UNM pt

 

Division of Physical Therapy
UNM Health Sciences Center
MSC 09-5230
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone: 505-272-5479
Fax: 505-272-8079
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UNM Division of Physical Therapy Expands its International Reach

The University of New Mexico Physical Therapy program - and the UNM PT students - have long made a commitment to service learning, both in the U.S. and abroad. This spring, to help fulfill that commitment, five students, Tatenda Chibanga, Sean Horner, Troy Jaramillo, Jonathan Lewis, and Lisa Peterkin accompanied PT Division Chief, Dr. Burke Gurney to Addis Ababa, Ethiopia to provide skilled physical therapy treatment for those in need. For two weeks, the students spent their mornings treating outpatient orthopedic and pediatric patients at Tikur Anbessa Hospital. While there, each student was paired with a recent graduate of Ethiopia’s (and in fact Africa’s) only DPT class to date. This allowed students to develop their skills and exchange knowledge with their Ethiopian counterparts - as well as serve the community in a meaningful manner.

PT Students

The students at Addis Ababa University on the first day of clinic

Tikur Anbessa - or “Black Lion” - is a teaching hospital similar to UNMH. Like UNMH, it is associated with a University, Addis Ababa University. In the center of the city, future nurses, MDs, PTs and pharmacists attend classes and treat patients and, after graduation, many practitioners choose to stay at Black Lion and continue to practice. Named after a resistance movement that fought the occupation of Ethiopia during WWII, Tikur Anbessa is a 600 bed hospital that sees over a quarter of a million patients per year. Thanks to a robust orthopedic surgical department and a high prevalence of childhood disability, many of these patients receive physical therapy as part of their health care management.However, treating at Tikur Anbessa differs from UNM in many ways. The hospital is located in a city of five million people - nearly ten times that of Albuquerque - in a resource poor nation. The crush of population is evident in the twenty-thousand to one patient-to-doctor ratio in Ethiopia. Because of this imbalance, wait times for treatment throughout Tikur Anbessa are long - and the PT department is no different. Furthermore, due to the scarcity of resources, the hospital is often subject to rolling brownouts and often has to switch to generator power for some or most of the day. In addition to the frequent brownouts, the water went out in our building for a day. Finally, unlike UNM, Tikur Anbessa is often critically short on supplies. This shortage means that physical therapists must rely only on manual therapy and exercise therapy for their patients. However, because of this, the therapists are left to their creativity to make do. They do amazing work on a daily basis with very little.

Oromia, Ethiopia

A pastoral scene in Oromia, Ethiopia

In the afternoons, students would either accompany Dr. Wintana Mekonnen, a DPT graduate from Tikur Anbessa, to her private outpatient orthopedic clinic or they would join Dr. Gurney at the Missionaries of Charity Home for the Sick and Dying Destitutes to treat patients with advanced neurological and orthopedic conditions. While at Missionaries of Charity (MOC), students treated patients that truly had nowhere else to go. The Missionaries of Charity organization, established by St. Mother Teresa in 1950, attempts to provide “whole-hearted free service to the poorest of poor.” The Missionary home located in Sidist Kilo, a suburb of Addis Ababa, serves meals to 900 people daily and houses many of these men and women who have nowhere else to stay. 

Daily treatment and care at MOC is generally performed by 6 technicians with no formal education - but all have a great deal of commitment to their patients. These techs treat in two small rooms with very little equipment while still managing to make great progress with many of the patients of MOC. Every day, this small group of technicians see patients with a variety of diagnoses including muscular dystrophy, stroke, HIV-derived neurological conditions, developmental disabilities, orthopedic impairments, to name a few. In the MOC, the UNM students treated patients while trying to educate the MOC technicians and help them to expand their skill set. This focus on education with treatment ensured that the student’s time here would have a lasting impact and would benefit MOC far into the future, rather than just during the two weeks of treatment.

Treating a patient

Troy Jaramillo, SPT, treating a patient with severe contractures at Missionaries of Charity

For those students that accompanied Dr. Mekonnen to her private practice - Oslo Addis Physical Therapy and Wellness - the patient population consisted of adult patients with orthopaedic and neurological conditions, as well as pediatrics. Because Oslo Addis PT is a private clinic that accepts both insurance and self-pay, the socio-economic status of the patients there was different from those at either Tikur Anbessa or MOC. At Oslo Addis, the students worked with immigrants from across Africa, athletes, laborers, and everyone in-between.
In all three of these settings, the students found that the most difficult aspect of treatment was the language barrier. While the official language of Ethiopia is Amharic, there are over 80 different tribal languages spoken throughout the country. This often meant that the students were trying to treat patients through up to 3 levels of interpretation. In addition, many of the children and adults with neurologic conditions had trouble communicating in their own language, which compounded the difficulty experienced by the students. However, one thing seemed to be near universal among patients: they would often tell students that they didn’t feel like their therapists were doing their job unless the treatment was somewhat painful - this was a completely different mindset compared to many American patients. Due to this attitude, the students often described their patients as “tough,” “resilient,” or “brave.”

Tea time

The students and Dr. Gurney enjoying a traditional tea with Dr. Winona Mekonnen, a DPT from Ethiopia

Treating in these settings allowed the students to learn a great deal about the Ethiopian culture - about the culture’s warmth and Ethiopians’ trust in doctors and authority figures; about many Ethiopians’ easy smiles and willingness to undergo great pain to find healing; about their tendency to independence while still developing strong friendships; about the quiet strength that even the sickest of children displayed. While the students learned new techniques, evaluation skills, and treatment approaches from excellent clinicians, it is probably the strength they saw displayed by each and every patient - and each and every Ethiopian DPT - that most impacted them. Treating patients with so little who still fought so hard at each and every session was truly inspiring to every one of the student’s and they will be forever grateful for the experience.