The Monday Memo
March 12, 2018 PITT DPT STUDENTS
A Guatemalan Spring Break
This past spring break, 13 of my fellow classmates and I had the opportunity to travel to the beautiful country of Guatemala and provide physical therapy services to those who needed it. The trip was organized through Hearts in Motion, which is an organization that provides services both domestically and internationally to people in impoverished environments by “empowering […] volunteers to change lives of people in poverty”. Our entire trip was coordinated by Hearts In Motion, including our travel arrangements within Guatemala, day-to-day itinerary, and most of our meals as well, which was very helpful!
After driving to the Cleveland airport, catching a flight from Cleveland to Atlanta, GA, and then taking a second flight from Atlanta to Guatemala, we finally arrived in Guatemala City on Saturday afternoon. When we landed, we were greeted by Nancy Winiecki, The Hearts in Motion representative who worked with our team for the whole week. Nancy is a physical therapist herself and works in different physical therapy clinics located near Zacapa, Guatemala in addition to coordinating all of the service teams that come to Zacapa through the Hearts in Motion organization. After meeting Nancy, we loaded our luggage onto a bus and drove about three and a half hours northeast of Guatemala City until we reached our hotel, Hotel Atlántico, in Rio Hondo. The hotel was a beautiful complex with colorful buildings each consisting of two bedrooms that slept two people each. There was also a pool, a little park in the middle of the complex, and a lobby with a bar that served beer and wine for any guests desiring a late night beverage!
The first night after we arrived, we settled in to our rooms and then all gathered for a group dinner and orientation meeting. Then, we went to sleep so that we would be well rested for our first day in the clinic.
For our first clinic day, we packed up the bus with all of the donated medical equipment that we brought down with us from the U.S. which included suitcases full of pediatric and adult AFOs, braces for multiple different joints and extremities, theraband of various resistances, and adult and children’s shoes. We also loaded the portable treatment tables and documentation materials onto the bus and then proceeded to drive about 45 minutes away to the town of Chiquimula. When we arrived, Guatemalans were already lined up outside of the building waiting to be seen, so we quickly set up our workspace, divided into groups of about 3-4 people, and then began seeing our first patients! This pop-up clinic turned out to be extremely busy, and we ended up evaluating and treating a total of 43 patients by the time we finished up for the day!
The next day, we set up another pop-up clinic in an old indoor basketball court in the town of Santa Cruz, and this clinic proved to be just as busy as the first pop-up clinic! We evaluated and treated just fewer than 50 patients with a large variety of orthopedic and neurologic impairments. Some patients lived close by to the clinic, but some had travelled from multiple hours away to seek our care!
On Tuesday, after awakening to the beautiful sunrise and getting a yummy breakfast in our stomachs, we stopped by a children’s nursery where we got to meet nine Guatemalan children (3-4 years old) and play duck, duck, goose (or as they say in Guatemala: pato, pato, gonzo) with them. It was so fun to interact with the kids and to see their endearing little smiles! For the remainder of the day, we split into two groups. One group stayed in the Teculutan clinic to treat patients, while the other group went to a nearby special needs school to paint some of the rooms. We painted the sensory room a dark blue to promote calming and relaxation, and we painted the other classroom a bright yellow so that it would be more of a stimulating environment for the children to learn in. The kids at the school were so welcoming to us, and some even hugged and kissed us as we entered. Needless to say, the students were very curious as to what we were doing in their school, and they kept checking up on our painting progress throughout the day. While it was definitely hard work to transform the original dirty grey walls into bright blue and yellow ones, it was rewarding to know that we helped to make the children’s environment more conducive to their needs, and hopefully they enjoy the new wall colors! After finishing up painting for the morning, we washed off all of the sweat and paint from our bodies as best as we could and headed over to the clinic to treat patients for the next 4 hours! When our work in the clinic was completed, we quickly changed and headed to a small restaurant right outside the hotel to get some homemade empañadas as a little appetizer before dinner!
On Wednesday, we worked in one of the Hearts in Motion clinic’s stationed in Zacapa for the entire day. We got to see many patients here too! The patients I treated had diagnoses and complaints ranging from cerebral palsy, to back and neck pain, to a lady with foot pain after a toe amputation, to a two-year-old child with microcephaly (possibly due to the Zika virus) and significant extensor tone. We also had the opportunity to tour the Range of Motion Program (ROMP) building that was situated right next to the physical therapy clinic and see where they make different orthotics and prosthetics. After spending about eight hours in the clinic, we headed back to the hotel and had a poolside yoga class led by our fellow student volunteer and yoga instructor, Hillary Cummings! We definitely all benefitted from a little stretching out after some long days of work!
Thursday, some members of our team went to a pop-up clinic, and the rest of us went to a nutrition center in Gualan. Here, we evaluated and treated patients and also participated in a large “group feed” in which we assisted over 50 children who are enrolled in a program at the nutritional center to obtain the free lunch that they are entitled to each week. The view outside of the clinic was beautiful here with mountains stretching out as far as you could see in either direction.
Then, after five days of hard work in the clinic, we woke up around 4:15 am Friday morning and headed for the city of Antigua, where we stayed for the last two days of the trip. Some highlights from Antigua were attending the large local market that was full of colorful Guatemalan souvenirs and accessories, making chocolate from scratch, and of course hiking the Pacaya Volcano! The volcano hike was about 7 kilometers up a very steep, narrow path consisting of rocks, gravel, and volcanic debris and was challenging to say the least. However, the view from the top definitely made the hike worthwhile! We also got to roast marshmallows over an opening in the lava field that was still hot from the most recent eruption!
In the end, the experience was full of memories to last a lifetime. It was so satisfying to be able to apply all of the knowledge that I have learned the past two years in PT school to help the wide variety of patients that we saw. This experience also increased my ability to think outside of the box and provide effective interventions for patients with limited time, resources, and information about their impairments available. I also loved having the opportunity to work with my fellow classmates and the three very knowledgeable clinicians that accompanied us on the trip to treat patients as a cohesive team. This strategy enabled each person to draw upon his or her individual clinical experiences and knowledge to come up with unique intervention and treatment ideas. We were then able to combine everyone’s individual ideas into a unified treatment plan for the patient, and I feel like this cooperation really helped to elevate the quality of care that we were able to provide to the patients. All in all, 9 days after we had departed from the U.S., my classmates and I returned to snowy Pittsburgh with hearts not only warmed by the Guatemalan sunshine, but also warmed with the knowledge that hopefully we were able to help at least a few people in Guatemala move better and experience less pain. To me, that definitely qualifies as a productive spring break!
-Hannah Zangara, SPT Class of 2019