America International Development (USAID), the U.S. State Department and Canadian Forces (CF) components. The CF portion includes a technical engineer team, military police, security forces, support personnel and a cimic detach- ment. The cimic detachment is com- prised entirely of army reservists and is the primary enabling tool of the KPRT. The cimic officers are selected from army reserve regiments across Canada for their combat arms proficiency, leadership and their civilian skill set. Civilian qualifica- tions are considered to add value and increase the credibility and capacity of the organization as it assists the Afghan people and government. It is worth noting, then, that among the selected professionals – including a teacher, police officer, forestry director, information technologist, public service worker, agricultural and international relations specialists, engineer, and ER nurse – a doctor of chiropractic was considered an important choice for the team, for his/her skills and health- care knowledge. Because of Dr. Tondreau’s expertise in the health field, he was tasked to assess the health-care facilities and health-care delivery. He worked with the Afghan Health Development Services (AHDS) and medical outpatient clinics to develop facilities and improve Afghans’ access to health care. AHDS is a non-governmental organization (NGO) contracted by the Ministry of Health to provide basic health-care to rural Afghanistan. THE PERILS OF RECONSTRUCTION WORK IN RURAL AFGHANISTAN All regional hospitals are managed by the government. Medical staff are employed by the government or AHDS and, thus, are targeted by the Taliban. As a result AHDS was reticent to provide medical staff to rural Afghanistan. The lack of medical staff to those areas compounded the high infant mortality rate – which is 42 per cent prior to age five – and high incidence of infectious diseases such as tuberculosis, hepatitis, gastro- intestinal parasitic infections, typhoid and leishmaniasis to name a few. (Leish- maniasis is a dermatological condition caused by phlebotomine sandflies, and resulting in disfiguring skin lesions.) Ideally, KPRT detachments would move into areas that were secure, or www.canadianchiropractor.ca THE VALUE OF CHIROPRACTIC FOR KPRT PROJECTS On arrival in Afghanistan, Dr. Tondreau reported to the Role 3 medical facility at Kandahar Airfield. He met with the chief From left to right: Dr. Tondreau, Sgt. John Courtney, the district chief of Zharey District and his administrator. When meeting with guests, Afghans practise “pashtoon wali,” a code of hospitality that is deeply ingrained in their culture. includes food, shelter and protection from hostile forces and has been one of the reasons why the Taliban will not expose their own guest, Osama Bin Laden, to Coalition Forces. recently rendered secure by the actions of Coalition Security forces, to do reconnais- sance and assess regions for infrastruc- ture, government, security forces and standards of living. However, operating within a secure environment was often not possible. Liaison with tribal elders, to discuss issues and needs, was essential to encourage self- governance and capacity building. Priorities would be established that were consistent with both the tribal needs and KPRT policies. The tribal elders were expected to formulate plans and implementation strategies before the KPRT would support the projects. This would facilitate capacity building and ensure a sense of ownership. The intent of all these initiatives was to establish, and maintain, a safe and secure environment by extending the influence and authority of the legally elected government of Afghanistan. In some cases, certain areas are under the influence of the Taliban and a continued physical presence is required to facilitate the reconstruction efforts. In other cases, the Taliban are unwanted, and an intermittent presence with minimal supervision of projects was sufficient to maintain the reconstruction momentum. It of staff, Major Savage, and discussed providing chiropractic services to co- alition soldiers. Major Savage was very receptive and enthusiastic concerning this unexpected offer of assistance. According to the military medical community, 80 per cent of injuries sustained by coalition soldiers are musculoskeletal. Conditions predis- posing the soldiers to these injuries are multiple and exposure is daily. Carrying heavy loads, cross-country driving, restricted space in armoured vehicles, sleeping on the ground or on camp cots for extended periods of time, long work hours, rugged geography, geographical elevation, climate, combat operations, hard rations eaten for weeks at a time and the stress of being in a hostile environ- ment all contribute to spinal stress. A soldier’s basic load, which he is required to wear daily once he has left the security of the base, weighs in excess of 65 pounds. A basic load includes items such as weapons, body armour, helmet, ammunition, grenades, radio, night vision goggles, water and food. Certain patrols require the soldier to wear a patrol pack, weighing an additional 40 to 75 pounds. Therefore, it is not be uncommon to wear 100 to 140 pounds of equipment on a dismounted – i.e., foot – patrol. Afghanistan is approximately the size of the state of Texas. It is a mountainous Continued on Page 42 CANADIAN CHIROPRACTOR | DECEMBER 2007 • 11
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