Last Days (Clinic Day 9, 10, and Saturday)

Thursday and Friday:

As the week ends, I decided to sum up the days a little more quickly.

Thursday we arrived at the clinic and one of the physios was leading prayer. It was a great experience to pray alongside the patients to start the day. I wish I had seen it earlier and joined them every morning.

I mentored two students with one being a students second mentoring session and the second being one of the weaker ones of the trip. The first was George who was the head of the department with 30 years experience that I saw last week. He wanted to show he had learned from the first time and I could tell he was really trying to integrate the lessons from last week. He still needed a lot of guidance with the critical thinking but he was much more thorough with the questioning and trying to gather information. The focus today was to work on using objective impairments to treat. We worked on doing muscle testing to figure out which to treat and to assess joint mobility to figure out where to mobilize.  He said that he has always just treated based on what the x-ray showed or just where the patient was experiencing pain. I think that George will continue to grow so much during the residency year due his openness for change.

The second student was from a rural area of Kenya and he has been practicing 11 years.  He had trouble doing basic measurements and testing all of the simple things. I had to do a lot of teaching with him. The most troubling part of his session was that he filled out all of the objective examination  based on looking at the patient. He explained that he rarely tests and just guesses. I really tried to stress that this way of practicing medicine is unethical, not safe, and not helpful. After the session I spoke with residency staff and they were aware of weak he was, but said they changing his practice would help many patients because of where he works. They said the lower skilled therapists tend to work in the rural areas.  I loved that they are trying to not just make the good therapists better, but trying to improve the care as a whole.

At night our group went out for an Ethiopian meal with some of the residency staff. I was the only one from our group who had tasted this type of food so it was a great cultural experience for all. After we got to experience reggae night at a local bar. We had a great time.

On Friday we had a half day so we only had a few patients. Emily and I mentored together at first and then Lauren asked for some mentorship with a highly irritable case. At the beginning, he had severe pains and fear of movement. After some education, manual therapy to the abdominal muscles and obliques, and graded exposure to movement and dissipation he left with much less pain and was able to squat and even do a sit up!  It was a complete change and was so happy to end my clinical experience with this patient.

Our group presented gifts to the mentors and staff which they really enjoyed. The staff also presented us with gifts for our education and collaboration over the past two weeks. I was presented with an amazing handmade shirt. It was a perfect style for me and I could tell they picked out the fabric based on what I had been wearing all week and my personality. It was very thoughtful.

In the afternoon the students headed to the airport after our final reflection over lunch. All 6 of us really grew and learned a lot from this experience. It was hard to believe how many things we were able to do and accomplish in two weeks time.  For me, my low was that I was unable to treat more patients. With mentoring you are focused on teaching so it is more indirect patient care. It is also slower so we could not see as many patients as I would typically see I a day at home. But our focus was to impact beyond our time here, which brings me to my high which was the idea that we were able to provoke a change in thinking about patient care. Our influence as educators, if it resonates, will make a much larger impact on the country then the time we spent here. That is the best part of this work and experience, sustainability and progress!

(Some photos with our driver DJ Ken! He made our travel so much fun.)

At night, Emily and I went out with Martin for a few hours to enjoy our last time together. It was a great time!

Saturday:
Many people who stay at Grace House come for the week and travel on weeekends so it was a ghost town when we woke up for breakfast.
Emily and I packed and had our final meeting with Erastus and Martin.

We had a great trip, so much that we ran out of money on the last day which limited what we could do!  Luckily we had seen everything we wanted to except the Karen Blixen Museam. I did some research on her instead so at least I got to learn about her impact on Kenya.

We headed to the airport and prepared for our long flights home. I plan to use that time to reflect, work on my Haiti course lectures, and prepare for the next two weeks so I can hit the ground running on Monday.


Reflection:
Overall, this was such a great experience for myself as a therapist, global citizen, and humanitarian. My passion is to learn the world and make an impact as much as possible. Each journey has been teaching me more and more about myself and the world around me.  I feel so lucky to have opportunities like these and hope that everyone who read this blog was able to learn more.

Thanks for joining me on this journey!

-Kyle