Volunteers from five continents came together to establish World Spine Care, an organization dedicated to providing evidence-based spine care to low- and middle-income countries. The organization aims to use resources and care integrated with the local culture, according to an article published in the Journal of Bone and Joint Surgery.
The organization's research committee approves and oversees projects that serve the underserved populations around the world and provides education to prevent spinal disability in the future. The article published in JBJS examines four WSC projects.
Medical mission trips have traditionally been short term trips that included surgeons and other medical professionals that completed independent projects. However, there is a "lack of sustainable evidence-based model of care."
Here are the four projects:
1. Establishing spine surgery expertise in Botswana, Africa: The project's goal was to find opportunities to advance the spine surgery training for orthopedic and neurosurgeons in sub-Saharan Africa as well as describe challenges for a Botswana-specific spine surgery program. There are few spine surgeons in the region and limited opportunities for surgeons to gain training in the future.
The project found the next generation of spine surgeons needs training and mentors as well as funding to complete spine surgery fellowships outside of Africa. One surgeon who went through the mentorship and fellowship process abroad returned to Botswana and opened the first spine center in the Botswana Ministry of Health's public healthcare system.
2. Case series of patients in the Dominican Republic: The case series aimed to describe patient characteristics in Moca, Dominican Republic and how spine pain can affect the quality of life. The researchers found navigating the country's ethics review board and the timeline of the project challenging. The cultural differences between the patient and physicians were also a challenging.
The study was paperwork intensive for the clinical staff, but they were able to establish a baseline of information about the patient population that can result in improved clinical protocols.
3. Culturally relevant patient-reported outcomes for low literacy populations: The WSC aimed to create and test patient-reported outcomes questionnaires for low-literacy populations, as they didn't perform as well on the traditional patient-reported outcomes questionnaire. The new questionnaire was given to 57 patients at two clinics in Botswana and conducted a follow-up after eight treatments or until they were discharged from care.
The researchers found patients were able to complete the questionnaire with relative ease and responded to symptom and physical function changes. The organization also developed an adverse effects questionnaire.
4. Musculoskeletal disorders in rural Botswana: This project's goal was to examine musculoskeletal conditions for people living in rural Botswana. The researchers visited Botswana three times in three years and were able to establish relationships for collaboration in the future.
The project hired, trained and retained a "small cadre of villagers" to participate in data collection.
"To date, the lessons learned include the importance of incorporating stakeholder perspectives, understanding knowledge transfer activities in other cultures and ensuring optimal organizational and mutual collaborative relationships among researchers, clinicians, local governments and local leaders," the study authors concluded. "With cooperation and funding, it is possible to conduct the research necessary to provide sustainable spine care programs that have the potential to improve the public's health and quality of life."