Well, I made it to the Dominican Republic and have finished my first week here! And I can honestly already say that this experience has been and will continue to be eye-opening and a wonderful learning experience.
First, let me say that I am a physical therapist from Kansas City, MO. I have ten years of experience working in adult outpatient, inpatient, skilled nursing facilities and home health physical therapy. I have spent the last five years working at a large inner-city trauma hospital as an inpatient therapist seeing all types of adult patient populations. Prior to working at my last hospital, I lived in Quito, Ecuador for about ten months and volunteered in the outpatient department of a large hospital in Quito. Although I did work with some children there, most of the patients were in their late teens and up.
In the Dominican Republic, I am working at Cure Hospital, Centro de Ortopedia y Especialidades. This hospital specializes in pediatric orthopedics and provides inpatient and outpatient surgical and rehabilitative services. I will be here for eight weeks, assisting the hospital’s only physical therapist in the post-surgical rehabilitation of the children treated by Cure’s orthopedic surgeons.
So, since I have had very little exposure to pediatric physical therapy, I have spent the last few months worried that I may not be of much help to the children and to the physical therapist here. I knew that the need for therapy for these children is critical in helping them to regain function and a sense of “normalcy” and that the availability of professionals is limited, and I didn’t want to disappoint the people here. But, within the first few hours of my first day at the hospital, I realized that first of all, there is not enough time to worry about such things, and secondly, that I didn’t have to be a pediatric therapy expert in order to be able to help these children.
I am staying at the Ocean Breeze Apart-Hotel located in the Zona Colonial of Santo Domingo. The Zona Colonial is a tourist area, close to the main tourist street of El Conde. My room has air condition, my own bathroom, a refrigerator and stove. It is very comfortable here, and the administrator, Alex, is very kind and accommodating and speaks both English and Spanish. There is a medical student named Matt staying at the hotel as well. Matt arrived the same day as me and will be here until next Sunday.
On Monday morning, Don Jose arrived at 7:30 am to take Matt and I to the hospital. Matt and I met our host, Orfa Gonzalez, and then were introduced to the Executive Director of CURE Dominicana, Steve Bostian, and the Medical Director, Dr. Scott Nelson. Then, Matt and I went our separate ways. I was taken to the physical therapy department and introduced to Altagracia Felipe, the hospital’s one and only physical therapist. As therapy is extremely busy, Felipe, as she likes to be called, and I immediately got to work.
Felipe has worked with CURE since it was established in 2003. She does not speak English, but since I have a Spanish background, this is not too much of a problem – except that my Spanish is rusty and the Dominicans speak quickly and with an accent which is very different from the Spanish I heard in Quito. Despite this, I was able to communicate with Felipe, who is a very patient and kind woman with a heart of gold!
For most of the morning, I shadowed a very busy but very calm Felipe. As the day progressed, I eventually worked with a couple of patients on my own, both of whom were straight-forward ortho cases. I went home that day, feeling a mixture of emotions – sad because of the number of children I had seen in therapy but relieved and happy because I felt I had been able to help and grateful for the chance to work with such amazing children. My heart was so warmed by the smiles, resilience and toughness of these kids. The therapy is often times very painful, and some of the kids cried during therapy, but at the end, they still give Felipe a hug and kiss good-bye.
The patients we see have congenital deformities, deformities which have developed insidiously, orthopedic trauma which occured during birth, after a fall, etc. Some of these kids have had previous surgery elsewhere to correct deformities or broken bones, but that did not heal correctly after surgery. We see a lot of children who, post-operatively, have external fixators that they will have for months after surgery since they are used to correct club feet, genu varus or valgus, etc or to promote leg-lengthening. The fixators are color-coded so that parents can easily make adjustments to them so that over time, the bone is restored to its correct position or length. The children are allowed to weight-bear and get the device wet. In addition, we see many patients with various degrees of severity of CP who have needed tendon-legthening procedures in order to be able to sit, stand and/or walk.
By the end of this first week, I was seeing my own caseload of patients and assisting Felipe with re-organizing the patients’ records. I’m already understanding the Domincian accent with more ease, and I have all but shaken my worry and fear of not being able to help these children and the staff at the hospital. I had a great week and am looking forward to going back to the hospital tomorrow. I am so thankful for the opportunity to be here. I am, once again, reminded of how fortunate we are in the States. And, I would encourage anyone thinking of volunteering for a medical mission to do so. It is truly an amazing learning and life experience.