Guatemala - Day 7

Dear Evan and Nathan,
     We arrived in Antigua today.  It took about six hours to get here, but the PT group had our own van so we could stretch out a little, which made the ride more tolerable.  Antigua is a beautiful city nestled between two volcanos.  It was settled in 1542 and many buildings were destroyed by an earthquakes in the 1500s, 1600s, and 1700s.  The architecture is truly astounding.
     I have tons of pictures today.  I love you.  Good luck in your games tomorrow.  Have fun!
Love, Mom

La Merced Church

Façade of the Cathedral of Saint James



Hacky sack in the main plaza under the shadow of a volcano



Inside the Cathedral of Saint James



You can lunge anywhere.

And perform a manipulation, too.

Note the handicap sign on the sidewalk.  Not sure how this helps someone with challenges in mobility.  

 

The façade of the San Francisco Cathedral, which was damaged in an earthquake in 1565 and continued to be damaged until the earthquake of 1773.

Nuestro Senora del Carmen Church, destroyed in earthquakes in 1917 and 1918

Getting ready for the processions during Santa Semana

 

Guatemala - Day 6

Dear Evan and Nathan,

     This was our last day treating patients.  I haven't done the count of how many patients we had yet, but it was a little lower than other days.  This morning it rained, which kept people away.  We were back at the clinic in Gualan and saw a few patients that we saw there on Monday and a few follow-ups from our mobile clinic in Morales on Sunday.  The patients from Morales had to drive nearly three hours to get to us. 

     I am so proud of how well my students have done this week.  They have worked long, hard, hot days and have treated patients of all ages with a wide variety of diagnoses - some of which (diagnoses) they may never get to see again.  This is true direct-access, and they have spotted zebras in with the horses.  They deserve their time in Antigua.

     I miss you and can't wait to see you on Monday morning!  Here are a few pictures from today.

Love you, Mom

 

This kid, Henry, was so fun!  He is full of energy and enthusiasm and worked hard.  By the end of this treatment (his second with us this week), he was sitting erect and rotating through his trunk.  Becca will be able to continue working with him.

Aquatic rehab on the coldest day Gualan has had in a very long time.

Reviewing treatment for BPPV with Becca so that she can follow-up with a patient I treated in her clinic this week.  No comments on body mechanics.  We do what we can with what we have.  Becca is an amazingly flexible and resourceful PT.

 

 Where does this rod go?  To the second rib?  The dark spots are bullet fragments.

 

I am so blessed to be working with these future PTs!

Guatemala - Day 5

 Dear Evan and Nathan,
     Whew!  What a busy day!  Our clinic saw 39 patients - 27 of them by my group of students.  We are sure worn out at the end of every day.  We saw a wide variety of patients of all ages and diagnoses.  We also got to walk through the hospital and two students even got a tour of the hospital.  We have a lot to be thankful for.  We never lack for specialists or equipment or space.  The hospitals we have been in are luxurious compared to the one in Zacapa, which is the only hospital in the district.  Patients are resourceful with their own care and the care of their loved ones, though.
     Tomorrow is our last day of patient care and then we are off to Antigua.  This has been a terrific experience and I feel like we are making a difference for a lot of people.  There is a severe shortage of rehabilitation specialists in this district and in Guatemala.  Even though we won't be here to continue caring for the patients we see, other groups of PTs and PT students will follow us so the patients will continue to be cared for.  Until more PTs are trained in Guatemala, it is better than no rehabilitation at all. 
    I miss you so much!  Here are some pictures from today.
Love you, Mom
    

Co-treating with speech therapy.

Kaitlynn and Hannah hard at work.

 

This is the x-ray of a patient that Hannah and Kaitlynn saw on Sunday.  He had almost no flexion and absolutely no internal rotation of his hip so we suggested an x-ray.  He got it at the hospital this morning and brought it to us.  Can you spot the hip joint?  We can't, either.  Beyond the poor x-ray quality, there is no joint left.  Looks like possible necrosis, too. 

Is there a better exercise than the lunge?  

Pediatric PT is fun!  Danny had crawling and crab walking races with this kid while Hannah corrected his (the patient's) form and acted as the judge.

Guatemala - Day 4

Dear Evan and Nathan,

 

     We started our day with a visit to a daycare center in Tecutlan.  You might remember me telling you about a lady named Maria.  She had polio as a child and was left with severe problems with her legs.  When she was 9, she went to live in the United States with Karen, the founder of Hearts in Motion, so that she could have corrective surgeries and a cochlear implant.  She lived with Karen for three years through several surgeries and a lot of physical therapy.  When she returned to Guatemala, she was a translator for H.I.M.  As an adult, she saw a need in her community for a daycare.  She saw that kids were not attending school because they were taking care of their younger siblings while their parents (or single moms) worked.  She partnered with H.I.M. to start her daycare so that the younger kids would get quality care and the older kids could go to school. 

     We spent eight hours seeing patients at the H.I.M. house in Tecultan.  We saw 18 patients.  Once again, we saw a lot of different diagnoses and my students did a terrific job. 

     I miss you!  I hope you are being extra good for Lauren.  I know I can count on you both to help her out.

     Love you, Mom

 

A rousing game of pato, pato, ganzo (duck, duck, goose) at Maria's daycare.

 

Danny chasing down a little girl in pato, pato, ganzo.

 

Bonnie is treating a young woman who had a stroke.  Otto, our driver and translator, is beside her.

This is a busy clinic!

 

The end of another long, but productive day.  The girl to my left is Taylor, a pre-PT student at WSU.  She was a big help to us.  I hope to see her application come through at UPS.

Look at this beautiful bird!  It was really big, and there were two of them together in the same tree.  The second one is on the branch just behind this one.  You can see his tail feathers through the palms if you look closely.

Guatemala - Day 3

Dear Evan and Nathan,

     Another great day!  We worked in the clinic in Gualan today.  The complex includes a PT clinic, nutrition center, orphanage/foster home, and senior center.  The nutrition center houses malnourished children and nourishes them until they are healthy enough to return to their families.  We saw 18 patients with a wide variety of injuries and ailments.  We saw patients with strokes, gun shot wounds, venous ulcers, soccer injuries, post-operative total knee replacements, head injuries, and more.  Whew!

     I sure miss you guys!  Here are some pictures from today.

Love, Mom

 

The view from the nutrition center.

 

Danny and Lucas helped out this man who had a stroke.  There is a music group for kids that meets in the building next to the PT clinic.  While they were working with him, the kids started playing, "Eye of the Tiger" and all three of these guys really got into it.  They even did ankle pumps in time to the music.

We see a little bit of everything.

The end of another successful day!  Becca, on the right, is the full time physical therapist at this clinic in Gualan.

Guatemala - Day 2

Dear Evan and Nathan,
     Today was a very busy day.  We left our hotel at 7:30 AM and didn't get back until after 7:00 PM.  We traveled with a speech therapy team from Washington State University to the town of Morales, which does not have rehabilitation services.  We set up a clinic in a covered play field (like a gym without all four walls).  Local community advocates had let people know that we would be there and word also spread after we arrived.  When we arrived, there were already patients waiting to see us.  We set up our tables and got to work.  And boy did we work!  Together, we saw 28 patients!  That is a lot for one day.  Some of the people we saw waited patiently in a hot covered ball field all day to see us.  We saw patients with strokes, back pain, rheumatoid arthritis, osteoarthritis, neck pain, and more.  About a third of the patients we saw were children.  Families brought their children with significant physical and communication disorders to see us.  Most of them were not going to school and were not being seen by a doctor.  None of them were receiving any rehabilitation.  My two favorite kids were a nine year old girl who could stand with supervision, but could not walk, and a 15 year old boy who was cared for by his sister and her husband.  He looked younger than Evan, and he also couldn't walk and had to be carried by them.  We didn't have walkers for children, but we modified an adult walker for the girl and she walked for the first time!  The organization I am working with will get a pediatric walker for her, but for now, she can still walk with the adult walker!  Imagine how excited she was.  We measured the boy for a wheelchair and hopefully he will receive it soon.  That will make a big difference for him, too.  These kids and many others were also seen by the speech therapy team, and it was amazing to see the team help the kids and parents learn ways to communicate with each other.  They made communication boards, communication bags (with tools for therapy the parents could do), and binders with instructions for Guatemalan sign language.  It must make a huge difference in the families' lives.
     My students were terrific.  They worked all day with only about a 10-minute lunch break.  It was hot and hard work, but they gave just as much attention to the last patients as they did to the first.  What a day!  Here are a few pictures.

This is the little girl who is walking for the first time!

Hot, tired, but satisfied at the end of our day.

A picture from our trip home.

Guatemala - Day 1

An open letter to Evan and Nathan.

Dear Evan and Nathan,

     After a very long overnight flight (but not nearly as long as Dad's trip to Thailand last week), we arrived in Guatemala this morning and immediately took off on the three+ hour drive to Rio El Hondo in the Zacapa district of Guatemala (in purple on the map).

     We had some down time in the afternoon.  It is hot here!  We immediately cooled off in the pool. These are the five students who are with me. 

     
     We had a lovely sunset.  We will jump into patient care tomorrow so I will have a lot more to write about.

     I may be a day or two behind on the blog.  Our internet connection is very unpredictable.  It took 15 minutes just to load these pictures and this is my third try trying to do it. 
     Great job on your soccer games yesterday!  Dad said you both played well.  I miss you!
Love, Mom