December 2005

A decade of chiropractic in Russia

Russia is undergoing tremendous change, politically, economically and socially and its health care delivery system is similarly affected by these changes. In the mid‑1980s, there was growing concern on the part of officials and the public over the serious decline in the country's health and the low quality of medical services available to the general populace.

Reforms in the 1980s called for eliminating over‑bureaucratization of medical services, improving medical training and salaries, expanding fee‑for‑service care, and significantly increasing funding to improve the quality of health care nationwide. The '90s brought with them a tremendous struggle as some aspects of health care delivery began to enter the free market. As Russia undergoes this metamorphosis in health care, chiropractic is there as an integral part of this change.

Nearly 10 years ago, a prominent Russian businessman received a life‑changing adjustment from a chiropractor in the United States and decided to share the miracle of chiropractic with others in his country.

In a letter to his partner in Russia, he wrote that the goal of the project would be to send chiropractors to Vladivostok "to train the Russian counterparts and cure the sick people."

Matthew McCoy, DC, was selected as a key player in the project and, for two years, lived and worked in Vladivostok to make the chiropractic convert's dream a reality. "Reading his letter excited me more than you can imagine," he stated. "He had a keen sense of the potential chiropractic held for his people, and throughout the project he has remained committed to the goals which were originally discussed."

One of the project's goals was to build a world‑class chiropractic treatment, teaching and research center in Vladivostok, to serve the people of Far Eastern Russia and attract patients, scientists and clinical experts from around the world. It took years of hard work, but Dr. McCoy and his colleagues in Vladivostok more than met those goals.

McCoy coordinated the entire project, including selecting a location, building the clinic, acquiring equipment, training staff and caring for patients. Because of these efforts the first chiropractic treatment, teaching and research center in Russia's history has been fully functional for nearly a decade.

The Regional Center for Chiropractic ‑‑ Spine ‑‑ is located in the Primorski Regional Diagnostic Center in downtown Vladivostok. Vladivostok, the largest city in the Russian Far East and its capitol, is located in Primorski Region and is ideally nestled between China, Korea and Japan.

The largest and most developed of the region's scientific communities is based in Vladivostok, which adds greatly to the Center's success. The city's 14 research institutions employ about 5,500 people including nearly 1,500 professional researchers.

Industries in the Primorski Region are labor‑intensive. Heavy industry is the most highly developed sector of the economy. Fishing, shipping, mining, lumber, ship repair and defense make up the bulk of the Primorski's economy and these industries entail a great deal of physical labor. This type of labor invariably leads to serious injuries, human suffering and resultant loss in productivity. The economic implications of subluxation, spinal injuries and instability are significant in this region of Russia.

Educational exchanges

The cultural, educational and scientific exchanges, which began in April 1996, were also part of the initial goals of the project. They have included numerous formal and informal meetings, symposiums and educational/cultural exchanges. Invited lecturers from outside Russia typically spend from one week to one month working and teaching at the Center and, at this time, all invited lecturers have graciously agreed to cover their own expenses.

A unique aspect of Spine is that it has brought together chiropractors and other conservative authorities specializing in a wide array of techniques with one goal: spinal hygiene. This includes specialists in subluxation, scoliosis, rehabilitation, corrective techniques, radiology, outcome assessment technology, diagnosis, pediatrics, research, biomechanics and clinic management. Also included are manual therapists and physicians specializing in orthopedics/orthopedic surgery, neurology/neurosurgery, physical medicine and rehabilitation.

School of chiropractic

The main goal at this time is to establish a chiropractic curriculum within the University system in Far Eastern Russia, which will ensure the continued training of qualified Russian citizens in the practice of chiropractic. This will create the doctors who will staff future chiropractic centers and create the seeds for the establishment of chiropractic as a separate and distinct profession in Russia. Russian citizens have also begun studying at American Chiropractic Colleges including Ekaterina Malakhova, MD, DC who recently graduated from Life University. Dr. Malakhova, a Russian trained pediatrician, served as director of Spine prior to coming to the states to study chiropractic.

Chiropractic is not licensed or regulated in Russia and ‑‑ according to a decree issued by the Minister of Health in July 1996 ‑‑ it, like osteopathy, is considered part of the practice of manual therapy, hence, the practice of medicine.

"Our biggest challenge is going to be to legislate, license, define, and establish chiropractic as a separate and distinct profession in a country that has only one primary health care profession ‑‑ medicine," McCoy stressed.

Comparatively speaking, chiropractic in the United States, Australia, Canada, and Europe is highly integrated into the existing health care systems and the profession and educational systems are highly organized. The goal is to encourage the same in Russia, the Asia Pacific and Far Eastern Regions. This includes establishment of legal definitions regarding chiropractic practice, establishing standards of care for chiropractic and the establishment of licensing standards for chiropractic practice. "The profession needs to be very careful about the steps it takes to bring chiropractic to Russia. It would be too easy for people and groups in Russia to simply take advantage of it and shut out the actual development of a separate and distinct profession," stated McCoy.

Nevertheless, the stage has been set for this achievement as discussions with local government officials have led to preliminary plans to begin the process of establishing chiropractic as the first primary health care profession apart from medicine in Russia.

Recent efforts to expand chiropractic in Russia by others have also begun. Dr. Sherry Durrett made her first trip to Russia in June of 2004 and is currently working on establishing a clinic and educational program in St. Petersburg. Dr. Durrett has made several trips to Moscow and St. Petersburg with representatives of the International Spinal Health Institute and the Regional Center for Chiropractic Spine in Vladivostok, participating in these exchanges. The International Spinal Health Institute and Spine have made numerous documents, translations, and literature from its decade of work available to assist Dr. Durrett's efforts.

The International Spinal Health Institute

In order to help accomplish the goals of Spine and this project, a non‑profit institute was formed in the United States several years ago called "The International Spinal Health Institute" (www.internationalspinalhealthinstitute.org)

The Institute's vision is to ultimately serve as a worldwide center for the dissemination of knowledge regarding advanced methods of achieving optimum spinal health. The vision will be accomplished through international education, research, training, and cultural exchanges. Widespread effects on health of an optimally functioning spine and nervous system will be the Institute's cornerstone.

The Institute's mission is to ‑‑ on a global basis ‑‑ introduce and develop progressive, conservative modes of analysis, correction, reduction and prevention of spinal disorders. The chief mode will revolve around the science of chiropractic and other conservative measures. The primary entity addressed will be the vertebral subluxation and its effect on health and well‑being.

The Institute brings together expertise and guidance from a wide array of disciplines in order to accomplish these goals. Participating professionals include: chiropractors, manual therapists, physiotherapists, rehabilitation specialists, neurologists, orthopedists, traditional (oriental) medical physicians, and surgeons. The expertise will be found among practitioners, researchers, academicians, hospital administrators, government leaders and consumers of health care.

As Russia continues its metamorphosis from the Soviet era it will no doubt struggle with providing effective health care to its citizens. With cost effectiveness an even bigger issue in a country with little to spend on health care resources, chiropractic has much to offer the population of this great country.

For more information on how you can assist in the project to bring chiropractic to Russia please contact Dr. Matthew McCoy editor@jvsr.com or visit the website of the International Spinal Health Institute,www.internationalspinalhealthinstitute.org.