Humanitarian Work
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Osteopathy Without Borders: Mission to Pakistan
A Memoir: To the Karakoram and Back
I’d spent a lot of time travelling through India and some time working there as a volunteer osteopath in an ashram. I’d gone to Kenya on a voluntary humanitarian medical expedition. I was looking for more. A combination of the two, perhaps; something that rang true to me osteopathically, geographically, spiritually. I forget how I found Osteopathy Without Borders, possibly via an internet search. It is a foundation that was set up eight years ago by Sylvie Erb, an osteopath from Switzerland who works in NYC. Sylvie went trekking for seven weeks in the Karakoram, a large mountain range spanning the borders between Pakistan, India and China and decided to take osteopathy to Pakistan. This was for reasons that remain: it is a country that can benefit greatly from a holistic medical practice which enables a community to be treated sustainably by using manual medicine. All that is needed are a skilful pair of hands with mindfulness behind them and a place to treat; ideally a treatment couch and pillow. Treatments remove restrictions to the inherent healing capacity of the body, thereby forgoing the need for continued allopathic/pharmaceutical input which serves to address symptoms yet not what might be considered (the tissue at) the root of the disturbance. (See Appendix for a description of osteopathy and cranial osteopathy) The reason I was drawn to this organisation more than some others is that its mission includes teaching and training students and existing healthcare practitioners to become osteopaths. This truly takes osteopathy to Pakistan. It will enable people to live and work in the rural areas they are from, maintaining and serving communities. Villagers will therefore receive profound medical care without travelling for days to the nearest city. (See ‘Links’, Osteopathy Without Borders). And so it goes, eight years later I participate in one of their missions.
I flew from London to Islamabad on the 15th August 2014. A stopover in Dubai enabled me to update myself with the perennially volatile situation in Pakistan. The Foreign Office had warned against travel there and all but essential travel to Gilgit-Baltistan and the KKH (Karakoram Highway) - both of which were on our schedule. As is (perhaps) always the case, the vagaries of foreign travel are more unnerving when the territory is unknown to you; infinitely more manageable when there or with those whose lives go on, whatever political rally exists ‘down the road’.
I was greeted in Islamabad with a sign saying ‘Kapy Peasdie’ and picture of a flower (a very important detail at times like this - foreign airport, 2am), whisked through customs and baggage claim by this smiling local and gathered into a waiting jeep. I suddenly found myself, curiously happily, sitting in a jeep with a driver who doesn’t speak English, hopefully driving to my destination. It was a luxury compared to the manifold times i’d arrived alone at various airports around the world, only to have to find a reputable taxi, make it safely to a reputable guest house (there was always a chance of being taken on an excessively long route or even somewhere else, when in a public taxi) and be let in, to hopefully find water clean enough to wash in and a bug-free bed. The next moment my bag was carried into a secure house (I noted a pair of polo boots when walking downstairs to further my intrigue), had showered and collapsed in a very comfortable bed and was asleep before I could wonder as to the view behind the double doors. Islamabad.I was woken at 11am and made my way to the kitchen to find two Asians and a Pakistani which was slightly confusing as I was looking for a tall, blonde Swiss lady. I thought I was in a guest house and so wandered into a few other rooms which were all empty before realising these people were probably something to do with the mission. I found out they were two of the Montreal osteos., Sheryl Hoo and Faisal Naqvi, and the other was family. It was the family house of Aleema Khan’s sister-in-law. Within minutes, I felt an overwhelming sense of relief that they speak the same (osteopathic) language as me. It could be said that we are all talking about a dance. Not about addressing musculoskeletal structures to address pain but to release restrictions, torsion patterns, tensions and decreased motility and so, concomitantly, habits and limited views of self and existence in the world. We can help someone prepare for surgery or recovery post-op. and we can address low back or neck pain but we undermine osteopathy by limiting ourselves to using that as a description of what osteopathy is/does. ‘The Dance’ is the patient/practitioner exchange that occurs when, for me, all factors align for healing to occur in a way that transforms, or we may say ‘returns’, the patient to a state of health. Arguably, this occurs after all treatments. However, this is achieved with love and a sense that we connect with a universal oneness so omnipotent and beautiful that many factors interplay and healing occurs. Joy for all.
‘Reality is in the observations, not in the electron.’ - Heisenberg
‘Physical concepts are free creations of the human mind, and are not, however it may seem, uniquely determined by the external world.’ - Einstein
The beauty of it is not all osteopaths would agree with me. This is because it is an art and a science which allows, even demands, the practitioner to draw on all their resources when diagnosing and addressing the tissue looking for health, in that moment. This is why one osteopath may see the primary lesion differently to another.
Back to the trip. We waved farewell to our hosts and the first of many friends we’d make and set off for Lahore, a four hour drive in a huge, luxurious, white jeep. This flew by due to the jovial nature of the jeep’s inhabitants, the intrigue of getting accustomed to each other and, though driving along a highway, the view into the fields was mesmerising, intriguing. There were field workers cycling home in the dusk light along the banks of waterways, flat-roofed dwellings, children playing. How I wanted to wander there, head covered to achieve anonymity, absorbing life and the mundane of this new land.
Within the group, we accumulated examples of what we termed ‘full circle’. This is when (and it occurs mostly in the developed world or amongst higher educational status) a lifestyle, state of mind or even habit, reaches a point where it is not only elevated beyond what may be considered the level of socioeconomic status, awareness or level of comfort but yet transcends that to return to its original context. An example of this may be junk food. When travelling in developing countries (defined as countries where, on average, people have lower life expectancy, less education and less money (income)), (and we observed this in Pakistan) some see eating junk food as elevated beyond simple, local, sustainable food of, e.g. rice and dhal. (And in many ways it is, as it is not readily available unless you travel to a larger town or city). To come full circle would be to realise the negative health and ecological impact of eating processed and packaged food and return to simple and local produce/methods.
Another example of full circle is how white skin is coveted. In many parts of Asia, whitening creams and avoidance of the sun denotes a city or desk job as opposed to working in the fields which would lead to brown or lined skin and therefore a sign of lower socioeconomic status. In the west this may denote working too hard in an office and not having the time or financial gains to support taking time off or a holiday in a sunnier climate.
A further example may be to open a boutique hotel up in the mountains rather than an eco lodge. The former would serve a 1% elite population, whereas the latter a conscious, informed and aware traveller who wishes to help sustain local ecology and economics. This is commonly termed ‘cradle to cradle’. We are, of course, privileged to even observe this phenomena, and, for many, accountable for the purchase of the latest status symbol. “We see that a lot of what we thought was true – that you had to work 24/7 to succeed – is not true at all. New scientific findings show there is no trade-off between accomplishment and having time to unplug, recharge and renew ourselves.” - Arianna Huffington.
We arrived in Lahore and settled into the home of Sohail and Aleema Khan, exceptionally welcoming hosts. Shanzé, their daughter-in-law, made us comfortable in the city over the week. An introduction to Khaadi (a fabric/clothing shop with the idea of reviving the craft of handwoven fabric) was a hit of downtown Lahore which Faisal could probably have done without, third visit in. An ice-cream and exploratory debate about religious practice sufficed to cool any shopping trauma.
The groundwork done, I was privileged to be a part of the team treating and teaching in hospitals in Lahore; many of the doctors and dignitaries at one with our methods, having experienced previous years’ results. We spent time discussing a part-time osteopathic course in Lahore to teach existing medical practitioners osteopathic techniques. This involved discussion with many powers that be; all interesting and helpful opinions regarding regulation, teaching, duration, students, finance, etc. etc. We treated a number of them so they can talk passionately about osteopathy, having experienced it for themselves. Treating on the wards was less similar to and sometimes more rewarding than treating at home, for me. It is osteopathy as it was; osteopathic medicine. Once a practice is well-established in the west, people present with medical conditions. Until that point, most patients present with musculoskeletal injuries, pain or restriction. This is basically the most gross, late-stage level at which we can address an issue, compared to maintenance or preventive. It is just as valid, of course, as all is relative to the person’s needs at the time. It can be more beneficial than treating pathologies as, if symptoms are addressed when in the early stages of development, disease can and is prevented. If addressed when a pathology has developed, more treatments are needed.
I treated a 28 year old female admitted for fever (which she’d had for five months) and bilateral leg pain. She was underweight. Her PMH (past medical history) included TB granuloma right buttock, kidney transplant (left) one year ago, amenorrhea six months. She was recently experiencing a frontal headache, shaking and numbness in the hands. When treating, I found scarring around the left kidney from the transplant, decreased expression of the cranial rhythmic impulse through the left clavicle, right foot and hip and throughout all cranial bones. I addressed these areas. Post-treatment, this patient sat up, felt better overall, her eyes were bright and her temp. had decreased by one degree. Further follow-up would enquire of the other symptoms inc. leg pain. Treatments often take a couple of days to unfold as we address deep connective tissues, largely at the fascial level (rather than purely musculoskeletal, the results of which would be quicker to manifest though not always permanent).
A 21 year old male was admitted with infective endocarditis, cerebral malaria, congenital heart disease, aortic stenosis, typhoid fever, cough, weakness and diarrhoea and vomiting for two weeks. He had been prescribed three types of antibiotics, paracetamol and NSAIDs (3% of 18-44 year olds experience diarrhoea after two weeks of antibiotics (due to an overgrowth of C. diff.)). Probiotics can be of use; these were not given/available. After treating him at the level of the primary respiratory mechanism (see Appendix), serving to release restrictions to the inherent motility of all structures in the body, this patient, who had been bed-ridden, got up and went for a walk outside. We saw him, when we were leaving, having a mango juice in the courtyard - wonderful!
‘The side effects of osteopathy are improved health.’ - Sylvie Erb
We saw many cases of road traffic accident injury in the orthopaedics wards, 99% of fracture admissions there, including some amputations which could easily have been avoided with appropriate nutrition, sanitation and osteopathic care to remove other somatic dysfunctions in the body inhibiting the immune system from focusing on the area concerned.
There was an alarming case of an eight year old girl who presented in a state of physical prostration/intermittent temporary paralysis from the waste down. It was revealed whilst there that her father, dumb and mentally retarded, had taken her to what may be described as a witch doctor in their village two months prior for a fever that did not subside. This ‘doctor’ physically and sexually abused her. She had not spoken since and had intermittent paralysis. When I first saw her, she was rigid, wrists flexed, right knee slightly bent to cover her left leg, upper lip over lower and looking out of her eyes without turning her head. On treating her, I found low amplitude PRM SBS L side; locked R side; zygomae locked, neck musculature rigid, sacrum nutated, solid-feeling and hot. She had experienced vomiting for five days and fever for two months. No external bruising had been present, though there were scars near her mouth which someone on the ward said was a result of the abuse. I engaged with her cranial rhythm as well as possible and was able to access a certain inherent movement. I released off areas of restriction via the PRM. Post-treatment she had relaxed significantly and was lying straight without guarding her pelvis and had improved eye contact. This was a case which needed a number of follow-up treatments and, for me, the frustration associated with the circumstances was immense, especially as there was clearly no likelihood of the family being able to make a change to the social circumstances.
After a week in the cities, I felt claustrophobic. We were privileged to be driven everywhere and to receive overwhelming hospitality. However, I craved to be outside, to explore and to see the real Pakistan, it being my first trip. My prayers were answered when Sohail picked up on this and whisked us away to the city for some exploring. Why such joy? Such simple measures. I think it was the first time I felt i’d lay down my hat in Pakistan - observing street life and joining in the custom of the (elite) locals (but locals nonetheless). I’d for a long time been intrigued by Pakistan as it is, essentially, the same land as India and that is the country I have felt most connected to at heart. And so why would Pakistan be different? Same geography, food, climate, genetics, pastimes, geology… Indians would say they gained independence from the Brits in ’47; Pakistanis would say they gained independence from India. And so there is a divide and it is a religious one. Why else was a line drawn through the country separating Hindus and Muslims over 60 years ago? The divide lives on, interestingly, and it doesn’t feel like purely a religious thing as that’s not what draws me to India and keeps me returning. Adeney (2007) demonstrates that institutional design is the most important explanatory variable in understanding the different intensity and types of conflict in the two countries rather than the role of religion. Adeney examines the extent to which previous constitutional choices explain current day conflicts. Unger, B. (1999) suggests ‘India's multi-layered culture has a literary and religious history stretching back to the Rig Veda, written about 3,000 years ago; Pakistan has that, plus a national commitment to Islam. These traditions blended and clashed and bumped into others, producing achievements and sensibilities shared with no other part of the world. The last thing India and Pakistan want is the sort of normality that would wash their civilisations away.’ In his recent, long-awaited opus, Oborne (2014) describes Pakistan’s ‘uncanny ability to produce moments of unexpected genius—including dashing tail-end partnerships. In at least two important ways, Pakistani players changed cricket: by reinventing wrist-spin and inventing, in reverse swing, a new fast-bowling art.’ Oborne goes on to say that ‘None of these achievements have been fully appreciated. Perceived as an awkward, sometimes aggressive, threat to cricket’s erstwhile-white custodians, Pakistani cricketers were often viewed with suspicion or disdain. Too often, it must be said, they invited this; corruption, including bent umpiring, ball-tampering and, more recently, the blight of match-fixing, has been increasingly evident in Pakistani cricket, as in Pakistan.’My personal comparisons aren’t paralleled as my experience of India is as a lone backpacker. How could I not meet people when travelling alone - on trains, buses, bikes, walking through bazaars, entering temples? Yet, here I was, being driven around, from post to post and on a mission, as an osteopath. I am thankful for this opportunity, for i’m not sure travelling through Pakistan would be easier than India, as I was told at the high commission, London. The streets of Gilgit were 98% male; the 2% female a couple of elderly ladies. I experienced no aggression when in Pakistan but was never alone or separate from the group. Overwhelming hospitality flowed everywhere we did, whether transportation or dining; openness or purity of heart. I don’t think it would be ideal to do humanitarian work any other way unless the mission was over a much longer period of time in which it would be possible to embrace the vagaries of basics such as travel and food. ‘Private transport. I could grow to like it. This jeep wasn’t going to break down. Ibrahim wasn’t going to lay his head on the steering wheel and declare the jeep khatam, finished. If I wanted to take a photograph, or go behind a rock to pee, a simple word was all that was required.’ (Jamie 2007, p.239)
Our work done in Lahore, we set off for Islamabad from where we’d fly to Gilgit and embark on our work in the mountains. En route it was suggested we go straight to the rally… Two days before we flew into Pak., politician’s inc. Imran Khan rallied against the embattled prime minister; a revolt against the state. Our hosts in Pak., closely related to Imran, took us to treat him and a few other dignitaries present. When treating him, I was surprised how a person with such weight on his shoulders - the pressure of overthrowing the government of Pakistan- could be so open and genuine. He was in great need of sleep (having got just an hour the previous night, nervous system heightened) and got 11 hours immediately after the treatment. I was happy it was of such benefit, though we as a group debated whether it was worth the whole team being tired for a day or two afterwards due to losing a night of sleep. It’s also debatable as to whether we should be seen to ally with any political party as humanitarian healthcare workers. Our name ‘without borders’ translates through all levels of society, inc. religion and politics. The city was busy and many access roads were blocked with shipping containers. We weaved our way in and through the check points with Sohail’s unwavering stare. I don’t know how we managed to get through other than with the power of the universe and sheer confidence. The area of the rally was heaving; approx. 20 000 in the immediate vicinity. Imran was on top of the container in which he was staying, at the focal point. We made our way through the crowd. Faisal was at the back, keeping an eye on us. He didn’t get through at the barrier into the women’s area - three guys descended (or ascended - he’s over 6’) on him. At first he pushed harder then, with complete presence and love, touched the back of one of them and looked him in the eye. They, along with Sohail’s words, let him through. We hung around outside the container. The atmosphere was energised and electric; an exhilarating experience to be near the forefront of a charged crowd and barely able to hear each other. Women and children were in the immediate, fenced area; the rest of the crowd reaching down Constitution Avenue. Realising Imran was planning his next speech and not ready for five hours, we decided to leave and possibly return later, first getting a better view of the proceedings from the nearest hill. History in the making. A remarkably calm crowd, considering the plight and the numbers. We grabbed some food, a nap and returned when things had calmed down a little and the action was more or less over for the evening. The crate was shabby - I couldn’t believe a politician could stay in such circumstances for so long. David Cameron wouldn’t have lasted five minutes! My eyes were streaming- fumes from the generator; tissue was stuffed into a hole where the door handle should have been; stale AC air and a great lack of the feminine. There were two large, frame photos of Imran; one from behind, also addressing a huge crowd. In hindsight I should have treated Shershah (his nephew) as, though the treatment was hugely beneficial, Sylvie and I treat differently so it was not easy to work together with someone for the first time and under such circumstances yet remain autonomous and so my efforts would have been more focused elsewhere. From the rally we went to the airport.
I had felt it a challenge to remain focused on the task at hand, until we got to the mountains where my prayers were answered.
We flew to Gilgit airport, many factors aligning to land, i.e. getting tickets for seven on a fifty-seater plane and suitable weather conditions to both take off and land. We flew at an altitude lower than the mountains; sharp, arid peaks on one side, snow-bleached on the other. I felt relieved and exhilarated to be rid of the confines, pollution and pace of the city. Such serenity when I stepped foot outside of the airport I felt like crying. A huge billboard of master polo players on their horses greeted us.
A jeep took us to PTDC Gilgit, a colonial affair with lawns, roses, white-painted iron furniture and the spectacular guard of the mountains behind. The rooms simple, we recovered from a sleepless night (due to the rally and flight) then took off in a jeep for Nagar via Gilgit market for supplies, Chalt and Karimabad. We stopped off at Rakaposhi peak (7788m) and glacier 11km away, the highest unbroken slope on earth. The cool air streamed down the mountain. I paddled in the icy waters of the stream - so cleansing, reviving. We were blessed with an auspicious rainbow.
We snaked up from 1800 to 2500m, along the Hunza River on the (in)famous KKH, passing lady finger (mountain peak) then finally turning off for Nagar Valley.I remember looking back along the road, the valley, the gorge, with increasing awe for wilderness, expanse, sparsity of inhabitants. I wondered where people walking along this stretch of road with nothing for miles came from, what they did and where they were going. Did they walk it every day? Did they sleep on the side of the road as many workers did? ’The problems for a woman traveller are largely offset by the advantages, save in this quarter. Toilet facilities are nil, especially on journeys. You may wander among the roadside boulders, among the evidence that you are not the first to seek privacy there, but such is the interest aroused by a lone woman, she is never left alone…Islamic women, like Victorian women, don’t shit.’ (Jamie 1992, p.164)
We passed light-eyed children on the roads before arriving just before sunset at the palace where we were to stay and treat for three days. Views of Golden Peak welcomed us, aptly named as the peak turns a golden hue as the sun sets over the valley. Apricot, apple, pear and mulberry trees dappled the light entering the palace grounds. We were greeted by Prince Qasim, a fashionista, eccentric in the circumstances; his mother Princess Rahat; Ibrahim an old friend of Sylvie and mountain guide and many children and helpers- such warm welcomes, I felt at home at once and very thankful to be there.
‘I left the men in the jeep, and walked just a few yards across a boulder-field. A high, cool wind played about me. Three or four hundred feet below was the thin turquoise band of the river, weaving between snow-covered sand-banks. Upstream, on the shelves of fertile land between the mountainsides and the river, were villages. There are words we reach out for out of habit, like desolate, bare, barren, colourless, but these are not true. There were colours, but subtle, just a breath of pale blues and snow-greys, a smudgy brown denoting a village at the riverside. Above the river and villages, mountains slammed upward, young, hasty, sharp-edged. Now and again the summit clouds parted and an impossibly high jagged fragment of rock and snow seemed to float all on its own. But for the wind, all was silent.’ (Jamie 2007, p. 239)
Treating in the grounds of the palace was the most idyllic setting I can imagine. We set up day beds on the grass, under the apricot trees, surrounded by children, sheep and the towering peaks of the Karakoram range, the highest concentration of peaks over 8000m in height to be found anywhere on earth, including K2, the second highest peak in the world 8,611 m. The air was clean, warm and there was a stillness that centred my whole being. As a group, we created a wonderful vibration which meant what we could palpate was enhanced by treating together, rather than alone. There was a continuous stream of patients - old and young, acute and chronic. We had to triage to some degree as, because we would only see most (if not all) of them once, we had to choose those who would benefit most. More chronic cases, found in older patients, generally need a handful of treatments to continually reinforce optimum function. The majority of children here in the valley experienced, as babies, a practice which serves to flatten the back of their heads. This is a sign of beauty there. A fabric band is used to prevent expansion of the cranium. As a result of this, we saw endless cases of diarrhoea (due to irritation of the nerves which exit the skull and supply the gut), fever and headache (poor drainage of the head and neck), dizziness, respiratory conditions and generally poor CRI due to this restraint at the base of the cranium. Some children coped with it better than others - due to many factors such as the birth process, diet, water, sanitation, etc. Overall we were able to successfully release off the restrictions to the free movement of the cranium and other parts of the body affected as a result.
Evenings at the palace were spent having dinner together with the family and any guests. In general in Pakistan, meat was offered as a sign of great hospitality, though three of four of us are vegetarian so we enjoyed rice, chapati, dhal and vegetables, often followed by a huge bowl of fruits such as mango, grapes and melon. We spoke of our mission to introduce osteopathy to Pakistan, plans the prince has for the valley, sustainable practises and many topics, all as if we were part of the family. Such a joy. One evening after supper, Faisal, Qasim and I sat under the stars; the milky way and spoke of Islam. This really opened my eyes to something practised by millions and berated by as many. It is intriguing to know the impetus behind certain ways and whether they come from a practice or a belief. I am sure there has to be a practice with basic principles for all to progress and grow in a way that unites, rather than divides. I learnt so much from Faisal, feeling non-judged, accepted, supported and sharing a wonderful, child-like sense of humour.
‘This Milky Way; in Burushaski language, we say :Charkay Palash’; it means ‘turn the world’. These Burushaski people believe that it is the power of this Milky Way that turns the world round.’ (Jamie 2007, p.102)
Whilst in Nagar, we also treated at two schools. A stunning, high altitude walk took us up to one. As we climbed through villages we saw workers threshing their crop- hitting sheafs of wheat to separate the grains; apricots drying on woven platters-flashes of bright orange against the greens and faded browns of the valley; goats grazing- too tightly tethered to their tree; and children playing in their kingdom- carrying rocks or each other, oblivious to the towering mountains behind.
‘The air was so clear that distance and light played tricks: greenish slopes that seemed close enough to touch were a day’s walk away.’ (Jamie 2007, p. 130)
Very cute children hid behind each other and were then dragged in for treatment for similar issues to those at the palace. They left happy. I’d love to know what they thought as, unfortunately, full explanations of what we do weren’t given, just something along the lines of a ‘western medical practice to cure disease and take away pain’. Faisal and I took to wandering back from the school rather than drive. We found such simple beauty along the way - children carrying each other, lying around while their parents worked, bird’s eye views of the 450 year old mosque, mulberry trees, crops, etc. My Hindi, phonetically the same as Urdu, did not go far in this area with local Burushaski dialect.At the second school, I treated a woman, age 25, who presented with palpitations, angina at night (1-2 years), fever, headache, incomplete inhalation, dyspnoea and a sense of choking.. She has an eleven month old baby. It is an interesting phenomenon to, as an osteopath, pick up on trauma when hands-on. Almost none of the patients we saw in the mountains or even in the cities professed to having been in a road traffic accident or other trauma. There must be some inauspiciousness to it as we certainly saw the impact of trauma where, apparently, none had taken place. I ‘knew’, in terms of suspected according to tension patterns in the body, that this lady had experienced some physical (and possibly sexual) abuse, including to the throat, by her husband or someone close to her heart. During the treatment, I focused on integrating the core link (Frymann 1968). This patient’s tissues released off very well, she took four complete inhalations and appeared much more centred.
The emotional and the physical are two side of the same coin.
Three days later we (at least I) reluctantly left the palace to head back to Gilgit. The jeep journey to Gilgit was a lot of fun. We stopped at Karimabad for a short stint of shopping. If i’d appreciated it would be our only chance i’d have bought more. It’s always an issue that anything seems extortionately expensive compared to what one spends on basics such as food, etc. but, when you get home, you spend the same on a weekly shop as you may have on a beautiful woollen rug to use for life. I, however, bargained (with great help and translation from Faisal - a priceless advantage there) for a string of rubies.
The view from Karimabad is shared with The Baltit Fort. The weather was misty and wet. This created an eery shadow behind the mountains as we glanced back and over the Hunza river. Journeys in such surroundings present one memorable image after another, opening the heart a little further.
Faisal and I treated children at The Aga Khan Medical Centre, Gilgit. One patient was a boy aged two who had fever and diarrhoea. His right lung was full of crackles on auscultation. I treated the lung, diaphragm, sacrum and movement of all cranial bones, leaving him with a far greater sense of inherent motility throughout the CRI.
A six year old boy presented with whole body itching, generalised weakness and anorexia for 3-4 months, also fever and lethargy. On examination his right hip, liver and frontal bones were fixed. I released all, leaving him with greater vitality and sitting up, alert. The space we held at that time may be termed, ‘the dance’. A treatment of ‘being love’. I gained energy from it. Faisal’s patient’s head looked more round at the end of it! That day I gave two of my best treatments.
’There is only the dance.’ - Eliot
The next day was spent at Sehhat Hospital, also in Gilgit. My most memorable case there was of a seven month old with urinary retention. He had a history of seizure and meds. and an inability to latch on to feed, congenital onset. He had been circumcised six days prior, apparently due to urinary retention though I couldn’t believe any medical professional would think circumcision would cure urinary retention so perhaps it was a communication/lost in translation issue and the procedure had led to the retention. I found pressure around the pubis, the prevesical fascia and the diaphragm. There was a huge amount of tension in the lungs/pleura and in decreased motility in the frontal bones of the cranium. All neurological tests were normal. He responded very well and all the above tissues released off fairly easily. After the treatment, he latched on to his mother to breastfeed properly for the first time. She left the hospital positively beaming.
Our time in the mountains over, we arranged our return to Islamabad. We, due to 'connections', managed to get seven seats on a fifty seater plane last minute and hoped the weather would be in our favour - the only factor out of our control, it seemed. After an evening with such welcoming doctors and heads of hospital, we managed to get some sleep before heading to the airport for the 6:30 a.m. flight. Everyone studying the skies, we remained hopeful. (Another) contact at the airport seemed positive. Then, cancelled. My heart fell to the floor as that meant a 17 hour jeep journey down. We were told it was twelve yet, seventeen hours later, we hit Islamabad. The one plane from Islamabad had not left, due to the weather, so it therefore did not arrive to take us down. My distress was due to two main things: firstly, my back. I prolapsed two discs four years ago, caused by many factors and triggered by minibus journeys on pot-holed roads on a humanitarian medical expedition in Kenya. I hadn’t done a long vehicle journey since and had a lot of fear. At the time, four years ago, I couldn’t walk and had radiations into my left foot and foot drop (i.e. sensory and motor loss). I had avoided surgery with Vipassana meditation, yoga (five weeks intensive) and osteopathy. No meds. at all. The second reason for my fear was the road. The foreign office website advised no travel on the KKH under any, even exceptional, circumstances due to threat of terrorist attack. Three months prior to the last time the group did the journey on a public bus, it had been stopped by sunnis who took all Shi'a muslims off the bus and shot them dead. Faisal’s surname is Shi'a, though he is not, and so why even risk being involved in such an event? I was eased by a very calm group who had done the journey, some a number of times, before. Faisal had treated me three times during the trip, with miraculous effect, and so I was more confident about my back than ever. After one of the treatments, I felt I was no longer fighting to stay upright comfortably in a way I hadn’t experienced perhaps since the PIVD. I also saw my feet flat for what might have been the first time ever. I had talopes equinovarus congenitally and so my toes flex, even when my feet are relaxed. This reassured and calmed me considerably. We set off.
I am thankful to have had the opportunity to take the KKH, the highest paved international road in the world. It connects China (Xinjiang region) and Pakistan (Gilgit–Baltistan region) across the Karakoram mountain range, through the Khunjerab Pass, at an elevation of 4,693 metres. Due to its high elevation and the difficult conditions in which it was constructed, it is referred to as the Eighth Wonder of the World. We stopped at Babusar top, 4100m, to meet a polo pony acclimatising to the altitude. We had a lunch stop at Chilas, the most dangerous place we could have chosen, I later discovered, known for its unkind inhabitants. We found toilet stops where very kind people allowed us to use their facilities, though we had to climb through a pitch black room where the cattle sleep to do so. We saw ancient rock carvings and followed the old silk route, still visible as a thin, snaking track up what appears to be an almost sheer rock face, with room for perhaps a single traveller and their horse. According to Neelis (2000), the earliest sources available reveal that 'Brief inscriptions written on rocks at Hunza-Haldeikish provide valuable written sources for understanding history, religion and languages during the first millennium CE.'
We spent our final, recuperative and peaceful day at Imran Khan’s house in Islamabad. Family around, dogs, inc., we enjoyed amazing hospitality, as ever, food, swimming pool, sun and cleanliness. We, at 7pm, were driven to Lahore by Sohail, our faithful friend there whenever we were in need. We arrived to dinner and farewells as the Canadian crew then Sylvie left for the airport to fly home. I spent one final day in the city, enjoying the fort and Fakir Khana museum before heading to the airport myself. I felt quite down and alone, sitting at the gate waiting to board. I looked like a local in my salwar kameez. I took to writing about my experiences of a trip that would compound my love for osteopathy and reinstate my belief in connecting with others on a level I forget can happen.
‘It is refreshing to be in a country which believes the future will be better than the past. Corruption is rife, governments are unstable and nepotistic, wealth is greedily held in private hands, but Pakistan is still an idea.’ (Jamie 2007, p.47)
‘Please wear loose clothing.’ (Jamie 2007, p.112)
Bibliography
Adeney, K. (2007) Federalism and Ethnic Conflict Regulation in India and Pakistan, Palgrave Macmillan.
Einstein, A. & Infeld, L. (1988) The Evolution of Physics, Simon & Schuster, taken from Lever, R. (2013) At the Still Pint of the Turning World, Handspring Publishing.
Eliot, T.S. (1944) Four Quartets, Faber and Faber. taken from Lever, R. (2013) At the Still Pint of the Turning World, Handspring Publishing.
Fryman, V. (1968) The Core-Link and the Three Diaphragms In: AAO Yearbook. United States: AMA, p. 13-19
Heisenberg, W. (1958) Physics and Philosophy, Harper Torchbooks, taken from Lever, R. (2013) At the Still Pint of the Turning World, Handspring Publishing.
Huffington, A. (2014) New science is validating ancient wisdom, Positive News, 16 Sept 2014.
Jamie, K. (1992) Among Muslims, Sort Of Books.
Neelis, J. (2000) Hunza-Haldeikish Revisited: Epigraphical Evidence for Trans-regional History. In Kreutzmann, H. (ed.) Karakoram in Transition. Oxford: OUP.
Oborne, P. (2014) Cricket in Pakistan: Batting for Survival, Simon & Schuster.
Unger, B. (1999) ‘A Survey of India and Pakistan: Not Cricket’, The Economist, 20th May 1999, Print Edn.
Appendix
Cranial OsteopathyOsteopathy
Osteopathy is a system of diagnosis and treatment which works with the structure and function of the body.
The maintenance of good mechanical function is essential to good health. Problems in the framework of the body can disturb the circulatory system or nerves to any part of the body, and affect any aspect of health.
Osteopaths work to restore the structure and function of the body to a state of balance and harmony, so helping the whole person.
What is Cranial Osteopathy?
Cranial osteopathy is a refined and subtle type of osteopathic treatment that encourages the release of stresses and tensions throughout the body, including the head.
It is a gentle yet extremely effective approach and may be used in a wide range of conditions for people of all ages, from birth to old age.
Osteopaths may have different specialities including sports injuries, paediatrics, and visceral osteopathy (treating the internal organs of the body). Cranial osteopathy embraces all of these.
lnvoluntary Motion- The Cranial RhythmCranial osteopaths are trained to feel a very subtle, rhythmical shape change that is present in all body tissues. This is called Involuntary Motion or the Cranial Rhythm. The movement is of very small amplitude, therefore it takes practitioners with a very finely developed sense of touch to feel it. This rhythm was first described in the early 1900's by Dr. William G. Sutherland and its existence was confirmed in a series of laboratory tests in the 1960's and '70's.Tension in the body disrupts the cranial rhythm. Practitioners compare what your rhythm is doing to what they consider ideal. This shows them what stresses and strains your body is under at present, and what tensions it may be carrying as a result of its past history. It also gives them an insight into the overall condition of your body, for example if it is healthy, or stressed and tired.
Accumulation of stress and strain in the body
When we experience physical or emotional stresses our body tissues tend to tighten up. The body may have been able to adapt to these effects at the time, but a lasting strain often remains. Any tensions which remain held in the body can restrict its free movement. Gradually the body may find it more and more difficult to cope with accumulated stresses and symptoms may develop.-taken from <http://www.cranial.org.uk/page2.html>
Links:
Osteopathy Without Borders: http://osteopathywithoutborders.com
https://katyteasdale.blogspot.com/2014/09/osteopathy-without-borders-mission-to.html
Katy Teasdale BSc (Hons) PsySc., BSc (Hons) Ost., DO, DPO
Registered Osteopath
PHYSICAL MEDICINE
"To find health should be the object of the doctor. Anyone can find disease." - A.T. Still
To view clips of the OWB team working in Nagar Valley, Gilgit-Baltistan, go to: http://youtu.be/Sre6A_Zt7Zo and http://youtu.be/9h15h3gb2rQ
Katy Teasdale is a (GOsC) Registered Osteopath who graduated from The European School of Osteopathy, Kent, UK in 2008 where she then assisted in the teaching of visceral osteopathy for two years. She also has a degree in biology and psychology (London).Katy applies the principles of osteopathic medicine to any condition and especially enjoys paediatrics, obstetrics (pregnancy and labour), gynaecology, visceral (organs and disease) and cranial osteopathy as well as classical structural work. Katy believes treating pregnant women, babies and children is one of the greatest investments to health. Cranial osteopaths use specific, skilled, light pressure applied where necessary to assist the natural ability of the body to release stresses and tensions.
Katy has lived and worked in Singapore, New Zealand and the UK and has carried out voluntary humanitarian work as an osteopath in India, Kenya and Pakistan. Katy is a qualified yoga instructor and teaches yoga therapy, asana (postures) and pranayama (breath control), aware of the importance of incorporating patient independence into any treatment regime.
