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ThisPresenta,on

• WHO Frame Work Model and World Spine Care

• The Founder Scott Haldeman MD, PhD, DC.

• World Spine Care mission and vision

• World Spine Care as an organization

• The clinical goal including prevention

• The Education-fellows and graduate students

• The current sites Botswana, Dominican Republic, India, and Ghana

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WHOFrameworkModel

Improvedhealth

outcomes

Localhealthneeds

LocalContext

Health&Educa2onSystems

Fragmentedhealthsystem

Present&futurehealth

workforce

Op2malhealthservicesbasedonevidence

Strengthenedhealthsystem

Collabora2veprac2ce

InterprofessionalEduca2on

Collabora2veprac2ce-ready

HealthWorkforce

www/who.int/hrh /resources/framework_action/en/

Localhealthneeds

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TheWSCModel-SpineServicesforUnderservedCommuni,es

LocalHealthNeeds

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WorldSpineCareModel

Organization Administration

Education Sustainability

Integrated Spine Care

Research -Quality -Results

Funding

ImprovedHealth

Outcomes

LocalHealthNeeds

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ScoEHaldemanMD,PhD,DC

•  Founded World Spine Care in 2008

•  After the WHO Bone and Joint Decade Neck Pain Task force was completed, we were convinced we could do translation of evidence based knowledge to underserved communities

•  Assembled a team

•  Raised funds

•  Negotiated with the Ministry of Health in Botswana with a WSC Team

•  First WSC clinic opened 2011 in the village of Shoshong, Botswana

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WorldSpineCareModel

Village Care Shoshong

Mahalapye District Hospital

Princess Marina Hospital

Education Research

Integrated Care

ImprovedHealth

Outcomes

LocalHealthNeeds

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WorldSpineCareOrganiza,on

Board of Directors (S.Haldeman)

Funding

Executive Committee (J.Moss) Budget, MoUs, organization,

problem solving, policies, safety, capacity buliding

Clinical Team (G.Outerbridge) Clinics (training,

database, prevention) Start ups

Volunteers

Research Team

(M.Nordin/E. Hurwitz) Proposals/research Graduate students

Dissemination Fellowships/Scholarships

Promotional Team (G.Outerbridge)

Website Membership

Media Liasons

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World Spine Care is the only organization

worldwide that is tackling this global spine health

crisis in an inter-professional, evidence-based, collaborative and sustainable way

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WorldSpineCare:Mission,VisionandValuesTo improve lives in underserved communities through sustainable, integrated, evidence based, spinal care.

A world in which everyone has access to the highest quality spine care possible.

Sustainable: To empower local governments and communities to assume control.

• Evidence based: The emphasis is on evidenced based, integrative care

• Education: educating the community and local health workers

• Research: add to the body of knowledge of spine care

• Global: bring access to spine care, without discrimination, to underserved communities around the world

• Sensitive: sensitive to the local customs of the communities in which we operate

• Compassion: compassion for those we serve

Mission

Vision

Values

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TheWSCModel

•  Clinical

•  Education

•  Research

•  Building sustainability through collaboration

•  Fund raising

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Support from Botswana Ministry of Health

•  MOU signed with the Ministry of Health (MoH) on June 23, 2011 in Gaborone

•  MoH to provide: facilities, staffing, supplies, clinician housing expenses, and scholarship student expenses.

•  WSC to provide: clinicians, equipment and tuition scholarships

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Clinical Program

•  Low cost, low tech •  Evidence-based •  Fully integrated into local health

care infrastructure •  Long term presence •  Inter-professional and

collaborative •  Measured clinical outcomes for

outcomes, quality and research

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ClinicalTeam

1. Primary spine practitioner •  Screen for serious pathology •  Timely referral when appropriate •  Offer Evidence-based interventions:

o  manual therapy o  exercise o  education (including psychosocial) o  occasional mild analgesics

2. Surgical Specialists 3. Rheumatologists

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CapacityBuilding

•  Patient/community education •  Front line health care worker training/education, 2nd

Botswana Conference Spine Care April 21-22, 2016 •  WSC spine conferences and professional

development •  Student Scholarships •  Advanced surgical and non surgical training

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Sustainability Elements-Fellowships •  Tiro Mmopelwa – Orthopedic Surgeon •  Emre Acaroğlu – Orthopedic Spine Surgeon

Ankara Spine Institute, Ankara, Turkey

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•  Maria Hondras. University of Southern Denmark: Burden of musculoskeletal disorders among villagers in rural Botswana: A focused ethnography

•  Researh Committee. – Develop a data base for data collection

– Impact of HIV/AIDS and other infectious diseases as risk factors for spinal disorders.

– Follow-up questionnaire for low literacy clinical outcome studies

– Graduate Student projects

Research

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– Mufudzi Chihambakwe. Durban University of Technology: The perception of selected stakeholders of the integration of World Spine Care into the health care system of Botswana

– Candice Armstrong. Durban University of Technology: A demographic and disease profile of patients attending the World Spine Care clinics in Mahalapye and Shoshong, Botswana

– Sophia da Silva. Canadian Memorial Chiropractic College (CMCC), Division of Graduate Studies Toronto: A case-series of patients with musculoskeletal conditions presenting to a World Spine Care Clinic in Moca, Dominican Republic

Research

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SHOSHONG PROJECT Botswana

Raquel Delgado, DC, PT Clinical Supervisor

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Preven,on

•  Scoliosis screening •  Exercise programs

o  “Straighten Up” program o  WSC Yoga project

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• Creating TT programs for developing countries • Implemented at WSC locations • Focussed on MSK pain

WSCYogaProject

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Secondary Care Facility

Mahalapye District Hospital, Botswana

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Some conditions seen in Botswana

Aortic aneurism Blount’s disease DISH (Spine, knees, feet) Fractured dens TB Kidney infection Idiopathic scoliosis Scoliosis (Lumbar Hemi., CP) Paget’s RA Stroke secondary to low CD4

Sprengel’s deformity Stenosis DDD DJD Osteoporosis

We are hoping for a Spine Center with Dr. Tiro Mmopelwa in Gaborone

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WorldSpineCareModel

Organization Administration

Education Sustainability

Integrated Spine Care

Research -Quality -Results

Support from MoH

ImprovedHealth

Outcomes

LocalHealthNeeds

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Moca Project Dominican Republic

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India Mumbai Navi Project

MGM Institute of Health Science Faculty of Medicine

Department of Physiotherapy

Providing care for 10,000 people in 10 rural villages

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GhanaMarch2015SignedMoU

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www.worldspinecare.org

“Do a little bit of good wherever you are;

it’s those little bits of good put together

that overwhelm the world.”

Archbishop Emeritus Desmond Tutu Member of WSC Advisory board

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Thank you! Re a Leboga!