It's Not About Going and Leaving, It's About Leaving Something Behind
PTs, PTAs, and Students Transforming Society Beyond Borders
To fulfill the APTA mission of "building a community that advances the profession of physical therapy to improve the health of society," said APTA President Sharon Dunn, PT, PhD, at her APTA House of Delegates Presidential Address, the physical therapy community "must get involved—with open arms and open minds—not only as a community, but as individuals."
For quite a few physical therapists (PTs), physical therapist assistants, and students, this responsibility takes the form of global service. APTA recently partnered with Move Together, a nonprofit organization founded by members Efosa Guobadia, PT, DPT, and Josh D'Angelo, PT, DPT, to establish a physical therapy clinic in San Pedro Sacatepequez, a rural town in Guatemala.
APTA staff members Amelia Sullivan and Katy Neas participated in this effort, seeing firsthand how service, in partnership with local communities, can leave a lasting, tangible impact on people's lives. "The contribution of this profession to people's health and well-being is profound, and if we can leverage the strength and capacity we have in the United States to help build the capacity and partner with other communities that don't have the same level of resources, that's an honor and an obligation," says Neas. "People have every right to live without pain."
In addition to helping with construction, Sullivan and Neas interviewed Move Together patients and team members about their experiences and observations. These are their stories.
PTs as Partners
"Something I have loved about [Move Together] projects is that we invite the community to build with us," said Stephanie Irwin, PT, DPT. "This is yours. This is your space. We are not just coming in and [building clinics], we're partnering with local students, local clinicians, and asking them, ‘What are you struggling with? What do you see? What do you know?' We're learning from each other."
Maddie Patterson, PTA, told APTA, "I came on this trip because I'm really interested in how to set up physical therapy clinics in other countries, and how to create sustainable physical therapist practice in another country. I'm hoping to…equip [the local community] with the tools and knowledge they need to continue on when we're gone."
The partnership extends to individual patients as well. April Fajardo, PT, DPT, has participated in multiple Move Together projects in Guatemala. "What keeps bringing me back," said Fajardo, "is the relationships" she's built with the Move Together team, the local Guatemalan physical therapists, and the Guatemalan community—"all working together toward a unified purpose of increasing access to rehabilitative medicine." Fajardo hopes the people of San Pedro Sacatepequez "will take ownership of the clinic as their own."
A Tangible Impact
Irwin has seen the effect of previous Move Together projects. Getting ready to build the new clinic, she said, "I see the potential of what can be…. With the models we have developed, the people we are partnering with, and the municipalities, what we begin to create tomorrow is just the beginning to growing a lasting impact on the community."
In the clinics Move Together built in San Pedro Sacatepequez and Villa Nueva, PTs saw patients with a variety of conditions, from multiple sclerosis to pain after surgery. One patient, Adele, began coming to the clinic after a wrist surgery and improperly positioned cast left her with nerve damage and pain in her elbow and fingers. She said, through an interpreter, her fingers "were like wood," and she experienced tingling in her hand and arm. She had extremely limited mobility and pain from her shoulder to her fingers and couldn't wash dishes, dress herself, or perform other daily activities without help. Her PT in Villa Nueva has worked to increase her range of motion, increase her grip and arm strength, and recover her ability to pick up paper or a small ball.
Projects like this not only improve the health of the community; they also improve the local economy and provide jobs for PTs. Ismael Ubaldo Uz Gutierrez, architect of the San Pedro Sacatepequez clinic, said, "To have a space for physical therapy would be a great benefit for the community. There are a few places in the municipality for physical therapy, but it costs a lot. We are going to receive…an economic benefit as well, not just from therapy, because we don't have to pay money. It's going to help us in other ways."
Ariana Paz, a physical therapy and occupational therapy student in Guatemala, is one example. Three years ago, she told APTA, her mother had a spinal cord injury and lost the use of her legs. That inspired her to help people like her mother and to help her mom improve her life and her movement.
Increasing Access to Care
Jorge Medida, who teaches English for the municipality of Villa Nueva, said, "Helping with translation, I have seen a lot of patients; for example, children who were injured playing soccer. If they don't get proper treatment, their careers might be in danger. I see people getting to do what they want to do, living fuller lives, by getting [physical therapist] treatment."
"I have also seen a lot of older people [with issues like] diabetes or other issues that require physical therapy. So I've seen a lot of improvement there. People who regularly come to these clinics—of course there is improvement," he said, but also hope for people who otherwise wouldn't have access to physical therapy.
Several of the PTs who traveled to Guatemala with Move Together described their commitment to improving unequal access to health care, both at home and abroad. Much of "access" to health care is "structural," Guobadia told Sullivan. "It's not about going and leaving, it's about leaving something behind."
Gabi Borin, PT, DPT, who is originally from Brazil, said that "knowing that in Guatemala there are excellent physical therapists and students with a great passion to learn and provide the best care for their patients encourages us to continue to build connections with people in many other countries. I hope that this experience helps me to continue promoting changes to the lives of those who need the most, trying to build together a world with less inequalities."
Service Starts at Home
Service does not need to be global to change the world. The "best place to start is where you are," said Irwin. "Look to understand the needs in your community, or partner with local organizations."
Guobadia wholeheartedly agrees. One aspect of APTA's vision and mission, he said, is to "change communities, at the local level, the national level, and also the global level."
"I'm a strong believer that a strong profession around the world is a strong profession at home," Guobadia said. "And a strong profession at home is a strong profession around the world."