Making an Impact in Ecuador

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(An early version of this story appeared in the Fall 2015 Recorder.)

For many of the School of Health Sciences students, it would be their first time treating patients in such a context—navigating different cultures, different specialties, even different words. And if that weren’t novelty enough, they’d be doing it in Ibarra, Ecuador.

Since 2014, each summer a team of Chatham masters students from two different programs—Physical Therapy (PT) and Occupational Therapy (OT)—has teamed up to provide a week of interdisciplinary care for patients in different institutions in this small city in northern Ecuador, near the Columbian border. In 2015, they were accompanied by PT Assistant Professor Ingrid Provident and OT Associate Professor Sue Perry, and joined by Professional Doctorate in Occupational Therapy (OTD) then-candidate Elaine Keane.

Chatham’s OTD program is mostly online, which is how it’s able to count Keane among its students—she lives in Ibarra, where in 2013, she opened a clinic called CRECER. CRECER provides free OT services to children and adults in the community, and it’s where our story begins.

Treating patients at three centers
At CRECER, cultural differences were almost immediately apparent. “In the U.S.,” says PT student Laura Thompson ’15, “the very first thing we do is to look at the chart to learn the diagnosis. But many of the patients at CRECER haven’t been diagnosed; they’re just showing up with symptoms, which sometimes resemble those of cerebral palsy or Down syndrome.”

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The second location was FUNHI, a daycare center for adults in their 20s and 30s . The clients were mostly non-verbal, with differing levels of physical or intellectual disability. Over the course of the week, students and clients did crafts, held a birthday party, played horseshoes, and kicked around a soccer ball. Some PT students noticed that one client’s wheelchair didn’t fit appropriately. They were able to adapt it with duct tape, and even provide the client with a cushion, fashioned from a piece of foam cushion found on the side of the road that they cleaned and covered.

The third location was a nursing home. Students knew that the residents lead relatively sedentary lives, so the plan was to get everyone engaged in big group activities. Students and residents danced together—which they loved, noted Thompson—and played balloon volleyball and pin the petal on the flower. Whenever possible, they found ways to incorporate individual therapy. “We helped one gentleman with Parkinson’s walk around,” says Thompson. “I’m not sure how often he gets the chance to do that.”

Sharing best practices
At the end of the week, the students gave presentations to the staff of a nursing home in a nearby city. Topics included helping patients with osteoarthritis, how to make items like heating pads and ice packs out of everyday materials, and building awareness of the experience of elderly individuals with low vision and hearing. For this, students distributed glasses to the audience that mimic the effects of eye diseases such as glaucoma and cataracts. Then they passed out magazines, strings and beads, and the audience realized how hard it was for some of their clients to do such simple things.

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In the end, one of the students’ biggest takeaways was how much can happen when you approach a situation with flexibility, creativity, and an open mind, as OT student Hannah Huffman ’16 witnessed while working at the nursing home. “We made a shuffleboard game with duct tape on the floor, a balled-up sock as the puck, and a PVC pipe as the stick,” she remembers. “We wanted the residents to get up and stand in line to play. They wanted to hit the ball from where they were already sitting. So we made it so that they could up one at a time to play, and the others would cheer.”

Chatham's Doctor of Physical Therapy and Master of Occupational Therapy programs educate students who advance the quality of human life through excellence in clinical practice.