In Asia the Chiropractic profession is in its early development stages since the profession began in America 120 years ago, in 1895. Today there are some 100,000 Doctors of Chiropractic (DC) throughout the world where in some regions there are barely a handful of in practice while in other regions the development of the profession allows every community in their country access to one DC for every 5,000 population; in stark contrast to the 1: 4,000,000 ratio in the Philippines.
Similarly the formation of professional associations in each country has its own personal history of survival, struggles and eventually greater success in serving the needs of its communities and individual practitioners.
In Europe, similar to Asia, when each country has less than 100 DCs, the task of formalizing the profession within its country was daunting so, by necessity, the European Chiropractic Union (ECU) emerged and demonstrated the valuable role of collective regional representation.
In those days there was no World Federation of Chiropractors (WFC) so the case for the ECU was not difficult to accept. The next regional group to form in the shadows of the ECU was the Eastern Mediterranean Chiropractic Association that later expanded to include almost of the Arab speaking countries, renamed the Eastern Mediterranean & Middle East Chiropractic Federation. Latin America and SE Asia were next but only the Latin American Federation of Chiropractic (FLAQ) succeeded, mainly due to their common culture and languages, Spanish and English. In Asia, the only common language is English, a second language to most, but more significant are the vast cultural differences making it most challenging to succeed. The SE Asian Association failed in the late 1990s and it was re-organized, re-structured by encompassing the entire region to include “down under” and the Pacific Islands, called the Asian Pacific Chiropractic Doctors Federation (APCDF). The last Federation to form in 2013 is for Africa.
As in Europe and Latin America, perseverance for the development of APCDF typically falls on a small group of people who remain steady for decades in their active and supportive roles within their country and to a lesser degree in support of the APCDF. It is worthy to mention many of them here:
Dennis Richards, DC Australia | Laurence Tassel, DC Australia
Patrick Montserrat, DC Bali | Henry Chan, DC Hong Kong
Bruce Vaughn, MsCh Hong Kong | Amit Nanda, DC India
Tony Dawson, DC Indonesia | Kei Takeyachi, DC Japan
Graham Hunt, MsCh Malaysia | Thomas Ong, DC Malaysia
Martin Camara, DC Philippines | Michel Tetrault, DC Philippines
Janet Sosna, DC Singapore | Terrence Yap, DC Singapore
Taeg Su Choi, DC South Korea | David Chen, DC Taiwan
(Apologies for missing some we may have overlooked)
Since the formation of the WFC, now of 25 years in duration, holding the International position of representing its members, the Chiropractic National Associations (CNAs ) of the world, there are a small dissident group of DCs in Asia who feel that the WFC is sufficient to serve their support needs and that the APCDF is redundant. As an active associate member of the WFC for over 15 years it is clear that the mandate and the capacity of the WFC to locally assist CNAs in Asia is extremely limited in both financial and manpower support.
The WFC’s International role is undeniably important but in most situations it cannot be very effective in local critical matters. Its policy of “national self-governance” has resulted in dedicating available resources to focus on Education, Research and representation at the World Health Organization (WHO), areas of truly International impact.
Countries with a rich 50+ years of professional development in the APCDF region are Australia and New Zealand with the largest number of DCs and chiropractic schools and sharing similar cultures and language with the other advanced countries in the world. Asia and the Pacific Islands cannot claim much advancement with most countries having less than 100 chiropractors. Survival is the more accurate descriptive of their CNA if such exists and each country is confronting similar limited manpower and financial resources that severely limits its professional development within their borders.
The APCDF is at the same time also in its infancy, so it is up to the few key individuals who volunteer their time and finances to help build the organization to become more effective in supporting CNAs in its Federation region. It continues to be useful to look at the ECU model to guide the APCDF’s organizational development. One small but significant contributing factor in the ECU advancement came from the personal wealth and time gifted by just a few dedicated individuals of social standing; and so today the ECU can boast an annual budget of more than one million Euro that permits significant support for its member associations.
The APCDF will be well served by fostering its own beneficiaries committed to the development of chiropractic in the Asia Pacific region. If your heart and personal integrity is attracted to being one of these few dedicated supporters, you are welcome to pursue that interest and go to their website to introduce yourself.
There are unique problems that exist in the Asia Pacific region that cannot be met by the WFC, beyond strategic support. It really does fall on the leadership of each CNA to meet the challenges within their borders. Going at it alone is frustrating, with little internal participation by DCs in their own country who are just focused on their practices, family and economic survival. Meeting with colleagues of equal dedication through the APCDF activities brings much needed moral support, leadership training and the “out of the box” perspective in problem solving capacities that arise from a collective mind.
In time the APCDF Annual Assembly will mirror the successes of the ECU and recent regional activities of the EMMEF and FLAQ, not to be left behind. It cannot be emphasised enough how more challenging it will be for such a region rich in cultural diversity to function within a common organization and to effectively meet common needs.
The status of chiropractic in the Asia Pacific region currently looks like this:
2 countries are fully developed with 1 DC for every 5,000 population in Australia and 1 DC for every 10,000 people in New Zealand. 3 other countries have over 100 DCs with their own war stories of forming and maintaining their CNA; namely Hong Kong, Japan and Singapore. All three suffer internal dissent and multiple associations or groups of common interests or ideals. Countries with less than 50 DCs may or may not have a functioning CNA. These are India, Sri Lanka, South Korea, China, Taiwan, Thailand, Vietnam and Malaysia; Philippines, Indonesia, Papa New Guinea and a handful of the Pacific Islands such as Cook Island,Guam, Mariana Island, New Caledonia, Samoa and Tahiti. The remaining countries have yet to attract a single known permanent chiropractor.
Perhaps if we were to take a contrarian view to gain perspective… what would the Asia Pacific region look like in 50 years without the APCDF? That prompts many questions:
Will South Korea overcome its illegal status permitting the chiropractors to avoid imprisonment for electing to practice their profession? Will Japan consolidate its many associations and overcome the complex conditions that prevail because of the unqualified courses in chiropractic? Will chiropractic schools hold to CCE standards or will we see a plethora of hybrid schools such as we see in Indonesia, Japan and China today? What will that look like with many schools bastardizing chiropractic education and creating a sub-class of chiropractors that brings much public confusion and professional development problems in these affected countries that could bleed over to neighbouring countries, like Japanese intrusion of fake chiropractors in the Philippines?
Will China and Vietnam permit freely meeting professional organizations? Will India finally interest its expatriate chiropractors to return home and establish chiropractic schools to increase DCs in serious numbers? How long will it take Hong Kong, Japan and Singapore to match the advancements of Australia and New Zealand? Will CNAs be directed by the goodwill and integrity or by social class and vain interests of its leaders?
What challenges are to be experienced because of the strong presence of traditional alternative professions in Asia? Will CNAs still regulate its members or force local government and medical societies to get involved in the regulation of DCs? What challenges will be experienced when organized medicine decides to view the profession as a competitor in Asia? Will there ever be any DCs in the poorest countries?
The ECU now boasts a fully institutionalized organization that is able to support the former USSR countries entrance into chiropractic, relying on the strength of its advancing European member countries. The WFC is equally institutionalized in Public Health, Education, Research and representation at the WHO. The Bi-annual Assembly offers countries with some logistics and an exchange to bring their concerns and plea for assistance within their borders.
The APCDF has a long way to go to become as effective as these regional organizations; however, the long-term needs of the Asia Pacific region will be reached sooner and inter-regional harmonization of the profession accomplished by affording the APCDF the fullest support and broadest participation of its full and active CNA membership. The idea that the chiropractic profession in the Asia Pacific region can manage without the leadership role of the APCDF sounds quite preposterous. What do you think?