Guest post by Dr. Nardine Bekhit
For the past 12 years, Canadian Memorial Chiropractic College (CMCC) has organized an Outreach Abroad program for 4th-year students (clinical interns). The program is guided by Dr. Patricia Tavares and Dr. Les Wiltshire who select 12 students to travel with them to underserviced areas of the Dominican Republic and provide free chiropractic care.
Every year, Dr. Anulfo Lopez (a local medical doctor in the Dominican Republic) gathers volunteers/translators, arranges food and accommodation, and plans a new itinerary for the students’ stay. This year, we treated patients in eight cities: Tenares, Las Guaranas, Castillo, Puerto Plata, La Vega, Villa Rivas, Arreosa, and Francisco de Macorix El Cercado.
As we waited for our flight to Santiago, Dr. Tavares gave us a crash course in Spanish – a welcome distraction from our apprehension about leaving our comfort zone for the next 12 days. The morning after our arrival, we donned our scrubs, fueled up on a traditional Dominican breakfast and got on the bus to Tenares, our first treating location.
The first day challenged us – we had to quickly adjust to a new climate, language, and clinicians. We arrived to find patients already waiting with completed intake forms. They had been informed about our services and the type of conditions we treat. We unloaded our portable chiropractic tables off the bus and got ready for the learning curve ahead of us.
We worked at a very different pace than we were used to at our Toronto intern placements. After a focused history and physical to determine whether the complaint was mechanical and to rule out red flags, patients would typically receive soft tissue treatment, joint mobilization and spinal manipulation. It was often difficult to get patients to focus on one chief complaint as most had jobs involving physical labour, like construction or housework, so they had multiple areas of pain.
We saw various neurological and rheumatological conditions that had musculoskeletal implications – Parkinson’s, post-polio syndrome, polymyalgia rheumatica, to name a few. Sometimes the best thing we could do was connect them to Dr. Lopez for referrals to specialists. In such remote areas, we had to rely on our most important tools: our hands and our knowledge, to provide the best possible patient care.
We had much to learn from our clinicians. Whether en route to a venue, or before and after our treating day, we were eager to absorb their knowledge and expertise about orthopedic testing, palpation, and adjusting technique.
If I could summarize the trip in one sentence, it would be: chiropractic boot camp.
By the last treating day, every intern noticed a drastic improvement in their diagnostic and treating skills from the volume of intensive practice we experienced. In total, we saw 770 patients of all ages, and from every patient encounter we took away something that would shape our future careers as clinicians.
We got to see that we can have a very real impact on a person not only through our craft, but by simply listening to their story – how their pain started and affects their ability to function, and showing them that we care.