[Music] Welcome to the Global Physio Podcast. I'm your host, Alana Bevis. Welcome back to the Global Physio Podcast. You've probably tuned into this podcast because you're curious about or practicing global health. And chances are that you're a physiotherapist or physiotherapy student. But if you're not, no sweat. This podcast really is for any and everyone interested in global health. I am extremely excited about today's episode. My guess is that most physiotherapists tuning in are likely just beginning to dip their toes into social theory as it relates to their practice. For some physiotherapists, the catalyst for wanting to delve into social theory may be the growing public discourses around power and privilege, racism, sexism, colonization, etc. But why have it we as physiotherapists? Been exposed to much social theory before now. Physiotherapists and physiotherapy training programs have generally focused on understanding the body as machine and relegated social theory to the periphery. As we will discuss in today's episode, our collective lack of engagement with social theory and the socio-historical underpinnings of physiotherapy have resulted in our profession having some massive blind spots regarding who we are, what we do, and what our future holds. Our guest is Dr. Dave Nichols, a professor of critical physiotherapy in the School of Clinical Sciences at Auckland University of Technology in Outro, Rua, New Zealand. Dave has authored two books, the end of physiotherapy and physiotherapy otherwise. He founded the Critical Physiotherapy Network and the International Physiotherapy History Association, and more recently, Paradoxa, which is a site for people interested in studying the many posts, now disrupting orthodox healthcare. Dave is an executive member of the Environmental Physiotherapy Association and will be the 2024 conference chair for the In sickness and in health conference. A couple of notes before we jump in, firstly, this episode was recorded in person in Auckland during Tropical Storm Hale in January 2023. I was very privileged to spend 90 minutes interviewing Dave, and as such, I've split the interview into two episodes with this being part 1, part 2 will air on the same date. I want to acknowledge that the history and social dynamics that we talk about may relate more so to the experience in the global north, and lastly, I didn't travel with all of my sound equipment, so we focused on recording Dave's voice. My speaking parts were transcribed and recreated after the interview for the sake of sound quality. Hopefully that doesn't compromise the sense of rapport and flow for you, the audience. Without further ado, let's get into it. Welcome to the podcast, Dave. Thank you for having me. It's my honour and pleasure. Thank you especially for having us during this tropical storm. Well, thank you for coming to Auckland and it's lovely to have you here. I wish we could have put on better weather, but it's pretty awful right now. Well, it's definitely an experience. So we'll kick things right off. In recent years, you've authored two books which have been critical of and for the profession. The first being the end of physiotherapy, which contains a critical history of physiotherapy and calls for a professional reform in response to present day dynamics in society. And the second is physiotherapy otherwise, which is a sociological analysis of the physiotherapy profession. What I felt to be at the heart of both of your books is what it means for physiotherapists to be of service and to whom. It was also in the second book physiotherapy otherwise that you argue that the physiotherapy profession has been fundamentally interested in its professionalization project as opposed to being interested in serving the public. And it is for this reason that you expressed that the profession may need to be dissolved. Would you like to elaborate on that? Well, thank you. Yeah, that's a lovely start, a lovely question. I think to your point about physiotherapy being focused on its professionalization project, I'm not suggesting in the books that that's necessarily a bad thing. I'm suggesting it's been a necessary part of physiotherapy establishing itself as a profession in the way that other professions have done over the last 150 years. And we should remember here, of course, one of the fundamental points about all of this is that physiotherapy as a profession is a relatively recent invention. And in the course of human history, the physical therapies to which we attribute our status have existed forever, perhaps as far back as human recorded history. So we should keep in mind that the physiotherapy profession has existed for what, in some cases, 125, 130 years, but the physical therapies have been practiced for millennia. Keeping that in mind, it's worthwhile looking, I think, at the conditions that made physiotherapy as a profession possible, historically, why did it come about? How did it exist? What purpose does it serve? What direction, what place in society does it occupy? And the ways in which that place changes and shifts, we do like to think that we are autonomous in deciding which direction our profession goes in. That it'll be us that decides that. But everything that I've ever studied and read and tried to articulate, particularly in the first book, the end of physiotherapy, is an argument that actually physiotherapy is the response, is the effect, it's the achievement, if you will, of sociological and social changes that have called for a profession to do that kind of work. So to give one example, one of the reasons why the American physical therapy profession came into existence was in response to World War I. There was an enormous number of injured service men from the war that needed rehabilitation. Now, there's a great American writer, historian Beth Linker, who talks about how American attitudes towards war injury changed during the latter part of the 19th century and into the 20th century. After the Civil War, there was a belief that, particularly the Union soldiers that had won, deserved to be treated as noble veterans, to be upheld in society as being people of special status. They were exempted in a sense from having to do regular work or return. Their injuries were a badge of honour and society owed them a debt and that was realised through pensions. But by the end, by 1900, the debt level in America just to service the pensions of the Civil War alone was crippling. And the governments had to decide on ways in which they could treat these injured noble winners of the Civil War without at the same time being punitive. They didn't want to cut their pensions because that would have been seen to have been punitive. So they began to think about changing the way they spoke about these service men. They started to speak of them more in terms of having a responsibility, to want to get back to work, to not just taking their pensions and being seen as heroes. They needed something more. There was something missing about their manhood, if they had this injury, but they weren't working and contribute to society. This subtle kind of language shift became important because what they wanted these men to do was to take less pension money and get back into work and contribute to paying taxes and working in society. So by the time the First World War comes along, there's been quite a remarkable shift in the way that injured service men have spoken about. Such that now it's expected that if you get injured in war, you'll be put back into the workplace as soon as possible and you get the birth of rehabilitation centres being founded. You get the birth of work hardening centres where men will go and learn tasks again, if they've lost an arm, they'll work out a way to become a carpenter again with one arm. Adaptations prosthetic starts to be used much more readily. A whole branch of surgical science starts to grow to try and stop the kind of gangrene of injury and problems that they had afterwards. And there was a call for people to be these men to be rehabilitated. Now my point about this long story is that if you look back at the history of physiotherapy, virtually every adaptation that's happened in physiotherapy and every shift that's taken place is as a direct result of a historical or social turn that has made it necessary for that to happen. Now it's true, I think, that throughout the long course of physiotherapy.
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ож yn tsp'n rolinio'r takaithio b Texourlensaint. Borgion i fatyn ein sut ac 👀 it is it what it is in in a sense trying to provide a deeper level of analysis of what that is. But then at the end of that to then argue well if this is the situation Fizithirif finds itself in now where is that taking us and that's probably something that we'll need to talk about an unpack a little bit more. Yes thank you for laying out how rehabilitation science is a response to social conditions and social turns. One of the things that I noted in Fizithirif otherwise is toward the end of the book you expressed that if we had done some of this sociological work 30 years ago we might be in a better position now to adapt to these changing dynamics in society. If we had done that work 30 years ago do you think that the profession would be more viable today as opposed to potentially being in a palliative stage? Well I think we have to get to the root of that question I think there's a premise inherent in that question that I want to challenge and that's the idea that our job should be to rehabilitate Fizithirif. One of the underlying discourses that seems to exist around Fizithirif continually right now is when people believe that the profession is in a bad state when it believes it's in trouble for some reason. We think our job should be to rehabilitate Fizithirif, to reinstate it in some way, to find a new way in which it can be relevant to society. I understand that that imperative I understand that drive but I think there's a more fundamental question which I think if we'd have done the work 30 years ago sociologically to understand the profession might have brought us to another point which is what is our purpose as Fizithirifists? Are we there to promote the good name of the Fizithirif profession or are we there to serve the interests of the public? Now there's a question I sometimes ask in talks and meetings and seminars which is that if it was in the public's interest to dissolve Fizithirif by way, would we do it? Now I've asked that question to a lot of people and sometimes I see Fizios think for a moment about their answer and I find that incredible that there's any debate around this. I mean if it's in the public's interest to dissolve Fizithirif, of course we should, we have an ethical responsibility to do that because the key thing in the question is what is in the public's interest? I sometimes worry about not just Fizithirifists but any profession that would put the needs of the profession, its status, its social capital, all the things it's achieved, over public interest or the needs of the public. So I think 30 years ago one of the things that we would have realised straight away is that professionalisation is a very particular project that's been undertaken by certain groups in society to establish social capital, to establish their status, to create an enclosure around some knowledge or some practice so that it serves the interests of that group. Now that's been the case since really the early stages of industrial capitalism in the 17th century where you had trade guilds and you had people in competition with others, trying to establish a niche in a marketplace and using the same tactics we use today to define an area of interest to regulate those who should be inside and outside the profession to prosecute those that claim to be doing blacksmithing when they're not or whatever it is, the same tactics are used to create this enclosure. That professionalisation project became a serious venture in the health professions really only in the early part of the 20th century and in physiotherapy it only really became a serious thing after the First World War in most countries. But it is a project, it's a piece of work that is done usually following a set of stereotypical processes. What physiotherapy otherwise does as a book is it tries to break down the stages through which we've come to understand what professions are. And my hope is that by understanding something about the way that the functionalists thought about the professions in the 1930s and try to explain why medicine had become so popular, by understanding what they were saying about the professions are there to serve society because they bring balance and order. And then the ways that Marxists and critical theorists critique that perspective in the 1950s and 60s. And then a whole bunch of others came following symbolic interactionists and vebarians and postmodernists came, brought their own perspective. Can help us understand why physiotherapy is the way it is, why it does the things, it does, why it claims the things it does. And bring a more critical lens to those things because I think with that critical lens we would be asking a different question now. It wouldn't be how can we rehabilitate physiotherapy, how can we reinstate it? It would be for me, what is the future of the physical therapies, those things that have been practice by societies and cultures throughout the world for thousands of years? It wouldn't be what is the future of physiotherapy because to me it feels like that's a physiotherapies a historical project. That has lasted for 120-odd years but it doesn't mean to say it will last forever. And it might not necessarily be the best way to deliver health care, physical therapies to the greatest number of people in the future. We know that one of the problems that we face is that the skills of the very best are only available to a very, very, very small number of people in society. And not usually those people who really need it. Now we are entering what's now widely acknowledged to be a post-professional era. So the second question arises here which is will it be us even that decides? Because again going back to my first point about how physiotherapy like all the professions is an effect of social change, it may well be that the world at large is shifting to such an extent that whether we want physiotherapy to exist or not, we might not be the ones that choose. So to me the main focus has to be how do we secure the best access to the physical therapies for the most people, particularly those people who needed in the future. And if we can stop thinking about how to revive the fortunes of physiotherapy and focus on that instead, we might be able to offer something a lot more equitable and more effective because I absolutely fundamentally believe in the physical therapies. But I think that physiotherapy as a profession is an act of enclosure. It's an act of colonisation. It's taking therapies that have been practiced for thousands of years and saying no you can't do that, only we can do that. It's putting a ring fence around things that things that should be available to everybody. And in that act of enclosure is an act of denial. You can't have this, you can't do this, you can't do this because you're not an expert, you can't do this because you've not had a three or four-year training, you can't do this if you don't have this name or title. There was a piece of legislation in New Zealand that was the longest piece of profession-specific legislation in our history, was enacted in 1949, it was called the Physiotherapy Act. And it was a piece of legislation that protected physiotherapy. And it lasted until 2003 when a new piece of legislation came in called Health Professions Competence Assurance Act, HPCA. The Physiotherapy Act stated that you couldn't practice therapeutic massage unless you were a trained physiotherapist. You could only become a trained physiotherapist if you'd gone through the course at the one school in New Zealand which was in Dunedin. If you wanted to claim to be doing anything therapeutic with massage and you weren't a trained physiotherapist, you could register but you had to register under the Massage Parlor Act, which was the act that covered brothels and prostitutes, which is ironic really when you think about our history of how we've kind of competed against prostitutes for sensual forms of touch in the past. So that kind of legislation is an attempt to try and protect physiotherapy and massage, massage, which is one of the most fundamental human activities you can perform. And yet the
The legislation says no, you have to be a physiotherapist, you have to do a three-year degree, it has to be under-need and you can't do it otherwise. Or else, you know, register as a prostitute. The lengths to which we have been happy to accept that level of protection are quite remarkable sometimes. And something that needs to be challenged, I think. What I picked up as a central theme in what you were saying is the question, how do we centre health equity and the public's interests? And what I'm hearing is that your response would be that we might need to look at dissolving the physiotherapy profession. I think this is an interesting question because I do use that phrase and phrase is similar to that in physiotherapy otherwise because I couldn't really find another way to express it. There's two problems with it. One is my point earlier on that we'll be the people who decide because it implies when I say physiotherapy profession, like we will dissolve it. So the first problem is we might not be the ones that dissolve it, it might get dissolved, it may well already be being dissolved. And I think this era of post-professional health care, which is this idea that it's not getting rid of the professions, it's that the professional power will increasingly be moved centrifugally to the margins. That people will find a hundred ways to engage with the physical therapies, we will be one and an increasingly small actor in that field. So we'll become increasingly marginal, less central than we have been before. So I think on the one hand, we might not be the ones who decide. So in a sense when I talk about dissolving physiotherapy, it might be other people that dissolve it for us. It won't be an act of volition on our part, it just happened. And then the second thing is the temerative believing that we own the physical therapies at all anyway. Like we should, it's like the word empowering, I'm going to empower my patients. As if you are giving them power, you're gifting them some powers, you're kind of large S. There's an arrogance in that that I think is problematic. We don't own the physical therapies, we are best or probably custodians or stewards of the physical therapies. And I think our history shows that we've done a pretty good job with handling those things in a respectful, dignified way. I don't take away from the work of the physiotherapists throughout our professions history that have done some quite noble and honorable things with the physical therapies. But they're not ours to hold, they're not ours to give away, they're not ours to dispense. So I do struggle with the idea of how we can be actors in this process. Now one of the things I talk about towards the end of physiotherapy is the challenge of giving stuff away. And the example I talk about in there is what celebrity chefs have done. Now if you think of, I don't know, who your favourite celebrity chef would be, Nigella Lawson or, I don't know, let's say Jamie Oliver. Everybody knows Jamie Oliver, which is an interesting point in itself. If you look, you can probably find every single one of Jamie Oliver's recipes online somewhere. There's probably videos of them, probably videos of him doing them. Everything he has, he gives away. And it hasn't stopped Jamie Oliver becoming world-known. It hasn't stopped his book selling in the thousands, hundreds of thousands. So the idea that if we gave away our skills and knowledge, we would somehow lose something. I think it's not clear, it's not certain. There's another example in the book that relates to this kind of idea, which is around the number of nutritionists, registered nutritionists that work in New Zealand. I think there's about 400 of them. Now they're desperate to hold onto the idea that they are the experts of a nutrition. But there's so few of them now and the complexity of the illness that so many patients are experiencing in acute hospital centres. That really their work is only just keeping people alive in intensive care units around the country. At the same time, food culture in its broadest sense in New Zealand has gone crazy. People are watching Netflix channels and they're doing their reviews on Google of restaurants they go to. They're baking at home and they're looking at buying recipe books in their millions. People just love food. So the food culture has taken off in a massive way and people are engaged in it, enormous, to an enormous extent. But the registered nutritionists are over here going, "We're the only ones who can speak with expertise about nutrition and they're getting smaller and smaller and smaller as this whole culture takes off." The same thing is happening with the physical therapies. You see this with things like our professions move towards evidence-based practice and the desire to want to be evidence-based about the way we work, which is in itself not a problem. But right now for instance, it seems like touch-based therapies, massage, are just completely out in physiotherapy. You can't use them. Nobody wants them. They're seen by a lot of people as low-value care. They're expensive to administer because it has to be done by one person to another person. And their efficacy, their evidence-based efficacy, is not clear. So let's get rid of them. Let's replace those things with activity and functional and exercise-based forms of rehab, which you can administer to lots of people. You can do YouTube videos of it. And one person can disseminate therapeutic advice to millions in effect. Nothing wrong with that, in principle. But of course what evidence-based practice has done is it's only taken a very particular view of a phenomenon-like touch, which is so multifaceted and complex. It's ignored the fact that in a post-COVID era, we know that people are desperate to try and understand the place of touch. In their world now, is it safe in the future to be hugging your grandchildren? Is it okay to go to mass-er in the high street and just have somebody give you neck and shoulders of massage? Should I be getting a physiotherapist in when I've got a swollen right leg and I don't know why? What is safe and what's unsafe, what's acceptable and what's unacceptable, what should we do and what shouldn't we do? People have got all sorts of questions about things like touch and the culture around the physical therapies is taking off. People are exercising and massaging and doing water, spa trips and all kinds of stuff in unprecedented numbers. But we are acting like the nutritionists in going, no, you can't do that, shouldn't be doing that. We are going to control our little world of physiotherapy. And gradually we're going to be moving ourselves to the very margins. So what do you do with that? Do you reject the idea of evidence-based practice as a governing framework for what you do? If you do that, would the public lose trust in you as a voice for authority? That raises the question about whether the public on a broader discursive level accepts the voice of authority anymore. It used to be that a grandparents said the doctor knows best. Nobody says that anymore. In a sort of post-truth era, the whole question around the value of evidence-based practice to professionals like physiotherapy becomes questionable. So just blind faith to that in the context of a shifting culture around the physical therapies seems immensely problematic and something we should be having a conversation around. But we're not. We're just not really. Our reaction is to say, no, we just have to do more of what we've been doing. Everything you've said here on the podcast and in your books, I agree with you on all accounts. And yet, I'm still a physiotherapist. I'm on holiday right now, but I'm going back to work next week. And the question that lingers for me is, what do I do in the present moment with an understanding of the social dynamics and where the physical therapies might be heading? And what should my role be during this very interesting point in time? How do I continue to advocate for equity for my clients and in society while also holding space for maybe the most equitable thing to do is consider how we might dissolve the profession? It's a very interesting time to be a practicing physiotherapist. Well, I think one of the my hope is for a book like Physiotherapy Otherwise is that it gives people tools. One of my favourite philosophers, Giel De Luz, he has a saying that says, the challenge is not to fear or hope, it's just to look for new weapons. And physiotherapy otherwise, as a book is an attempt to try and give physiosome weapons, it takes each chapter looks at a different social theory, a different way of thinking about your professional practice. So very briefly, the first main chapter is about functionalism, which is the idea that professions bring balance to society, and that you can identify what makes an elite profession by the traits or the characteristics. And some of those traits, for instance, were originally thought to be things like altruism and service to the public.
Now you could read that chapter and go, "Right, I'm going to think about my practice from here on outward, like a functionalist would, and I'm going to shape my practice accordingly." If you read the following chapter, the chapter that comes afterwards, which is a chapter about Marx, and Marx's ideas of things like wage slavery and alienation, Marx critiqued the functionalists, or Marx's work has been used to critique the functionalists, because the functionalists said nothing about power. They said nothing about the fact that actually doctors, for instance, aren't always selfless and public-spirited. Sometimes they're money-grabbing, and they're avaricious, and they're unethical. And if you want to understand why medicine achieved so much status in the world, and why it is an elite profession, don't look at it as a kind of balancing agent in society. Look at it as a competing capitalistic drive for power. And then the next chapter looks at critical theory, and how the professions were then starting to be critiqued for the way that they asserted gendered norms, that they became projects for the proletariat, the white to middle class male population in the 19th century, and then into the 20th century. How they were a vehicle for colonization, how they normalize things like ability, gender norms, so that you could justify having a profession, because it would be the ones that restored those people who were quotes, abnormal, back to normal. How those kind of ideas have just been accepted by the professions as norms, and just used in their favour. There was a great chapter in a book, a decade or so ago by John Swain and Sally French user, blind physiotherapist, called our all health, our all the professions parasites, because they feed off their labelling of people as disabled or abnormal or whatever, so that they can justify their existence in the world and offer the treatment that the public didn't know it wanted in the first place. The chapter that follows that in the book is about Max Weber, and the Weberian said, "Well, Marx is all saying that the professions are all about power, but there's something missing there." And Weber's stuff was all about the idea of status and social capital, that it's not just about gaining money for the work you do or the operation of power, it's about status, and that's where all of the stuff around, and the closures comes in, and how professions acted, to fence off areas that they were owned and then push people away. And then you get the symbolic interaction as to come in and go, "It's not about implosion, it's about relations. It's about relationships, lay professional relationships, it's about relationships between professional groups." So forget all this competitive talk, it's actually not about competition, it's about relationships. You could be a physiotherapist who reads that chapter and goes, "Yeah, that's more me. I like that. I can square with that idea, that's how I want to look at my practice in the future." Then you get the postmodernist come along, and basically they're arguing that anybody who claims to have the answers is probably suspect, and you need to be questioning all of those beliefs about why the professions exist and how they work. And again, you could be a physiotherapist who reads that chapter and goes, "No, I prefer that. I like that." And every chapter is an attempt to try and explain how these very different perspectives on how the professions work and what they're trying to achieve can give you different ways of thinking. I think one of the best examples of how that could work is when you think about the popularity of things like the biopsychosocial model, which has really come into Vogue in physiotherapy in the last decade. One of the things that if you were to map the biopsychosocial model out as a simple vector, with biological and psychological and social, is three circles overlapping. One of the things that's really obvious is that there's a desire to move away from the purely biological, the body as machine idea. And the direction it's gone in is definitely towards the psychological. Now that's psychological domain is a very broad domain and it's meant to encompass anything about the person's lived experience, their subjective experience of life, their unique individual mind that they bring to a health kind of context. Now interestingly, so far, most of the psychological stuff that's been brought into the physiolitriature is primarily around sort of behaviourism and cognitive psychology. Now that's the aspect of that sphere that is the easiest to measure. It's classical kind of biomedical measurement objectivity, almost conditioned response stuff. What hasn't been embraced so far is the idea of a pure subjectivity, where the person's subjective experience lived experience, their phenomenological experience of health, is a unique feature that has no basis in biology or the social context, but only exists within their own world view. And what hasn't been addressed at all, or thought of at all, is how people experience health sociologically or socially, nothing is going in that direction yet. So I think it's entirely possible that you could read those chapters of those book and think, well, if I'm going to move away from a biologically-centered practice in physiotherapy, which direction do I want to go in? How do I make my practice such that it's response directly to? It emphasizes a person's pure lived experience. And this isn't some kind of fancy philosophical stuff. I mean, there's very practical applications of this. If you treat the body as a machine and you focus on the biology of health and illness, then you're probably going to concentrate on acute illnesses, because they're the things you can fix. You're probably going to have short treatment sessions because you don't need to get to know the person. You just want them to come in and look at their body, fix their tissue, send them away again. You're probably not going to spend much time building a relationship with the person. It's probably going to be very kind of quick, cold, objective measurements, lots of tests and stuff like that. And your treatment sessions are going to be in and out. And they're going to be lots of throughput. So this is the classic, old kind of musculoskeletal model of physiopractics. If you rejected that principle and said, no, I want to focus on a purely existential, experiential, phenomenological practice of physiotherapy, then you throw all of that stuff away. Now you're probably not likely to focus on acute illnesses, because you're much more likely to focus on those long term conditions that people have to live with rather than die for our more suffer and recover. You're going to be dealing with problems in people that last a long time to which they've got to come to terms with themselves. There's now fix for these things. So you're not going to be manipulating their tissues as much. You're going to be trying to help the person understand and make sense of the illness that they have. The sessions that you have with them are going to be longer. You're probably going to have repeated multiple sessions where you don't ever put your hands on the person. The sessions are going to be based around you building a relationship and so much of the therapeutic experience will be built in that relationship. And maybe the physical therapies are an aid to building that relationship rather than an attempt to fix their tissues. So the nature of your practice changes fundamentally just by changing the position the way you think about where you want the philosophy of your practice to reside. My hope is that physiotherapy otherwise provides people with some tools to take that in the direction of the social space, the sociological world as well. To understand how their practice could be radically different to both of those if it was sociological. And by the way, just as an aside, if you did decide, if we collectively decided that physiotherapy no longer sat within the body as machine by mechanical kind of world, and we wanted to shift it completely into a kind of phenomenological experiential subjective space, you can throw out all of that anatomy and physiology and pathology and by mechanics and kineseology that they're teaching at universities, you're not going to need it. You're going to need a whole different curriculum, a curriculum at the moment the students aren't getting, because everything that they get is just bolted on top of a fundamental desire to understand the body as a machine. So one of the biggest issues in the end of physiotherapy is the argument I'm making there which is that we have this thing of a physiotherapy paradox right now. We've used the body as machine to get where we are, we've used a kind of biomechanical biomedical approach to establish our status as a profession. But most of us now recognise it's either insufficient or it's just wrong. It's the wrong way to treat people as just purely bodies. To reject that and move away from that is a massive undertaking and you're seeing some quite interesting challenges to that right now. In going back to the biopsychosocial model all of the work around things like cognitive functional therapy and psychologically informed physiotherapies around chronic pain are quite clearly an attempt to try and offer a different model of physiotherapy that is not biologically centered. And yet of course the psychological models that those people have adopted are absolutely
a'r biomedicol framwyr, cygnisiau, a'r bihavirism. A'r brane yn ymdyn sy'n cymryddiol, a'r cymryddiol, a'r cymryddiol, a'r cymryddiol, a'r cymryddiol, a'r cymryddiol. Zeur eiff Jew aşk yn cedwnan a g氣 wyth yn regard trefym roasted reddo. Yn�n clpole Ch 여러 barledd yn beplateau gyd maethau rhănw conf Ryan hefyd ac roedd rhyw штfaeth arle��regio gyda gyferiad well? R broadbandiaeth fel diwyd a'r cyrirad taegysol, contain yw'r cyfrypiant ardag mith a'rtain시. Mae'r cyfryd ar gyfer unrhyw i ddoen. Mae'n gweld sut yn ei ddyn nhw'n ffrang oes. Mae'n ffysio oeddyddio gyfer oedd cyfrypiant am y gallu'r cyfryd. Mae'n ffysio yn ffysio? Mae'n ffysio yn yw'r cyfryd y ffysio'r cyfryd. Mae'n ffysio yn y cyfryd ar gyfer y cyfryd y ffysio'r cyfryd. Mae'n yw'r cyfryd y cyfryd. Mae'n ffysio'r cyfryd y cyfryd y ffysio'r cyfryd. Mae'n ffysio'r cyfryd y ffysio'r cyfryd. Mae'n ffysio'r cyfryd. Mae'n ffysio'r cyfryd y bryrgegau'r cyfryd. I want to thank the Global Health Division of the Canadian Physiotherapy Association for sponsoring this podcast. And last but not least, thank you to my husband Steven who travelled with me to Auckland. Who was my sound guy? Please feel free to contact me if there are any global health topics you want to get granular about. Interview-y suggestions or burning questions. You can always reach me via email at
[email protected] or find me on Instagram @globalphysio. Thank you for listening and see you next time.
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