I have been working on organising a group/ network in the north of Haiti for anyone involved in PT and I was thinking well why should physiotherapy be so important in Haiti? Surely there are much bigger problems in Haiti how will PT help anything??
The reason I wanted to be a Physiotherapist was because I wanted to do something medical but not medicine, so PT was the next best thing. I have worked in Haiti and I have worked in the NHS (in Northern Ireland) and often working in the NHS is frustrating. Patients don't do their exercises and then don't get better and then decide physio doesn't work. (this is a generalisation you do find some people who do what you ask!!)
I had a completely different experience in Haiti, I found very simple things worked very well. One of my first patients was an older man with arthritis in both knees, he was struggling to walk and was holding onto his wife in order to walk. I gave him some very very simple exercises to strengthen the muscles around his knees and told him to do them 3 times a day, everyday and come back in two weeks. I almost couldn't believe when he walked in two weeks later, unaided, a lot faster and visibly in much less pain. When I asked him how he felt he said the pain had gone and he was able to walk much better. Without the physio the scenario would have been go to the doctor to start on pain medication (which you have to pay for every time!), his joints would have got stiffer and stiffer making walking more difficult until eventually he couldn't weight bear anymore. Living like that is difficult in our culture, in Haiti its 1000 times harder.
Due to the lack of education in Haiti, especially health education the Haitian mindset is, if you are feeling sore, or you have hurt yourself, or you have had a stroke you stay at home, often in bed until you get better. This is the complete opposite to what PT does.
Imagine you live in Haiti and you fall and hurt your back and you work in construction. You can't go to work and there is no sick pay from your employer or the government. After a while you will probably lose your job, you also won't get any better making it impossible to work anyway. You will have also spent a lot of money going to different doctors and clinics, perhaps even a witch doctor to try to get better so now your at home, with back pain and no job and no money.
So how can PT really help people in Haiti?
I think the most important way is education, education regarding what PT does and how it can help. Trying to change the mindset of staying in bed when you are sore or if you have had a stroke. Using exercise and rehab to regain function so people can work. Not only for work but for general life, most people have to walk to collect clean water for their house, they cook everything outside, cooking from scratch, they wash all their clothes by hand, there is no electricity at home and you have to go to the market almost everyday for anything fresh. Imagine trying to live like that if you have had a stroke which hasn't been treated or you suffer from back or knee pain.
Another big area where PT is really needed is in paediatrics. Children with Cerebral palsy and other physical problems are kept at home often in bed, they develop contractures in their joints making it very difficult for parents to wash, dress and toilet them. PT aims to gives these children the best quality of life and reach their full potential. We also teach their parents how to best look after them. If we can we will also try to find a wheelchair so these children don't have to be indoors all the time which helps take away the stigma associated with children who have special needs.
Your probably thinking I have left out the obvious what about actual PT treatment which of course can help, especially when patients do what you ask them to do. Also being able to give out equipment such as crutches, walking sticks and wheelchairs can help a lot.
So I feel having PT services in Haiti can really help Haitian people who need those services.
I recently met with a Haitian PT who has no formal training but has been doing some PT in Haiti for about 20 years! Which I was really shocked at as it seemed when I was first here in 2008 no one knew was PT was. It was good to meet with her and see what has been going on and she has lots of contacts who we can invite to the first meeting of the group. Now I have to set up a meeting, work on a name and clear objectives for the group / network.
In other news........we have a small team from home here at the seminary this week. Its so nice to hear some Northern Irish accents again! They have been painting here at the seminary and visiting OMS ministries. One of the girls is a midwife and was at the ante natal clinic in the Bethesda today. Tomorrow we will be going to an ECC meeting to meet the pastors involved in church planting and spend the afternoon counting pills preparing for a mobile clinic which we will do on Saturday in an area called Fev. Our seminary students have been working in Fev for over a year, one of the graduates is the pastor of the church plant there. There is no clinic in their zone and we will also be doing some evangelising and praying with people from the village.