Friday, October 30, 2009

Physical Therapy in the Dominican Republic

You may have seen an article written in PT Priority by Heather Hall, BU DPT '11, about a trip to the Dominican Republic in March of 2009, or perhaps you read her blog while she was there. Recently another physical therapy team from Bradley returned to San Juan de la Maguana. I had the pleasure of accompanying Dr. Dawn Hall, PT, PhD, Abigail Walk, BU DPT '10 and Dorothy Fernandez, BU DPT '10, along with several others on an adventure to a city 3 hours from Santo Domingo and near the Haitian border during our Fall Break.

Everyday we examined patients in San Juan at a rehab facility associated with a local hospital. This clinic provides physical therapy to patients in the area, however in most cases the people cannot afford the 'luxury' of these services. The need for physical therapy appears to be the same as in the United States. By my best estimate, San Juan proper is about 130,000 people, and the rehab facility is the only one between San Juan and Santo Domingo (about a three hour drive.) It would be like having one PT clinic within 200 miles...only the drive to get there would much more interesting with partially paved roads and intermittent livestock crossings.) Diagnoses included SCI, CVA, BKA and patients with numerous neuromusculoskeletal issues, including many complaints of mechanical neck and LBP. In addition we saw a number of patients with diagnoses we probably just wouldn't have the opportunity to manage in the United States. For example a man with neurofibromatosis had a 40# tumor removed from his leg. Had the tumor not been removed, the man would have undergone an amputation, and my perception is prosthetic limbs in this part of the Dominican Republic are not readily available to all. Another patient had significant scarring on his chest and axillary region from a burn he received as a child. As a direct result of this, he has had limited function in his right upper extremity for the majority of his life. Because of the widespread access we have to quality health care here in our own country, conditions like these would be addressed much earlier in a patient's life and long before mechanical problems developed. Dorothy, Dawn and Abigail were involved in pre and post-op management and assisted in both surgeries. In just a week's time they were able to make a pretty significant difference in the lives of these patients.
Another cool thing on this trip was simply the opportunity to examine new patients, re-examine current ones and to teach health care providers another approach to patient management. During our short stay the physical therapy team addressed the needs of more than 70 patients, and the surgical team performed 37 surgeries. Also while we were there the entire Mission Awareness Team delivered over 1600 pounds of food!
On our last night we had dinner with those who had played a key role in making our trip a success. They graciously thanked us for our service, but I assure you, the pleasure was ours. We are looking forward to returning and future opportunities in both teaching and patient care. Our next trip is scheduled for late February, early March. We would love to have you join us! Please feel free to email me for additional details:

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