Shoshong, Botswana: The Pilot Project
In 2011, WSC launched a pilot project in the rural village of Shoshong, Botswana to spearhead the development of a viable model of care for spinal conditions in under served regions around the world.
The Shoshong project is:
- Developing sustainable capacity for effective spinal care in Shoshong and the regional health district;
- Implementing and evaluating spinal care screening, assessment, and treatment protocols, and the associated front-line health worker training program.
- Conducting research: including an ethnographic study of the burden of spinal conditions in Shoshong, longitudinal treatment outcome studies, and research tracking the nature and frequency of musculoskeletal conditions occurring in patients who are living with HIV/AIDS.
- Integrating into the health services provided by WSC such indigenous and alternative health care practices as are lawful in Botswana.
Primary Care
A primary spine care clinic has been operating in the village of Shoshong, Botswana since 2012. Over 20 volunteer clinicians had served in this clinic by the end of 2014. The clinic serves as a center for the screening of serious pathology and the diagnosis and management of patients with spinal and musculoskeletal disorder. In addition, the clinic operates as the nexus of research dedicated to the development and testing of outcome measures following treatment and the development of evidence based treatment protocols.
Secondary Care
A diagnostic rehabilitation center and second primary care clinic has been established in the Mahalapye District Hospital. The secondary diagnostic and treatment component of this program is for management of those patients who have been identified at the primary clinics to require more advanced care. This center has basic x-ray and laboratory facilities as well as access to advanced imaging and primary medical and surgical specialists.
Tertiary Care
Patients who require advanced diagnostic facilities such as MRI, advanced surgical care or surgery are referred to the are transferred to the major teaching hospitals in Gaborone, under arrangement with the Botswana Ministry of Health, WSC’s partner in the WSC Shoshong project. Volunteer spine surgeons and medical specialists including rheumatologists and neurologists affiliated with WSC are available to act as consultants to local specialists, provide education on the latest methods of managing complex spinal disorders and to assist on the management of more complex cases.
The expected outcomes of the Project are:
- Improved healthcare for people with spinal disorders and injuries in Shoshong and adjacent communities
- The establishment of community education programs to reduce the impact of spinal disorders
- To provide an ongoing and sustainable spine care program in Botswana through the training of primary spine care clinicians that can then provide similar programs in other communities.
Clinical Coordinator
Stephen Laski, DC
Dr. Stephen Laski, DC
Stephen is a graduate of New York Chiropractic College and previous Clinic Supervisor for the Dominican Republic clinic. His passion is to help people overcome their back and neck pain so they are able to live the life they intend to. In practice, he focuses on the diagnosis, management, and treatment of non-surgical, spine-related disorders through evidence-based and patient-centered care. He specializes in the integration of movement and physical rehabilitation so that patients can feel, function, and live at their best.
He is a certified Primary Spine Practitioner through the University of Pittsburgh, School of Health and Rehabilitative Sciences, and has completed additional education in pain classification, Dynamic Neuromuscular Stabilization, McKenzie Mechanical Diagnosis & Therapy, as well as other manual therapies. Currently, he works as part of the Volunteer Recruitment team to share World Spine Care’s mission with prospective volunteers and inspire them to become a part of their goal to create a world in which everyone has access to the highest level of spine care possible.
Clinic Supervisors
Mufudzi Chihambakwe
Mufudzi is a recent Chiropractic graduate from Durban University of Technology in South Africa. As a student, he was a member of the World Congress of Chiropractic Students which is how he first got involved with World Spine Care. In 2017, he carried out his research for his Master’s degree in the Mahalapye District Hospital where he was looking at how the local health care professionals at the hospital perceive World Spine Care. He has now joined the clinical team with World Spine in Botswana. He has a keen interest in African development and public health and is excited to see how health care systems across the continent evolve to better meet the needs of the local people. He is an avid blogger and part-time voice-over artist.
Carly Broderick
Dr. Carly Broderick is a recent graduate of Palmer College of Chiropractic West in California. She originally came to Botswana as a short term volunteer and enjoyed the experience so much that she came back in the role of Clinic Supervisor. Prior to chiropractic school, she earned a Masters of Public Health, which sparked interested in community-based health care in under-served communities. During the course of her studies, she became an avid rock climber with a keen interest in treating athletes. She has had additional training in extremity adjusting with a focus on returning athletes to sport. Always interested in embracing different cultures while working in a sustainable, integrated health care setting, World Spine Care has been an excellent choice.
The World Health Organization featured World Spine Care as a promising practice model.
WHO IntegratedCare4People
In 2016, the World Health Organization recognized the World Spine Care Botswana Clinic as a Promising Practice for Creating a sustainable model of spine care in underserved communities in Botswana.
In the 2018 report, Continuity and coordination of care: A practice brief to support implementation of the WHO Framework on integrated people-centred health services [PDF link], World Spine Care is highlighted on page 43 as an example of “Comprehensive care along the entire pathway.”
