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 underserved 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.
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.
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.
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.
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.”