Tuesday, February 7, 2012

2 months!!!


Today marks 2 months that I have been in Ghana! This trip is really going by fast. I’ve definitely had my moments where I’ve wished I could be back in the US. I’d be lying if I said this trip was all sunshine and rainbows. Living in a 3rd world country is not easy! However, the opportunities I’ve had here to advance the therapy profession, help others, and experience a different culture have been priceless!!!

I finally made it to Ho Regional Hospital! I spent the day in the physiotherapy department helping treat patients and instruct the therapists and students. Lewis, the head PT, attended the Step FaR continuing education course a couple of weeks ago. I thought he was great at that time and think even more highly of him after spending the day with him. He said he has become a more hands on therapist since the course. He feels what Sam, Ken, and myself taught him was extremely useful for clinical practice! It made me feel really good. I hope Step FaR continues to be a successful NGO for Ghana. Hopefully, I can help make that happen on future trips! J

We treated some interesting patients today. One case in particular was very interesting for me. Lewis has been treating a 4-month-old baby who has Erb’s Palsy. For those without a medical background, it is a nerve injury that affects the arm. It usually occurs during a rough childbirth. We do not see it much in the US anymore since the doctors deliver babies via C-section anytime they are concerned of complications. Erb’s Palsy has an interesting presentation where the involved arm is turned around and back. The way it was described in school is a server sticking his arm behind him with palm up to try and get a tip. It is how servers accepted tips in old fashion times.

The baby is starting to show active movement. Lewis has been applying a kinesiotape technique that Ken showed him in the course. Lewis feels it is helping! I tried to give Lewis so more suggestions. Everything I mentioned he already thought of so that’s good! J I do not treat pediatric patients much in the US so unfortunately I struggle a little with how to get a baby to perform active motion on command. We talked about trying constraint induced movement therapy (CIMT). CIMT is where you restrain the good arm, forcing the person to use the bad arm. They have been trying it with some success. The baby tries to suck on her good hand when this is done!

The baby has also developed some torticolis due to the Erb’s Palsy. The baby’s neck is stiff and always turned to the right side since the left arm was not working well. We were trying to problem solve ways to get the baby to look left and force her to keep her head left. We had her practice laying on her tummy with her head to the left. Also, we used toys to force her to look left. The techniques worked pretty well.

I made some silly comments. I talked to the mother about feeding the child by standing at her left side. I forgot that infants do not start on solids until around 6 months. I’m not really sure how to get the child to breastfeed with her head turned left or in a neutral position since it isn’t anything I’ve tried before. Haha! I think I will be able to treat children a little better once I have a child of my own. I will also probably have better patience.

I admire Lewis’s eagerness to learn. I hope myself, Step FaR and Therapists Without Borders can help in the future with his learning! Lewis and I were discussing how there are such great You Tube videos available that show many therapy techniques or new exercises. However, the internet is so unpredictable here that it makes it hard to access them. He likes textbooks too but they also are not easy to get a hold of and are very expensive. I hope I can be a resource for the therapists I have met on this trip. I hope I can keep in email communication with them once I return to the US. If I could answer their questions or direct them to the right resources I think I can help them even when I’m not in Ghana!!

Tomorrow, I will visit Ho Regional Hospital again. Then, I will have an interesting Tro Tro ride back to Kpando. It will prepare me for my longer one I have in a week and a half when I go back to Accra and Tema.

Love, Kari

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