Chiropractic Health Care in Samoa
by David R. Hobbs

In January 2004, I was contacted by a fellow-Rotarian, Marco Kappenberger (President of the Rotary Club of Apia, Samoa), regarding the feasibility of establishing chiropractic as part of the health care system in Samoa.

Currently, there are no chiropractors in Samoa and no legislation for the registration of chiropractors. There is a huge need for chiropractic services: the population is 180,000 with 400-500 expats. Many have experienced the benefits of chiropractic; members of the Samoan World Cup Rugby team have received treatment in Australia and in fact, patients sometimes travel to New Zealand for treatment.

When the Rotary Club of Apia and my club at Tweed Heads South became “twin clubs”, there began an exchange of ideas on how the two clubs might co-operate; hence President Marco’s request for assistance.

I made arrangements to travel to Samoa with Margaret (my wife and practice manager and also a Rotarian) for a week in April with the aim of assessing the need and, if appropriate, assisting in the introduction of chiropractic as an integral part of Samoan health care. In the meantime, I sought support from my fellow - chiropractors and the universities.

Barry Draper, Co-ordinator of International Chiropractic Programs at RMIT (Melbourne), began investigating the prospect of training Samoan chiropractic students at RMIT, and we discussed methods of accessing funding for scholarships. Barry also expressed interest in sending a pioneering team of final year chiropractic students with a supervisor to Samoa later this year to gain clinical experience and to introduce chiropractic to Samoans.

To gauge the interest of Australasian chiropractors wishing to participate in this history - making initiative, I submitted a short article for publication in the March issue of COCA News (Newsletter of the Chiropractic & Osteopathic College of Australasia). The response was extremely enthusiastic. Chiropractors responded from many areas in Australia and New Zealand, eager to practice in Samoa should our visit be successful. Roger Engel, Director of Clinics at Macquarie University (Sydney), proposed sending a supervised undergraduate team of chiropractors to work in Samoa for a few weeks.

With this encouraging support, we visited Samoa with several major objectives:

1. To ascertain the need for chiropractic in Samoa.
2. To meet with relevant government authorities to discuss the introduction of the necessary legislation for the registration of chiropractors. Before our departure, a suggested format for such legislation was prepared by Barry Draper.
3. To investigate the feasibility of sending Samoan students to study chiropractic in Australia.
4. To locate a facility where chiropractors could practise.
5. To establish, in conjunction with our Rotary colleagues in Apia, a facilitating committee to oversee the ongoing development of the project.

Before our arrival in Apia, a number of important appointments had been made by our Rotary colleague. He accompanied us throughout the week, assisting with introductions and cultural advice and attending every meeting.

Meetings and discussions were held with traditional healers, general practitioners, specialist medical practitioners, physiotherapists, and hospital administrators. All openly welcomed the prospect of chiropractic in their country, supported the legal recognition of chiropractors, and embraced the concept of Samoan students being trained and registered as chiropractors. One medical doctor expressed his frustration at having patients in need of chiropractic care which is simply not available at the moment.

Dr Stanley Dean, Director of Clinical Services at the National Hospital, is very keen to have chiropractors working in the hospital and has made the physio department available. He also supports the formulation of legislation to register chiropractors. In addition, he suggested advertising for Samoan B.Sc. graduates interested in gaining B.Chiro. in Australia. Dr Emosi Puni, Medical Director at Medcen Private Hospital, is very much in favour of chiropractic registration through legislation, and has offered his facility for chiropractors in private practice.

A brief meeting with the Dean of Health Sciences (Nursing) at the University resulted in a suggestion to find current B.Sc. students who could be interested in completing a B.Chiro. qualification in Australia.

Fruitful meetings were held with government ministers (the Minister of Education, the Minister of Health and the Minister of Revenue) and an advisor in the Attorney General’s Department. They were grateful to receive the suggested format for their legislation and to peruse CV’s we had received from several chiropractors. Government officials enthusiastically supported the future introduction of legislation and agreed that the provision of chiropractic training for Samoan students in Australia is a key to the ongoing success of the program.

Many of these people have experienced the benefits of chiropractic and are eager for a chiropractic clinic to begin. I spent one afternoon in the physio department at the National Hospital giving complimentary chiropractic care to many local business people and government ministers. Samoans are looking forward to the time when chiropractic is available on an ongoing basis allowing for continuity of treatment.

My presentation, “Chiropractic Health Care in Samoa”, received wide support from members of the Rotary Club of Apia, and attracted excellent positive press coverage.

Before we returned to Australia, a facilitating committee was formed comprising a Samoan physiotherapist, a Samoan traditional healer and two Rotarians: a lecturer at the university (Secretary of Rotary Club of Apia) and President Marco Kappenberger.

The role of the committee is to nurture the project to ensure its ongoing success and to act as a liaison between all interested parties.

There is still much to be done: for example, co-ordinating a roster of students and qualified practitioners to provide ongoing care, and working towards the goal of providing chiropractic training to Samoan students. We will be maintaining contact in Australia and New Zealand with all participating universities and chiropractors who have expressed interest in “Chiropractic Health Care in Samoa”. We plan to return to Samoa for a short visit later this year and in the meantime we will maintain contact with members of the facilitating committee, hospitals, universities and government officials in Samoa. Following our report to our fellow - Rotarians at Tweed Heads South, the club has recognised the need for a new Ultrasound unit for use in the physiotherapy department at the National Hospital and intends to make a donation of such a unit.

One the keys to success in this program is teamwork. Traditional healers and medical practitioners are looking forward to accepting chiropractic as an integral part in the Samoan health care system. This co-operative welcoming attitude should lead to a smooth transition for the introduction of chiropractic. To nurture this ideal environment it will be important to work together in mutual respect - traditional healers, chiropractors and medical practitioners - for the benefit of the Samoan people.

The economy in the villages is generally poor, and villagers usually consult the traditional healer first and only go later if necessary to the hospital. Traditional healers are highly respected throughout Samoa; their art has been handed down from generation to generation. Samoans are very proud of their cultural heritage and in general we found them devout, religious, friendly and gentle. The Samoan national motto is “Samoa is founded on God” and there are many church buildings. The weather is warm, the pace of life is slower.

To Australian and New Zealand chiropractors planning to work in Samoa: get ready for the experience of a lifetime!

David R. Hobbs
1 McAuleys Road, Terranora NSW 2486 Australia
(07) 5590 5509 Email: mardi13@bigpond.com.