Alex

January 17, 2014

Alex keeps telling me he is checking my blog, and that I need to get busy writing a new post! So, this post is in his honor.

I’m leaving St. Gabriel’s this morning feeling very positive. The rains here are increasing  – giving hope for a good crop. The physical therapy activities at the hospital are also increasing – giving hope for the benefits of therapy to reach more of the people in the community. The integration of physical therapy into the care at St. Gabriel’s has the support of many including the medical director, the clinical officers, a surgeon from Austria, the Matron, the nurses, the ward assistants and the community health worker volunteers.

Over the past 8 years, I’ve had the privilege of  working with Alexander Ngalande, the coordinator for Home Based Care. Although that is his official title, he wears many hats…distributing drugs at the HIV clinics, juggling the nurses schedules, coordinating the community health worker volunteers, and nurse on the palliative care and surgical wards. Although he was technically “off” this month, he coordinated the community health worker trainings, made a home visit with Father William and me, and worked on translations for training materials.

Teaching physical therapy activities to patients and guardians at the hospital has some challenges. The first step is for the patient to understand how physical therapy is part of their recovery from their illness. In a culture where patients have the choice to look for treatment from their traditional healers, they sometimes come to the hospital with hesitation. The hospital tries to provide good education about medicines, the patient’s diagnosis and the rationale for treatments. A lot of time is spent explaining physical therapy and it’s role in the recovery process.

Alex has a keen awareness of the culture, and a true love of teaching. He knows how to make teaching a meaningful conversation, based on mutual respect. I have appreciated everything he has taught our patients, the community health worker volunteers, the hospital staff, Pacific students and me over the years.  Thank you! Ndathokhoza!

Alex - ready to work on one of his "off" days

Alex – ready to work on one of his “off” days

 

 

The Malawian words for walking, just to be walking, is “moving around somewhere” – a perfect explanation for what I was doing this afternoon.

After I met with the new doctor to discuss protocols for physical therapy after surgery and after fractures, traveled to the village with Father William to visit a patient, and delivered some clothing and food to a family in the village I just walked around. I was actually taking some pictures for a friend who has an interest in maybe developing a use for all of the blue plastic bags thrown away in the village. I bought some for her to see them, and took pictures of the influx of blue plastic along the footpaths and even in the planted fields. Even though some market stores require you to buy your bag separate from the merchandise (only for about 1cent), unlike San Francisco, it doesn’t seem to be making an impact on the plethora of plastic bags everywhere.

Along the way, I met some groups of women who wanted their picture taken. My daughter wrote in her Facebook status this week that she got dressed in the dark because of early hours on her pediatric urgent care rotation, and had some crazy clothes combinations. Well, Elizabeth, the Malawian women pull it off beautifully. And they know how to peel, bite and get all the juice from a fresh mango while they are moving around somewhere…a task for which I need a knife, bowl and plenty of napkins!

 

Eating fantastic mangoes

Eating fantastic mangoes

More mangoes

More mangoes

Cleaning teeth  - from the mangoes!

Cleaning teeth – from the mangoes!

Mangoes in the market with a bowl to wash them, and blue plastic bags to carry them

Mangoes in the market with a bowl to wash them, and blue plastic bags to carry them

 

 

 

 

Respect

January 10, 2014

I started classes with the second year physiotherapy students on Monday. I began my week with a solid level of respect for these students -knowing they persevere in the face of limited resources and an uncertain future. By Friday, this respect had grown immensely. They showed their motivation to learn, their courage to explore, and their keen critical thinking. By the end of the Evidence-Based Practice course, they were not only critically appraising information, but also asking their own clinical questions. All of this without ever seeing a patient – and many without ever seeing a physiotherapist with a patient. By the end of our Normal Growth and Development course, they were reflecting on their own generation, showing that they can give consideration to different life stages in their therapy approach, and asking great questions about all of the concepts.

I was asked to give them some words of “inspiration” during an evening meeting. Humbled, I talked to them about the rewards I have experienced practicing at St. Gabriel’s as the first and only physical therapist. I encouraged them to be the leaders Malawi needs…they really have no real choice. They cannot wait, follow or delegate to another. I also reminded them that the people they treat will tell their story – and that soon there will be another generation of young people who will know about physiotherapy and aspire to be a student here. Most of all, I made it clear that it is they who inspire me. The world is watching this charter group as they join the global community of physical therapists!

Together with the second year physiotherapy students in front of their building

Together with the second year physiotherapy students in front of their building

 

The second year physiotherapy students

The second year physiotherapy students

Evidence-Based Practice in the computer lab

Evidence-Based Practice in the computer lab

 

Finding evidence

Finding evidence

 

Me and Steven Manyozo, the second year class president and the president of the student physiotherapy association at the College of Medicine

Me and Steven Manyozo, the second year class president and the president of the student physiotherapy association at the College of Medicine

 

 

Physiotherapy Students

January 9, 2014

The physiotherapy number of students here at the School of Physiotherapy at the University of Malawi College of Medicine has grown from 26 to about 130 over the past four years. In May, about 20 Physio4 students- the charter class – will graduate. I’ve been here in Blantyre for the week teaching. It’s been great to be in their “new” building (renovated “old” library), and meet the Physio2 and Physio3 students. The Physio2 class has spent most of their week with me – and they have kept me on my toes with excellent questions, professional presentations, and an incredible aptitude for critical thinking. It’s a privilege to welcome them to the global community of physical therapists!

An evening gathering of  some Physio 2, 3, and 4 students

An evening gathering of some Physio 2, 3, and 4 students

 

Physio 2 students in Evidence-Based Practice Class

Physio 2 students in Evidence-Based Practice class

 

Physio 2 students

Physio 2 students

 

The new School of Physiotherapy building - main classroom and lab area

The new School of Physiotherapy building – main classroom and lab area

 

 

 

Speed work chased by goats

January 3, 2014

I don’t have a picture of this, but will try my best to create the scene.

I have a wonderful running route in the morning – along the forest, through the bamboo trees, and back through another inner forest trail. At the corner of the forest and the bamboo trees there is a usually peaceful place that I love to stop and look out at the landscape.

Yesterday, that corner was crowded with six goats and three young boys (ages about 4, 5, and 6). The goats were each tethered on a rope. The older boy had charge of the 6 ropes (all tangled, of course). The younger boys each commanded a stick.

As I passed by, I greeted them and went on my way. Soon, however, I was being followed (chased) by the goats (some with horns) and the young ones driving the herd from behind. Here is where the speed work comes in. There aren’t many hills on my route, but this was a place that was a rough trail and a nice upward grade. I tried to get ahead of the goats being driven by the boys; but, soon exhausted, I  paused and let them pass.

Not off so easy. The boys decided that I should definitely be a part of their morning herd – arranging themselves so that I was between the goats and the stick-yielding drivers. So, now I am trying to escape the frequent smacks of the sticks. For my ultra-runner friends, these boys were sweepers to be reckoned with! For my friends who have been to Malawi, you can understand that once a group of children is on your trail, you cannot escape.

Luckily our paths parted at the top of the hill. They kept chanting “azungu” (a non-derogatory term for white person) as they traveled on their way. I wonder what story they will tell their friends.

I guess that’s speed work in Malawi.

Happy New Year to all!