Founder of Physical Therapy Haven
This is a reflection piece on service and my personal insights on how it can be delivered in ways big, small, and all other sizes in between. I have found that by serving people with all different kinds of tools, volunteers can truly make a difference. I recently embarked on a trip to Iquitos, Peru and what I found supports the above statement. We utilized medicine and rehabilitation. We utilized hugs and smiles. We utilized our Hearts.
After three years practicing as a Doctor of Physical Therapy my perspective on the changes that are possible in communities around the world through health interventions and quality time continues to expand. In the last several years I have taken five trips abroad to Mexico, Colombia, Peru, and twice to Guatemala. Deep down I know each trip has brought about a change in me, though I sometimes search to palpate that change or objectify how or what it is. I can however consciously recall and touch the past experiences themselves, and at those moments I know they are playing a part in who I am now and who I will be. Reflecting on these memories at times have become a source of strength that enables me to push harder and do better the task at hand.
There has been a longing question that I sometimes ask myself: What incents me to go on these trips and what does the concept of service mean to me? It is not fully answered now, nor am I sure that it will ever be. Is it for the gathering of memories and the building of my strength? Is it my hope and desire that while serving others I can help them develop good memories to hang on to and I can help them cultivate strength of their own? Is it both? I do not know.
What I do know is that after each trip I am reminded that love and hope are expressed in languages, looks, and moments that transcend time and space. I do know that I am very grateful for the opportunity to be a part of the life of another person in another country, even if it is for a moment in time, acknowledging that we are both helping each other in our own ways. I may never see many of those that I have encountered again, yet I will never forget them.
Something all five of the mission trips I’ve been on had in common was the pervasive sense of camaraderie and teamwork. I always take some time to stand back and enjoy the poetic scene of physical therapists, physicians, nurses, dentists, occupational therapists, translators, coordinators, and volunteers working together. It’s magical. It’s a reminder of all that can be accomplished when we look at not only what we can do, but what we can do together.
Trips differ as far as setting. Health mission teams can serve in a hospital setting, where physicians perform surgeries and professionals provide acute post-operative care, or they can serve in a rehabilitation center, where clinicians treat acute and chronic injuries, or they can serve in a clinic. The clinic setting is the most variable. A clinic can be set up in a hospital, a rehab center, or in a satellite town or village’s local church or community center. The lines are often so long your eyes cannot find the end, and patients frequently wait several hours to receive treatment. Despite the long wait, you can always count on the patients to show appreciation. So many of them have never had a healthcare professional take the time to listen to their problems, or treat or touch their hurts.
An organization called Hearts in Motion (H.I.M.) led my two most recent trips, which were to Guatemala and Peru. The mission of H.I.M is to ‘provide care and medical treatment for children, families, and communities through its programs and sponsorships in the U.S., and Central and South America’. The founder of H.I.M., Karen Scheeringa – Parra, is a woman who instantly inspires you with her actions, her words and the activity of caring you see in her eyes. She recently shared a story with me that always makes me smile when I think of it. A few years back while she was driving her kids to school one day, she saw a person who seemed to be in need on the side of the road. He was holding up a sign that said he had been going hungry. This sight touched Karen and tears instantly started streaming down her face. As she was wiping her tears away she happened to glance at her rearview mirror and she caught a glimpse of her kids – even though they were also sad at what they saw, they had a firm grip on their lunches and slowly shook their heads at her. They knew momma would be sharing whatever was in the car.
Guatemala October 2012
My October 2012 trip to Guatemala was wonderful. H.I.M. collaborated with the Range of Motion Project (ROMP), a group that provides prosthetic limbs and braces to those who can’t afford them or that don’t have access to them. I spent some time with one of the founders, David Krupa, after dinner one night, and we talked about their vision. He shared how he and his founding partner Eric Neufel wanted to help men, women, and children all over the world to walk. Many of those who receive help can’t remember the last time they walked, and others have never walked in their life. It was moving to hear how these men were attempting and succeeding at the task of trying to make this world a better and more able place. And as I spent time with David and listen to his stories of where they have been and where they hoped to go, I couldn’t ignore his sense of calm and confidence that was exuded and there was no doubt in my mind they their program was going to continue to excel. During the week I spent some time with a few of their patients and guided them with their first steps. It was a pleasure to be a part of their mission for a small time and I hope to see those inspirational guys and their organization again. Seeing someone take steps for the first time in a long time or for the first time ever is a beautiful and inspiring thing.
There is a particular incident from the trip to Guatemala that sticks out to me more than anything else. One day, while setting up for clinic, a man approached Gloria, who was another physical therapist, and I and explained to us that there was an elder lady in the village who needed rehab but couldn’t make it all the way to the town center. He asked us if we would be willing to go to her home. Without hesitation we responded yes. We walked half a mile into town before heading up a hill on the way to her house. When we arrived, the older lady was surrounded by her loved ones and they began to share her story with us. After suffering from a stroke several years ago, she was taken to the hospital. After only a few days in the hospital, she was sent back her home without any medical or rehabilitation follow up. The first 6 months after a stroke are a very important six months as patients try to maximize their recovery and here was this lady who had had no directed care. There was significant weakness and poor coordination on the right side of her body and this caused her to have a low functioning daily routine and poor walking mechanics and tolerance. Gloria and I proceeded to spend the next 45 minutes with her and her family, educating them on exercises, stretches, proper walking mechanics with her cane (which was fashioned out of a tree branch), and efficient posture and positioning in her favorite places around the house. It was a special time and there were many smiles all around as we worked through it all. During the end of that day, that week, and even now as I type these words I find myself thinking of my own grandmother. She lived her whole life in Nigeria and towards the end of it she too suffered a serious stroke. When I think about her I always hope that she had enough people around her that cared for her and attended to her needs. I made the connection sometime that week, that as I was treating and hugging and loving this older lady from Guatemala, I was treating and hugging and loving my own grandmother. Those are the moments that I remember and these are the feelings that spur me on while serving on these trips. Love and Hope. Even though my grandmother is no longer with us, by helping that grandmother in Guatemala, in some unique way I knew I was honoring my own.
Peru April 2013
The single story that emerges most as I reflect on my trip to Iquitos, Peru (near the Amazon River) is about a thirteen year old girl named Sully. One day as we were wrapping up during clinic, Deanna Kollias (another clinician on the trip), called me over to discuss Sully’s condition. Sully’s ankle was locked in a plantar flexed position. This presentation was affecting her walking mechanics and had begun to produce hip and low back pain and had already begun to limit her tolerance of daily activities. Although conditions like this are often congenital, she first noted the dysfunction after she kicked a soccer ball and had subsequent pain. Deanna had already spent some time using manual therapy techniques to improve Sully’s range of motion into dorsiflexion. Since clinic was over by the time I arrived over, we decided to bring her back to our lodging location. Deanna, Jessica Holloway (another clinician), and I each spent time doing what we could to decrease her tissue tightness in the posterior compartment of her leg and to improve her mobility at the ankle complex. We weren’t making much progress, yet we decided not to stop there. The three of us and one of our local coordinators, Nicole, made a plan with Karen to have an MRI taken the next day. We have now brought the MRI results back to the states. An orthopedic surgeon will review them to see if surgery is appropriate. If so, we plan to explore the option of supporting the surgical procedure with the consent of her parents. In the physical therapy world, there is a strong mantra that always guides me: if you can improve one’s’ function you can improve one’s life.
Our last night that week, I had a wonderful conversation with Karen. We talked about life, we talked about love, and we talked about service. As she shared her story and her motivations, her setbacks and successes, I was reminded that doing good things starts with the heart and willingness to stick things out. Karen reminded me that many people often want to serve yet don’t know how or where to begin. She also laid down a challenge. She said, “Now that you have seen and felt what you have on this trip and on trips prior, you have an obligation to continue this work in any way you can, and to help others along the way”. I felt that she was saying to me on that night, that whether it be through words or action, it is up to me to play my part, big or small, to inspire others and to facilitate positive changes wherever I go or where it may be needed most. That night, the magic behind the name of her organization fully struck me. Hearts that are in Motion to do good and to connect with each other can make this world a better place. If we believe in ourselves and the potential of those around us – anything is possible.
Efosa is the Founder of Physical Therapy Haven. He received his B.S. in Kinesiology from Umass-Amherst, and his Physical Therapy Doctorate from the University of Scranton. He is driven by his love for this profession which allows us to use our hands and words to help others. The site contains rehabilitation resources geared towards rehab clinicians and it includes videos, study guides, as well as links to other useful sites.