holistic their center is. Centered around community health-care, staffed with dedicated doctors, it also provides training schools in several professions (technicians, sewing,..) that ensure the graduates are able to earn and provide for their families.
Dr. Javaid Iqbal, director of the medical team there, quickly recognized a perfect indication for osteopathy: a woman came to Naim Shuk complaining of pain and swelling in her C-section scar for the last 3 years, for which she needed continuous medication. We had the attending physician examine her and asked what her recommendation would be: injection of pain-killers, as her abdomen was very tender, and prescription of an ultra-sound for further investigation. Instead, we treated this woman osteopathically and could release the scar tissue that interfered with the proper healing of the scar. This patient’s history was important here: this had been a third C-section, and the baby boy had died at birth. She had not been able to become pregnant again, and she was worried her husband would divorce her, as their 2 children were girls and he wanted a boy. Clearly, our intervention had to allow the patient to release the serious tension that was in her chest and diaphragm and kidneys, as a result of her stress, before attending to the relatively simple job of releasing the scar tissue. This case was a good illustration of why we shouldn’t try to offer a “simpler, shorter” training in osteopathy: everything is connected, and trying to release a specific tightness when the body is not able to integrate it could bring aggravation instead of relief. We treated the patient again a week later, when she was already 50% better and extremely grateful.
While in the medical ward at FMH, we could treat several interesting patients, including a 17-year old boy with high fever because of multi-focal splenic abscesses. He had a motorcycle accident 2 months earlier and had been at the hospital for 2 weeks. Since he was not responding to treatment, a splenectomy was schedule for 2 days later, a Thursday. While we were given the boy’s history he was being bathed with cold compresses to try to bring his fever down, shivering and moaning. He looked underdeveloped, more like a 12 year old, indicating to us some underlying issue. Sure enough, Faisal found a severely restricted cranial base that must have been there from birth. We actually couldn’t believe our eyes, when while treating our next patients, we saw this boy sitting up and talking with his brother and friend, before deciding he wanted to go to the cafeteria, walking off his bed for the first time in 2 weeks!! We actually got worried that he would crash, which he did 2 days later, but in the meantime, we asked his doctor whether he would consider postponing the surgery, to give a chance to his body to clear the splenic infection on its own. In view of the spectacular changes manifested, he accepted. Faisal was able to treat this boy 4 times in 10 days, and he was discharged, being active, without fever and seeming healthy. Osteopathy, like allopathic medicine, has its miracle stories and its limits. Unfortunately, the patient had to be operated on to remove his spleen anyway a few days later — his body hadn’t been able to clear the abscesses on its own. Possibly the walls of the abscesses had calcified. From our experience with trauma cases, certainly osteopathic treatment right after the fall would have avoided all these complications, and certainly the boy recovered better thanks to the improvement in circulation of fluids and nerves.
Every year, we treat many cases of motorcycle accidents, young men immobilized with limb fractures that are infected. The worst outcome is amputation, when even strong antibiotics are not effective. Osteopathy restores normal alignment and mobility in the tissues in the entire body, allowing the immune system to reach the wound and fight the infection. How much money and misery could be saved with osteopathy available to all?
Dr. Pervaiz
Sheryl and Usmara together treated a woman with multiple health issues: she had kidney disease, an enlarged liver, fever, generalized pain and vomiting. When we visited her the afternoon after her treatment, she already had no more pain, fever or vomiting. A week later, we called her and found out she was home and had stopped her medication because she had felt so good. She was starting to feel worse again, understandably because of the nature of her chronic kidney disease. Usmara could urge her to visit her doctor asap, and resume the medication still needed. This is a clear illustration of the importance of working as a team between osteopaths and physicians.
Dr. Pervaiz, orthopedic surgeon at Shaik Zayed Hospital (SZH), with the support of Prof. Anwaar Khan, then the chairman, was the first to open hospital wards to our teams of volunteers in 2007. This year again we split our time in Lahore between FMH and SZH. Residents recognize us from year to year, and there are always many patients for us to work with. Because of time limitations, we restricted our work to the orthopedic and pediatric wards, two departments where results can sometimes be immediately visible: children stopping their loose motions, sleeping through the night, pains being relieved. Our work there is beneficial for the patients, but the overworked doctors are happy to discharge their patients faster, without paying attention to the fact that it was the osteopathic treatment that made a difference. That is why our research at FMH is going to be so helpful to support our vision of integrated health-care.
group of physiotherapists at NISRA University
Last year, we met a physiotherapist trained in Belgium. Arjumand Mahmood, PT, who is ready to start osteopathic training as soon as it becomes available in Pakistan. In the meantime, she helped Dr Muhammad Naveed Babur, principal at ISRA (school of rehabilitation sciences in Islamabad), organize a half-day presentation of osteopathy to heads of physiotherapy departments and teachers in the region. Faisal gave them some practical demonstrations of osteopathic techniques to allow them to realize how differently osteopathy acts: how it works with the biodynamic force within the patient to induce a releasing of tightness, as opposed to stretching or mobilizing with outside forces.
We thank Dr. Naveed Babur and Arjumand for having brought together such a smart group of physiotherapist leaders.
When back at FMH in Lahore, we were invited to present at their weekly medical presentation. It was very well attended, by doctors and students, and we focused here on osteopathy’s results, presenting data from research as well as the principles of osteopathy. For instance a research with 110 babies showing 5-day decrease in length of stay (LOS) at the hospital for preterm babies treated with osteopathy. Same decrease of LOS was found for general surgery patients. A study on 57 patients compared results for otitis media on children: osteopathy is very effective to avoid surgery or antibiotics. A good study showed the benefit of osteopathy for IBS patients, a diagnosis that cannot be helped very effectively by allopathic medicine. Etc…
Thanks to OWB board member Aleema Khan, we had the pleasure to meet and treat staff and members of the Pakistani Cricket Board. They have a team of 14 talented physical therapists to support the precious players, and we are trying to organize an introductory course just for them. Faisal, who has a background in athletic therapy, helped an injured player recover mobility and alignment, and had excellent feed-back.
For the third year in a row, Aleema organized a dinner at the Punjab Club at the end of our stay, to gather friends and supporters of osteopathy. A very smart and dedicated group of people, doctors, educators and benefactors came to hear the latest developments. Thanks to their and your support, Osteopathy Day at FMH can be funded long enough to gather data to help ease the introduction of osteopathy in the health-care systems of Pakistan and the rest of the world.
Although the CEO and FMH are ready to start and signed a MOU of mutual exclusivity in the partnership, there are still many steps till the first osteopathic school can open in Pakistan. This pioneering endeavor is challenging and a growing experience for us all. We are very grateful to all who are supporting our vision in any way they can. We are proud to contribute to osteopathy’s growth with the research now taking place at FMH. Our sincere thanks to Shahima Rehman and her team for providing such a fertile environment for our project. The work continues…
To keep up to date with our project, please visit our web-site, www.osteopathywithoutborders.com or our Facebook page.