Tikkun Olam

 As I reflect on this year’s trip to Guatemala and the year leading up to it, I have a plethora of emotions and it is hard to find the words to express my thoughts and feelings. I return to the concept of my first year with this incredible team, we are a drop in the ocean and we are creating ripples.

This year a group of 10 young women and came together and became a family. They started out mostly strangers who found a common cause. The fundraising efforts of the team this year was enough that we not only funded our trip and an extremely large pharmacy to bring down, but also are now able to create an endowment to support the efforts of this community year-round. Ripples.

 

Our travels to get to La Ciudad de la Esperanza were full of obstacles. From canceled flights to changing itineraries, packing dilemmas and flat tires the team persevered and we made it, at last, to the clinic where what awaited us was growth and change. My first year at La Ciudad the clinic was composed of one building with two treatment rooms, an office/pharmacy and a dental room. Physical Therapy borrowed a room from the school and our triage area was outside under a tent. This year there is a two story second building with a huge room for PT, that we also shared with the prayer groups, and a second story that is soon to be a fully functioning laboratory. Ripples.

 

This year I was privileged to follow up with a few clients I have seen in past years. As a pediatric physical therapist in Denver, I have treated patients with cerebral palsy on a regular basis for years on end. In Guatemala I met a young boy, Freddy Alexander, last year presenting with left hemiplegic cerebral palsy. I had one visit to educate his mother on how to best support this young boy’s development and promote use of his affected side. I provided them with orthotics to support his feet and legs while walking and promote a symmetrical gait pattern and some strapping for his left arm and had to promote proper positioning for use of both hands together. This year when they walked in I was so impressed with the progress Freddy has made! He is spontaneously using his left hand as a “helper hand” in all activities, his gait is improved and he is an active, happy little boy. This is 100% due to his mom and older brother constantly supporting and encouraging him. Ripples.

I was also able to follow up with Anahi and Dany, siblings that presented to us on my first year with the team with skeletal dysplasia. These two children are close to all our hearts! My first year with the team I joined forces with the Dr. Christian, the dentist, to make molds of Anahi’s feet to bring home and make custom orthotics in an effort to prevent the development of permanent deformations that Dany already suffered from. This year, these two children bounded into clinic with all the energy and joy we have come to expect from them. They have grown very little, Dany has actually lost weight. Their parents reported that Dany had outgrown his custom orthotics and that Anahi’s have been stolen. I was able to provide Anahi new ones and demonstrate that with proper shoes Dany has more wear of his. We learned that Dany is walking to school 1 hour each way every day, expending a lot of energy which affects his ability to learn and participate. He is falling often as well. We decided that having additional support during these long walks would help him, as his mother now has to carry his new sibling. The entire team sprang into action and we built him a walker out of PVC pipe, with special help from our man of many hats Perla. Ripples.

 

Several patients that came to the PT room this year were seeking relief from pains and discomforts during exercise and activity. We had a gentleman come in with pain in his groin that onset during his three times a week swimming and exacerbated during his daily 60 km bike rides. Two young women complained of chest pain and shortness of breath during new onset exercise classes. An older woman wanted to continue her daily 500 jump ropes without pain. We were able to collaborate and provide stretches and strengthening exercises and breathing and mindfulness activities to target each of their concerns. We encouraged drinking safe water to ensure adequate hydration for these levels of activity, something the entire team strives for. We educated the students on looking at the whole body, the whole self. Ripples.

 

 

 

An incredibly special part of this project is the collaboration between all the medical professionals and demonstrating this important part of healthcare to the students. This year we had a patient arrive to PT status post stroke. Concepcion walks with a cane, head bowed and shuffling. She has little use of one arm and hand. Her daughter arrives with her. She wants to help her mom get better. As we do our interview it becomes apparent, the primary issue here is not her movement difficulties but her grief. We referred her to Dr. Richard for a work up, where she did not indicate the same concerns but rather complained of back pain. Fortunately, we had requested that she return the next day for more work in the PT room. We were able to set up a space within a space for Rosario, the social worker extraordinaire, to meet with this family. They spent at least an hour talking, crying, laughing. When they emerged, Concepcion was smiling. She walked taller and with more purpose and was able to demonstrate real change with some exercise activities. She had a plan to return to work with Rosario and do art therapy, decorate the PT gym. I cannot wait to see her creations. Ripples.

 

I was fortunate to share my space this year with Nan Mulligan, a PT and educator that joined us from the Global Health Pathways team at Regis University. Nan joined us in the capacity of expanding Regis’ presence in Coban, Guatemala with the aim at bringing a group of graduate students from the physical therapy and nurse practitioner programs on a second trip to the community. She also joined me in treating patients in the PT room. I feel fortunate to have her expertise in adult physical therapy with me this year as we were able to provide care to more patients at La Ciudad de la Esperanza as well as future years with more students that can learn and grow with this amazing community. Ripples.

This year we celebrated Shabbat together with the La Ciudad team on Friday evening, after a long day of clinic. Our chef, for the first time ever, made a homemade challah for the celebration. This amazing, beautiful creation to honor Dr. Richard and my heritage and share with these incredible people. Our medical team joined in by reading passages in both Spanish and English to include all those present. They also learned the Hebrew for the blessings, which blew us all away. This is the true meaning of Interfaith. Supporting and loving each other enough to take part, even when the religion differs from our own. Demonstrating to God and to each other and to the world what it means to truly love and care for each other. Ripples.

I could go on with stories forever. This year we provided space and care for a wide variety of patients, adults and children, seeking better movement, less pain, answers, grace, love. We taught exercises, provided manual therapy, dispensed equipment and medication, introduced women to their bodies, taught students to listen and look beyond the surface, learned to work together for the greater good.

Tikkun Olam, my friends, we work to repair the world.

Ripples.

~ Dr. Deb Bauer, Physical Therapist