Guest Blog — Beyond My Boundaries: PT Takes Trip of a Lifetime to Spread Healing
September 20, 2017
Guest blog by Allie Vollmer, PT, DPT
Since physical therapy is vital to a woman’s optimal recovery after suffering an obstetric fistula, in 2017, the Worldwide Fistula Fund invested in providing enhanced master’s degree programming in physical therapy at Mekelle University in Ethiopia. Prolonged, obstructed labor, which results in a fistula, often leaves a woman with additional pelvic muscle impairments and damage that cannot be corrected by surgery alone. Pelvic floor specific physical therapy techniques are taught during advanced coursework, however, WFF supports the entire physical therapy master’s program and invites US therapists to instruct in all aspects of therapy to Mekelle to support the curriculum.
As we drive out of the city into the country, it is just so beautiful, too difficult to describe in words, and I just keep thinking, ‘How is this my life? How did I get so blessed to have this opportunity?’ And I find myself in tears again at the beauty and magnitude of it all.
Allie Vollmer, PT, DPT
Before detailing the specifics of my trip, I wanted to share the above passage from the journal I kept throughout my trip, because it expresses how I felt about it so succinctly.
Without the help of the Worldwide Fistula Fund, I would never have gone to Ethiopia to teach at Mekelle Hospital. I’m going to do my best to express my gratitude to WFF for this opportunity, although the expanse of that will be difficult to truly convey.
Many would say that I am someone who is most comfortable in the familiar boundaries of the St. Louis area — which might make you wonder how I ended up so very far from St. Louis.
I was introduced to WFF by Theresa “Tracy” Spitznagle, PT, DPT, MHS, WCS, a former professor of mine from the Washington University School of Medicine in St. Louis, Physical Therapy Program. WFF has an amazing mission: to protect and restore the health and dignity of the world’s most vulnerable women by preventing and treating devastating childbirth injuries. How could anyone turn down an opportunity to be part of something so important?
The physiotherapists who work at Mekelle Hospital are responsible for inpatient and outpatient care. In addition, they are responsible for the duties, not only of a physical therapist, but also speech and occupational therapists. The pressure and responsibility is very high for these men and women. After touring the hospital and discussing the roles of the physiotherapists, we began teaching.
My role during this trip was to teach the second-year masters students, as well as the available first-year students, a variety of pediatric content. I found the students to be invested and engaged the entire time, and it was such a wonderful feeling to see them connect with the material and learn to apply it in patient care.
The students were so very kind and helpful – both in the classroom setting and outside of it. They are passionate, not only about patient care, but about providing the best patient care possible. I feel so blessed to have played a role in helping them provide more comprehensive and effective care. The students possess a great base of knowledge, which allowed me to simply expand on the information. But what seemed to be more impactful was teaching them strategies to apply this knowledge in direct patient care.
A typical day involved teaching in the morning and afternoon with didactic information, reviewing patient cases, and performing labs. We were, then, fortunate enough to complete patient demonstrations with the students’ past and present patients.
One patient was a three-year-old girl with whom they had been working for a couple months with little progress. She was unable to crawl, roll, get up from the floor, or complete a squat to stand. She could stand and walk, though with poor balance.
First, I had the student who was primarily treating this patient show me what treatment he had been doing. His care was on the right track, but not comprehensive enough. In some activities, he was offering too much assistance, and other times, he was giving too challenging tasks. I helped by demonstrating hands-on techniques and ways to facilitate different movements. The students and patient did great!
By the end of the visit, she was able to complete a floor to stand transfer by herself, squat to pick up a toy, and transition to hands and knees. This wasn’t because of anything special I did, but just by demonstrating to them different ways to help her move. It was wonderful!
By far the most impactful moment of the week for me was going on the home visit with Teklehaimanot (TT), one of the students. We went to the home of a private patient; the family was welcoming and very open. The child had a complicated medical history with a diagnosis of cerebral palsy.
The family just wanted to know if they were doing the right things and if the child would walk some day. The student demonstrated what he had been working on, and from there, we discussed different functional positions, handling, and prognosis. Then we had the difficult conversation with the family about the brain damage that occurs at birth with cerebral palsy, and that, as physiotherapists, we cannot change the brain tissue. We talked about the importance of keeping the child engaged with the family and involved in different activities.
We also stressed the importance of maintaining strength and stretching for better positioning. Although I didn’t have all the answers for the family or the best prognosis, TT said it was wonderful because the family learned that they are doing the best they can do for their daughter, whether in Ethiopia or America. He felt affirmed in his treatment approach and plan of care. The family was so grateful for the time we spent with them that they presented us with tea and honey. We had a beautiful evening with them, working together and enjoying each other’s company.
This experience far surpassed anything I could have expected, and I want to thank the Worldwide Fistula Fund for funding my trip. It allowed me to combine my passion for working with children, teaching, and travel into one magnificent trip!