The resources of the two Guatemalan communities the students worked in varied greatly. Their first service rotation was on Monday and Tuesday in Villa Nueva, an urban setting just outside of Guatemala City. Here the students partnered with the Guatemalan physical therapy students (while overseen by clinicians who also came on the trip to serve as clinical instructors) and worked on a variety of clients with conditions involving spinal cord injury, cerebral palsy, fibrotic impacts to the joints, stroke, and traumatic brain injuries, among other conditions.
“If you could classify it as a neurological condition,” said Mercuri, “we saw at least somebody who had that, which was really cool to see.”
The language barrier was brokered by Alves Fabian and Cardenas, whose family is from Colombia.
“What really stood out to me on this trip was the collaboration between everyone involved - both from those of us visiting from the US and those providing care in Guatemala,” said Cardenas. “It didn’t matter where we were from, or what languages we spoke, we were all there to help the community and that was really powerful.”
For Hansen, not knowing the dialect turned into a teachable moment throughout the trip.
“Through body language and picking up some key health related words in Spanish throughout the week, I slowly got better at understanding patients before my partner even translated things for me,” noted Hansen. “It felt a little overwhelming and isolating at times to not be able to jump into conversations with anyone I wanted to at any given time or to communicate with the majority of the kind people I met. I’ve always been in the majority at home being able to speak English, which I recognize is a privilege, but now I am able to put myself in the shoes of those who don’t typically have that privilege just a little more.”
The IHP students also provided daily in-services, or presentations, to their fellow Guatemalan students –on “Patient Education of Pain Neuroscience” and “Interventions for Low Back Pain.”
“On the second day we were also able to meet the Mayor of Villa Nueva who has been very invested in the amazing work being provided by those at the clinic,” said Cardenas.
Wednesday saw a six-hour journey northwest to Canillá, a remote indigenous village with limited resources. Here, some would travel a few miles by foot just to get physical therapy treatment. And parents would carry their children that far too.
“The folks of Guatemala have a lot of adversity that we can't even begin to understand,” said Baldwin. “I doubt there would be very few people in the U.S. that would walk three to four miles carrying their child to come to therapy, work an hour and a half really hard, and then walk the four miles home.”
“They spoke K'iche' so this was a completely different environment,” added Mercuri. “Here, I was lucky enough to see a lot of pediatric cases, and there were some conditions that I had never heard of before. Thankfully I was with some very, very smart clinical instructors that were able to help us guide the way.”
The limited resources forced the MGH Institute group to be resourceful.
“It challenged all of us in a positive way to be more creative and adaptive with our approach,” said Cardenas. “It was also great to see just how resourceful and effective the care providers were in Canillá. Not only were we able to make great use of the equipment that was already there, but our group had also brought over some more equipment that proved to be very useful throughout our visit and hopefully will continue to be helpful for those continuing on at the clinic.”
Nighttime was set aside for reflection on the day’s cases.
“We talk about some of the clinical care - what did you learn?” said Baldwin. “How can we approach things a little differently the next day? Is there anything that that you would see differently?”
While patients and procedures were a significant part of the experience, so was cultural immersion. During the group’s first weekend, they took in a coffee farm, toured art markets, ruins, and museums in Antigua, and climbed Mount Pacaya, an active volcano.
In the end, a new outlook on the field along with an appreciation for it and the Guatemalan people were just some of what was learned.
“This opportunity reignited a fire in me and reminded me why I wanted to be a physical therapist in the first place,” said Hansen. “One of the biggest takeaways was how amazing the Guatemalan community is. They are resilient, resourceful, hospitable, kind, and hardworking. Everyone welcomed us with open arms and were so excited to show us their beautiful land and their culture. They are truly some of the most inspiring people I’ve ever met.”
Baldwin hopes her students saw the positive attitude and gratefulness of the Guatemalan people despite not having much.
“I think the students learned about the importance of movement and getting moving in any way that is possible,” said Baldwin. “I think they saw the effects delayed treatment can have on folks, and the importance of having treatment as soon as possible after a stroke, a head injury or spinal cord injury. And I think they also learned that it's not always the technology that’s the important thing but it's the motivation of the patient, the support of the family, and the creativity of the therapist that can really facilitate folks getting better.”
For the students, it was all of that and more.
“The community itself expressed no shortage of gratitude which helped make this such a rewarding experience, knowing we were able to make a difference during our time there,” said Cardenas.
“It was just so much packed into 10 days and so much learning, growth and just an incredible experience,” added Mercuri. “The Guatemalan people are so great, and I just feel incredibly lucky to be able to have had this experience.”
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