The reality of the situation in France was put in sharp focus when we were forced to think about the fact that to practice chiropractic in France is illegal. This is in striking contrast to the development and growth of the French college, IFEC. Consider the determination of the French chiropractors deciding not only to practice in a country where chiropractic is illegal and the penalty could be jail, but also having the courage, fortitude and conviction to encourage students to attend the college. Place yourself in the mindset of the parents or students and ask if you would spend tuition dollars to attend a college for five years, knowing that the very profession you are about to practice is illegal. Would you do it? Would you send your son or daughter to this college? Would you recommend chiropractic as a career to a French student?
Take a moment, expand the circle of commitment and recognize that the European Chiropractic Union (ECU) and the practitioners of chiropractic in France have invested considerable dollars in helping the college get started and continue to survive. The ECU is a group of European doctors who pay considerable dues to belong to the organization. They are from all over Europe, as far north as Iceland, as far south as Cyprus. The differences in culture, recognition, and status throughout the European region are significant, but the common thread that bonds them is their love for chiropractic.
Attending the World Federation of Chiropractic (WFC) meeting this year was particularly significant for me, because as immediate past president I can perhaps dispassionately reflect on the significance WFC has made in the world. The maturity and growth of the profession throughout the world is truly inspiring, and the commitment of doctors around the globe is as strong as any movement in history.
Stories of individual strength, dedication, determination, and purpose are reflected in a very quiet and often shy, unpretentious manner of the individual pioneer doctors. Displaying a humble and calm exterior does not hide the incredible inner strength of their resolve to advance the practice of chiropractic in their countries:
Dr. Charles Sebwana, a shy young man from Uganda, practices alone, but is making incredible inroads in a country where the word chiropractic was not even known. He was present at the conference to explain the plight of chiropractic in his homeland.
Dr. Gamal Giroush, a chiropractor from Libya, is determined to make the profession legal in his country. His resolve, and those of Middle East countries, is fortified by the news from Iran where chiropractic has become legal.
In Ghana, where male authority rules, the sole pioneering chiropractor is a woman, Dr. Eno Sefar-Tawiah.
All of these accomplishments come not because of huge public relations campaigns or millions of dollars, but because of the dedication and determination and hard work by, many times, one or two doctors of chiropractic.
It is a humbling experience to hear the stories of the struggles and opposition these pioneer doctors endure for chiropractic in the year 2001. From an American perspective, we often have a difficult time imagining what it must be like to hear a knock on the door and wonder if you are going to jail; to recognize that you may need to uproot your family, flee your practice, leave your possessions and begin anew with no guarantee or protection of law. There are the stories of "going to jail" for chiropractic in America, and practicing without a license as recently as 25 years ago. For the vast majority of the profession practicing today, the struggles of our pioneering chiropractors have little or no impact. Those stories have been reduced to urban legend.
Chiropractic in the U.S. enjoys prosperity and the luxury of a common language, the protection of law, and the formation of national and state organizations well organized to help when problems arise. Could we do what these brave doctors overseas are doing? Would we be willing to practice as many of the DCs are doing around the world? Would we rise to the challenges facing them? The answers to these questions are in the hearts and souls of the practitioners who have made chiropractic advancement a personal mission.
The courage and determination, vision and purpose of the DCs that permeates the meeting rooms of the WFC conference is palpable. Doctors of chiropractic from the U.S. who attend these conferences are forever changed and moved by the experience of knowing that the chiropractic profession around the world is in the hands of DCs (doctors of courage). They are the modern crusaders for a worthy cause. The reality of seeing the struggles first hand transforms anecdotal history into stark reality.
The creation of the World Federation of Chiropractic (WFC) 12 years ago was a dream of a few DCs. They recognized that despite the courage and willingness of DCs to fight for the right to practice chiropractic in countries around the world, there must also be a body to provide the weapons and organization to advance these champions in their battles. In this modern war to advance chiropractic, the weapons are not rifles and revolts, but research and relationships; not planes and tanks, but politics and technology. The new method to win the war for international chiropractic advancement and recognition will be more focused on the strength and resources of those countries where chiropractic is highly developed to help those who are emerging. The expansion of chiropractic around the world has reached "critical mass" and nothing will stop it!
Under the capable leadership of David Chapman-Smith, secretary general of the WFC, there has been evidence that one individual can make a difference. David has provided the steady and superb skills necessary to drive an emerging organization from virtual obscurity to a world-wide force. There are many others who could be mentioned, but without his determination and dedication and special skills, the WFC may not have survived.
The immediate challenge to the profession in those countries where chiropractic is illegal is summed up in a question: "What will be the standard for chiropractic?" There are some who argue that the lowest common denominator should prevail, and that emerging countries will be better off with the "worst chiropractic delivery" than the best current health care model. Others are of the persuasion that the standards should be the most stringent possible in order to preserve and protect the profession.
Each country has its particular cultural situation, and through the individual lens of each country, the world looks considerably different. Japan, for example, has a good number of DCs graduated from accredited colleges challenged by the thousands who are practicing something they call chiropractic. How is this challenge to be dealt with? There are such sharp contrasts. In many countries in Africa (excluding South Africa) chiropractic is unheard of, with only are few DCs practicing. Contrast that against the backdrop of Norway and Denmark where chiropractic is highly developed and very sophisticated. All the various models are present, from each extreme, but how are they to be dealt with?
An emerging and reasonable solution seems to be predicated upon an "educational basis" for chiropractic to emerge in any country: an educational standard that considers the reality of a sound education balanced by the needs of emerging countries with challenges that are difficult to comprehend. It is not generally known that there are more chiropractic colleges outside the United States than within. In the next 10 years, there may be as many as 20 new chiropractic colleges opening up around the world; most of them will be affiliated with a university system. Think of the explosion and expansion of chiropractic around the world in the next decade. The reality of the chiropractic explosion must be taken seriously. It may emerge as a small ripple in one third-world country, but result in a tsunami in another.
The agreement of an educational standard is critical, and some comfort can be taken in the knowledge that the U.S. colleges and those CCE-affiliated colleges around the world appear to be talking, planning, forecasting, learning, cooperating and sharing information so that the basis of chiropractic around the world will have an educational perspective and a sound underpinning for global recognition.
The conference in Paris demonstrated the manifestation of another phenomenon: the emergence of the obvious sophistication of chiropractic research and researchers. How well I can remember when the first WFC conference could not produce enough papers to truly warrant competition. This conference produced 180 papers worthy, of publication, and the judging of the "best" research papers was a difficult task.
Research has truly bonded this profession, so often steeped in controversy at many political and philosophical levels. Research has become a common ground for all to stand upon, recognize, and support. How proud the profession should be when we think of the paucity of research we could present at the 1975 NINDS conference. Today under the leadership and guidance of Scott Haldeman,DC,MD,PhD, we can proudly hold our own in any forum. Dr. Haldeman, chairman of the WFC Research Council, has provided the leadership in the world of research. He can proudly wear the title he was given at this conference: the "father of chiropractic research."
The chiropractic profession is blessed with many fine researchers dedicated to advancing the profession with the building blocks of sound research, and leaving an indelible imprint forever on the DNA of chiropractic. While we will still have challenges in the profession, we are truly armed with information gleaned from sound reliable research from the fertile minds of our research community. This data will enable the profession to forge new alliances and alter the direction of the health care paradigm forever.
The educational community has provided the string to arrive at a common bond of understanding; the research community has tied the string that has united the world. The political organizations are taking this newly created information and, through the efforts of an organization such as the WFC, delivering it to whomever and wherever it must go. The profession has emerged and matured to a level where we recognize that no segment can operate independently, but rather we are truly interdependent and interconnected by much more than information, education, politics, and friendships, we are "connected" by the special bond and camaraderie that transcends languages, cultures, affluence, status, and personality. It is the love for chiropractic that bonds us together irrespective of countries.
In closing, there are many who have worked hard and I do not mean to slight any of them, and to mention any of them all would certainly omit someone. Leaders who are involved for the global good do not seek individual recognition. In the quiet moments of self-reflection they feel the inner glow of personal satisfaction of having been a part of something far greater than they ever could imagine. That is the true essence of leadership and greatness: doing what motivates the soul and drives the desire, for a goal that is significantly greater than any able to be achieved alone. We are blessed in chiropractic with many who share the vision and recognize the interconnectedness of each of us to the profession we have chosen.
We in the U.S. are in the midst of challenges. We will continue to emerge, grow, and succeed as we have done in the past. We can take solace in the slogan of this conference: Vive la Chiropratique! From all indicators, it will.
Louis Sportelli, DC
Palmerton, Pennsylvania
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