The Bone and Joint Decade at the 4/5ths Mark

Dr. Al-Kharusi is a member of the UN Road Safety Collaboration, a BJD/Oman partnership begun in October 2002. The partnership has achieved several UN resolutions to put road safety on the agenda for General Assembly proceedings. Its efforts culminated in a 2004 resolution that made WHO the coordinator for the Global Road Safety Initiative. Since publication of the WHO World Report on Road Traffic Injuries (www.who.int/violence_injury_prevention/publications/road_traffic/world_report/main_messages_en.pdf), a number of countries have adopted its best practices and manuals for road safety. In Vietnam, one year after adopting the helmet law for all two-wheeled vehicles, more than 90% of riders are using helmets, and road safety has improved by 60%, according to Dr. Al-Kharusi.

The next step in politicizing the costs of road traffic injuries will be to address their socioeconomic consequences, says Dr. Al-Kharusi. “We do not want just to rehabilitate patients and make them pain free, but we need to return their dignity. They need jobs and a way to earn a living so that they can fulfill their social commitments—marriage, family, et cetera—and be contributing members of their communities.”

Professional Education and Best Practices

Professional education has also been a major thrust for the BJD. ISC member Kristina Akesson, MD, PhD, professor of orthopedics at Lund University in Lund, Sweden, has been involved with the BJD Monitor Project, which, in coordination with the WHO, collects and reviews baseline data against which BJD efforts will be measured. She has also helped develop international curriculum recommendations to further train medical personnel in diagnosis and treatment of musculoskeletal conditions. Initial research revealed that musculoskeletal conditions—almost universally—receive very little attention in regular medical curricula. For instance, a standard medical history usually dictates assessment of all major organ systems—but not the musculoskeletal system. “We think that this is related to the fact that many musculoskeletal conditions are not perceived as a deadly threat,” she says. Curriculum recommendations, which provide for minimum training requirements in assessing musculoskeletal conditions, have now been translated and published in Chinese and tested in Canada, New Zealand, and Australia.

Projects have been varied and have touched all levels, from general practitioners to educators and policy makers, to individual national efforts designed and implemented locally by the National Action Networks (NANs), to broad-reaching international efforts. For instance, the BJD has also partnered with WHO to publish an online practical tool­kit for predicting 10-year risk of osteoporotic fracture (www.shef.ac.uk/FRAX) and, in February, released the international recommendations of the BJD Task Force on Neck Pain and its Associated Disorders.

Partnership with Patient Advocates

Since 2000, the BJD has fully integrated research, clinical, and patient-advocacy stakeholders in all its major initiatives. Leong notes that, “it’s not only multidisciplinary; it’s healthcare professional- and patient-oriented. To get an initiative like this off the ground with such high-level, United Nations recognition is a stellar coup for the patient.”