Day 1 of clinic

Sunday was a pretty relaxing day spent in a small beach/surf town 1 hour away

We got to experience the food, shops, and beach.  One dollar fresh made empanadas while sitting in the sand were phenomenal 

The group spend the last night before clinic began getting to know each other.  We have really meshed well but you could sense some anxiety about clinic beginning 

The walk to the clinic was about 15 minutes but today we took a truck to bring all of the donations

When we arrived 3 patients were already waiting outside ready for us

We quickly got unpacked, organized our supplies, and split into two groups.

Each consisting of a group leader, someone who spoke Spanish and both years of PT students

From 8 to 1:30 our group evaluated and treated 5 patients and the other group completed the same amount.

After lunch we saw another 4 patients per group until 530

We had a wide range of patients from age to diagnosis and functional level

The youngest patient seen today wa s 8 months old with slow developmental progress and hypotonic. All the way up to a 90 year old man with severe bilateral knee Osteoarthritis which has severely limited his function.

The focus for me today was to let the students get used to asking questions, struggling with the process, but also thinking critically.

They all did a great job applying what they have learned and know to really

Make an impact today.

To see first year students thinking critically and interact with a patient with confidence and poise in a new situation and different language was phenomenal.

For myself it was great to apply the residency training I received with UVA-Healthsouth. The evaluation and thought process really streamlined the treatment plan and helped me to feel confident that if I can only see a patient one time I am giving them the best care and long term plans that I possibly can.

It was very different to sit back and have more of a teaching role with the students. At first it was very hard but as the day went on I enjoyed the experience a lot. None of the students have learned about the spine so I get to treat all of these patients while still showing skills to the students 

The most rewarding patient interaction today for myself was a 34 year old male with a report of a disc compression injury two years ago. He no longer works as a fisherman or plays soccer due to his pain. His symptoms stayed very local to his back but he was very afraid to move and had severe cramps with each motion.

We spent time talking about his back and really worked on movement patterns and how positive the motions were for him.

After the talking, motor planning, joint mobilization, and exercises he left with full motions, 1/10 pain, and will be playing soccer between now and Friday when we see him again.

It is hard to see such great in session changes with an evaluation and even harder in a different culture and language so it was great to experience.

As a group we had a great reflection and sum up of the day

Excited for day 2!!!

First day in Puerto Lopez

After a 1 hour nap we started the day with a traditional breakfast and a camera crew. The small fishing town of Puerto Lopez is very excited for us, the mayors wife is heading up the clinic and she has been talking about us on the radio and TV.  They will be following us around all week and documenting our trip on Channel 3

Our group spent the rest of the day on a boating adventure. We packed into a boat for an hour trip to Isla de la Plata also known as the poor mans Galápagos Islands. The island has many birds that inhabit Galápagos including the Blue Footed Boobies. A two hour hike had some of the best views I have ever seen. 

We spent the rest of the afternoon snorkeling in the deep blue water off the reef. We saw every fish in Finding Nemo, blow fish, trumpet fish, star fish, and more that are above my fish knowledge.  Jake got some great videos on his Go Pro but sadly we could not add them here.

Did get some close ups of sea turtles before we anchored our boat 

Still didn't get my exercise fix in, so a group of us went on a beach run, sprints, and soccer with locals.

I am still very confident that I am a terrible soccer player and need to practice before I travel again

After another great meal with the group we did some reflection and enjoyed the beautiful beach weather

One more day until our clinic begins....

Day in Quito

Before bed last night (Thursday) we got to visit he new area of Quito which is very modern with tons of restaurants, bars, stores, and shops. We were shocked by how nice this was but learned from our local leader that this was built with the boom in tourism

On Friday we were able to maximize our day in Quito starting with an early breakfast.

We spent the morning visiting 3 churches with one being the largest in South America! The best part was the fact that we were able to tour while a mass was in session giving us the full spiritual effect. It also was pretty amazing climbing narrow stairs on the outside of the church to reach the bell tower.  I have climbed to the top of a church before in Europe but it was not close to this risky.

The other churches were much smaller but had a lot of great history and intricate artwork

We headed to the town center to see the presidents house, political buildings, and learned a lot of Ecuadorian history from our local leader Miguel.

After lunch at a local restaurant that consisted of meatball soup, meat, rice, lentals, plantanes, and salad, we took a trip up the mountain to a statue of an angel which can be seen all throughout Quito.  

The view was something out of a magazine with the Andie mountains cradling this vast city 

The final stop before dinner was the local market. The smells, sounds, and sights reminded me of my other experiences and made me remember why I love the cultures around the world 

The real adventure started after dark when we embarked on our 9 hour overnight bus trip from Quito to Puerto Lopez. 

Packing 16 bags and 8 people in a 12 person van without a trunk was hard enough.  Adding a wheelchair was an adventure. Luckily the bus was much more spacious but I can say it wasn't the most sound sleep of my life.

Travel day

Today was a busy day of travel for our thrive group

We left Winchester at 4 am and met as a group of 8 at Dulles bright and early

Preparing as a group beforehand really helped to quickly form a bond

We had a 5 hour flight to Panama and then a 2 hour layover before making the final leg to Ecuador 

Our group was able to collect a lot of donations (wheelchair, crutches, braces, splints, theraband, and other supplies) which is great, but the bus we had for the hour long trip to the hostel so we had a nice cramped ride

We had just enough time to put our bags down before grabbing some authentic Ecuadorian cuisine 

 

Equator is a very clean and organized country so far. It has such a better infrastructure compared to the Central American countries I was been to before.

Headed to bed early for a tour of Quito tomorrow 

Ecuador 2016 SU Medical Mission Trip: 3 days away from the trip

Three days until we head to Ecuador for the first medical mission trip of 2016. 

I am so excited to return back to Thrive as a clinician. It is crazy to think that Grant Davis, Jordan Hoile and myself began Thrive 5 years ago on our first trip to Haiti. 

It is awesome to see where SUPT students have taken Thrive and I cannot wait to keep seeing the growth. 

Our group to Ecuador will consist of two clinicians, three second year students, and three first year students. Each person brining their own aspect to the table. 

We have been meeting every few weeks leading up to the trip to get to know each other, mesh as a group, and prepare so that we can maximize our efforts while we are away. 

The trip will be 10 days (Thursday to Sunday) with two days spent in Quito and the rest in Puerto Lopez. We get to spend 6 days in the clinic and it sound like they will have enough patients to keep us busy. The local leaders have been making announcements that we will be in the country for the last few weeks. 

Looking forward to a fantastic trip of self exploration, patient care, friendships, and growth. I only hope I can give to the people of Ecuador as much as they will give to me from this experience 

  

Amazing Village week

 I was so fortunate to be able to spend my final week in Ghana living in a small rural village 1 hour outside of Takoradi.

Fasin Village is a farming community of about 1,000 people. Emma and I lived with a farmer named David, his wife who trades the cassava that he grows in the local market, and 2 of his children who are still living at home. The house they live in has 2 rooms and the kitchen is a separate building next door. They have one of the nicer homes with a finished floor and roof. Outside of the house is the shower area. Without running water you have to go fetch water from the river and bucket shower. David's brother Prince lives next door and both families share his long drop outhouse. 

The living area 

Shower area 

Squat style bathroom with a smell like no other. 

During the week Emma and I worked in the health clinic from 8 to 2. We split time working in the outside area (collecting information and doing vitals on each patient) and the inside area (talking with the patient about complaints, doing malaria quick tests, determining diagnosis, and prescribing medications from the small selection at the clinic). At this clinic the main diagnosis is malaria and GI worms. They also do some wound care and family planning. All sever cases and referred to the large hospitals near by. The staff are all nurses who are sent to the small clinic to work by the government. 

The clinic is not as busy as the hospital so people come from all over to visit this clinic (even people from takoradi come to get care). They take both insurance patients and cash patients who do not have insurance. It was very cool to work in this general health setting and get the exposure to medications and diagnosis I do not see in physical therapy. The clinic gives injections so I even learned how to give them!!

Very few of the patients come with symptoms that could benefit from physical therapy. I did see 2 patients and tried to work with them how I normally would in an outpatient setting. This clinic had never had a Physio before and it was very evident that the staff was unfamiliar with the treatment and concept. The people in this area belive that the only way to make you better is a medicine so they are not satisfied when you educate and give them exercises. 

Clinic 

After clinic our guide, Ebineser, showed us different aspects of the village. We met the chief and the linguist and got a history of the village and it's people

The linguist always sits infront and speaks for the chief. 

We also got to see how the village people make coconut oil and palm oil

Helping stir before extracting the palm oil

Straining the coconut oil 

Went to Busua beach for one afternoon and after we went to the market to see David's wife Mary selling the families cassava.

We even got to spend an afternoon learning how they make local Gin from the Palm tree. They add a local root to help give it a yellowish color and fruity flavor 

I was very interested in this afternoon because of my interest in brewing beer. It was also the first time in 4 and a half weeks that I got to hangout with more then 3 guys my own age at a time.

We also got to visit one of the farms and helped to weed the cassava plot with machetes. After that we helped the cook prepare dinner by pounding the Fufu (cassava and plantanes that are pounded together into a sticky paste like consistency).

Preparing the spicy fish soup you eat the fufu with. 

Finished product 

Ebineser was a great resource and friend. He treated is like family and even had us meet his friends. We got along so well with one of them that he decided to join us for dinner and brought a bottle of wine to enjoy our Fufu with 

Myself, Messick, David the father of the family we lived with, and Ebineser. 

In the afternoon I was able to do some exercise every day (running on the beach, running from Fasin to the neighboring villages, and even getting creative with the cement blocks laying around). At first the kids just watched but as the week went on they started to join in. It was so much fun and great to have them join in. Emma took a few pictures one of the days.

The village kids were the best part of my time in Fasin. Everyday we had a group who walked us to clinic, walked us home, and even sat near us during dinner so that as soon as we were done we could play with them. They taught us dances, games, songs, and we showed them some games we used to play. 

These kids were the hardest thing to leave on Saturday. They were so much fun, always had a smile on their faces, and were so caring you would have no idea that they only have 3 outfits and very few toys (unless you count the sticks and natural resources they turn into toys). It will be great to see boys like Daniel, Darius, Jacob, Wisdom, and Dadi grow up and have great success in life. 

Darius and I hanging out before dinner. 

Overall this was an amazing week. I loved living this basic lifestyle and getting to really feel the culture. It was a great way to end this amazing adventure and I cannot wait to tell everyone about the trip when I return home!!! 

My favorite picture from the entire trip. After the workout the boys wants to compare muscles so Emma snapped this photo.