Ann in Haiti--- Day Three

It was our third day in the clinic today. Bridgitte walked with her walker with a platform attachment 20 feet with only contact guard! She also put her brakes and footrests on and off by herself. Her daughter said that she needed minimal help to transfer. Bridget was very excited that we gave her the walker to take home! Progress!
Doing PT here can be a bit frustrating at times. Yesterday I worked with a man who had had a proximal Tib/fib fracture stabilized with an external fixate. He had -20 degrees of ankle DF, a lot of soft tissue scarring, and edema. After some edema massage, joint mobilization, passive stretching, wrapping with an ace wrap, giving him a night splint and gait training to try to keep his heel down as long as possible during stance, he went to see the orthopedic surgeon. He came back afterwards saying that the doctor said that he needed a different type of ace wrap. Since we did not have any other ace wraps, we decided to walk into the hospital and talk with the doctor, and see what he had in mind. The doctor wanted a wrap that went around the patient’s ankle to keep him from externally rotating. I explained to the Dr. that I felt he was turning his foot out due to his lack of DF Range of motion, which we are working on, and that I was not sure that wrapping the ace differently would help much. The Dr. was very pleasant, but insisted that wrapping would help. So the pt and I walked back to the clinic, and I wrapped the ankle again…. Clearly, the surgeon did not have much exposure to PT and was not used to working with another professional who might have expertise that was different from his. But, he welcomed me to come and see some patients with him on Friday. Maybe we can educate him about what a PT has to offer just by the exposure!
There is a definite need for PT here, but the patients and Dr.’s do not always realize what we have to offer because they have had little exposure. There was no history of rehab in Haiti until the earthquake when professionals from around the world came to help. Since then, however many of the patients hurt in the earthquake seem to have disappeared. The host at the guesthouse where we are staying says that many are just coping as best they cannot realizing that PT could help them more and that it is available. The more that we are here helping people to get better and helping surgeons to have better outcomes, the more the word will spread. Ultimately, there is a need to train rehab professionals in Haiti.
Tomorrow is another day! I am planning to show up and see patients with the orthopedic surgeon being very diplomatic in my suggestions!--- Ann