If you ever find yourself lucky enough to have the opportunity to serve as a PT/PTA in another country, DO IT. On February 24th, I landed in Managua, Nicaragua along with 25 of my classmates and 6 faculty members from Marymount University Physical Therapy. After a bit of a rough time getting through customs, we were on our way! In the short 20-minute drive to our hotel, many of us were already in awe of the country. We saw the native people in town, many wild animals, and beautiful colors everywhere. Even the trees and graveyards were painted bright colors! Upon arrival at Estancia Victoriana, where we were staying, the first thing our professor had us do was walk straight to the lookout to see our view. The Masaya lagoon and volcano were directly across from Estancia!
In the next two weeks we spent time at clinics in Masaya, Managua, Nidiri, and Catarina while also having the opportunity to teach a class of medical students at UNICA and doctors at the National Rehabilitation Hospital of Nicaragua. Our class was split into groups to work in clinics with pediatrics, outpatient orthopedics, inpatient, skilled nursing, and a community clinic. Each location and every student had different experiences with their patients and patient populations. Some days were happy, some sad, some motivating, and some just downright frustrating. I was lucky enough to work at a community clinic where we saw a broad spectrum of patients, from pediatric to geriatric.
My most memorable patient experience was with an older woman with the diagnosis of cervical cancer. She was brought into the clinic on a stretcher; the doctor came up to my colleagues and I and asked if we would see her–the obvious answer was yes! She was rolled through the tiny dark hallway into one of the back rooms we had taken over. This sweet woman, a pained look in her eyes, winced with every motion the gurney made. The only position she could tolerate without screaming in pain was supine, slightly leaning to the left. She physically could not roll to the right, had a pressure ulcer on her left greater trochanter, with obvious muscle wasting throughout her lower extremities. It was clear she had not moved in a long time, secondary to the amount of pain she was in. While we couldn’t do much for her aside from assisting with positioning, we were able to help with her home life. After learning she was transferred to a chair and dragged to a homemade bedside commode, we scheduled a home visit and promised a better way of life for her and her daughter (her primary caregiver) with a new bedside commode, or at least a bedpan. That home visit was the most heart wrenching experience I came across in my time in Nicaragua. Seeing the joy we could bring to someone who just needed some advice, better positioning, and simple equipment to better her quality of life was touching.
Not every patient I saw was quite so involved. An 8-year-old boy wandered into the clinic with his mother with a complaint of mild neck pain. After some digging, he revealed he only developed the pain while working on his homework. I so badly wanted to say, “Well then I guess you can’t do your homework now then can you?!” but refrained… Don’t worry, I was pretty thorough, and this little trickster may have been bluffing. But I sent him home with some postural re-education exercises and quickly became his new best friend.
Our faculty did an outstanding job planning excursions for us to do during our downtime. We walked to local parks, watched cultural dance performances, tasted the one and only POPS ice cream (more than a few times), went to a pottery factory, to the lagoon, made our own chocolate bars, went zip lining, to the top of the active Masaya volcano, and had a full resort beach day! This trip was the perfect amount of community service, involvement, and integration. By the end of the second week, we could almost get by without our translators (but thank goodness we were lucky enough to have them!). When looking back on this experience I think it’s safe to say that we all have more compassion for our work as physical therapists, a stronger drive to better our profession, and a completely different outlook on life.
I would encourage you to take any opportunity to serve, whether it’s right here in your community, or across the sea in another country. There are so many individuals that can benefit from our services and the impact we can make worldwide is inspiring. Movement is medicine. Let’s make it known! It’s honestly hard for me to stop talking about this trip and I will keep talking until we see the change this beautiful country needs and deserves. I’m excited for this trip’s future with the upcoming classes in the Marymount PT program and many of us hope to return one day and continue serving! If you’re interested, you can check out more stories on our blog or contact me!