Today was our last day of clinical stuff. The morning was full of going to the hospital and doing the usual routine. In the afternoon, we held a wheelchair and orthotic clinic for children in the surrounding area who needed changes in their wheelchairs or AFOs (ankle foot orthosis). It was fun because we had to use a heat gun to warm up the orthosis and pliers to change the shape of them to fit the child. So many orthotics that people in the US may have simply thrown away were donated to our program. So cool. Later that afternoon, we gave inservices to the people who are going to continue helping the children in the Santiago area. Night time festivities included food, dancing and socializing with the people from the clinical sites. I even got a compement that I dance better than the Dominican women! A very fun, but busy day. Tomorrow, we're going to the beach to relax and enjoy the Domincan before we leave on Monday.

The last stretch

Well, it's the last week of my time here in the Dominican and we're all preparing to say goodbye. My favorite patient, the boy with a tumor in his brainstem left to get chemo at another hospital yesterday. Sometimes it's hard to think you're making a difference out here because I'm trying to educate the parents on what can help their children in spanish and I don't always know if they completly understand me. However, talking to this boy and his family and seeing his mom point to her son, us and then God made me realize how showing the parents the exercises and how much we care is so much more important than knowing a specific exercise.
We went to the oncology unit for the first time today. I started to talk to a little 3 year old girl who was undergoing chemotherapy. At first, she was really shy and wouldnt play with me, but by the end, she was laughing and smiling and trying to tap as many bubbles as she could. I made a sick little girl smile- I love how even though there's a language barrier, smiles and laughter is universal.
These 4 weeks have been so challenging. Each day, you have to go into a hospital room with 8 beds lined up and I have to simply pick a child and eval them with minimal or limited knowledge of their past or condition. It's very exhausting to eval child after child in spanish with limited resources as to their condition. I've learned so much, but I'm getting ready to go home!

Dominican culture stems from both Spain and Africa. Therefore, the predominate religion is Catholism combined with African rituals. There are so many kids we see each day because they took an overdose of some tea or drink due to a religious ritual. One girl we began to see earlier last week. She was almost comatose, opened her eyes sometimes when we asked her to, had no visual tracking and could not move her body consciously. When we walked in the room on Monday, she was sitting up in bed, talking and was able to walk a little bit with us. It was so amazing to see the drastic change in her condition.
On a sadder scale, there were 2 kids who also had toxic poisoning. As we walked into the ICU today, the doctors and nurses were surrounding this one girl who was barely had a heartbeat and was dying. As we were looking at the scene, we noticed the other boy lying next to her was staring off into space as blood was trickling out of his mouth. His monitors were turned off and no one was even paying attention to him. We notified the nurse who had someone attend to him as she told us that both were internally bleeding and going to die. We just stood there, feeling helpless, knowing that all there was nothing that we could do. I will never forget that far off look of this alone little boy as the blood fell from his mouth and the helplessness that I felt along with it.

A Day in the Life

So I thought I'd give you all a taste of what a typical day is like for us in Santiago, Dominican Republic during the week. I start off each morning going to the hospital de los ninos. To get there, we have to take a gua gua (a big van in which you basically try to squeeze as many people as you can in there-I think our record was 27 people in one van- there is no such thing as personal space in the DR) and take a car in which you also have to squeeze as many people in as possible. Each day at the hospital is a little different. Today we went into the burn unit and I got to play with a 9 year old girl with a burn wound (it's really important to keep moving if you have a burn otherwise you might develop contractures of your skin). From there we went to the orthopedic unit and had the kids there 'play' with us in order to keep them moving, yet still abiding by fracture and weight bearing status. Lastly we went to the neurological unit in which we daily work with a 14 year old boy who has a tumor in his pons (aka part of the brainstem). When we first saw him, he couldnt move half of his body. It's so cool because each time we see him, he can do a little more. Now he can walk and he starting to use his arm. His mom gives us hugs and tells us that she thanks God that he sent us here.
Afternoons are filled with various other cultural experiences or services. Yesterday, I stayed 'home' and people from the surrounding community came in with various PT needs. Today, we're going to a museum of the history of the Dominican.
Since yesterday was my birthday, we went out shopping and then went to an 'American' western restaurant. It was decorated like a saloon, had John Wayne cutouts all around, and the servers were all dressed like cowboys. It was really fun.
I'm feeling a LOT better now. Thanks all for your prayers and comments. It really makes me feel closer to home :)

The weekend off

This weekend, we got to take a very needed vacation. We went to Rancho Biaguate which reminded me a little of the tropical hotel version of Crystal Springs camp. There was a pool, pool table, ping pong, lounge and other adventerous excursions that we could do. I decided along with 7 other girls to go canyoning. Canyoning is basically scaling down a cliff with a harness, but we got to go canyoning on cliffs right beside waterfalls. We all had to get wetsuits and helmets on. Half of the trip was hiking on slippery rocks and through waters. In some places, they had us go down the rapids like they were water slides! We went down a 'practice' cliff and then got to scale down 2 waterfalls. The first one was only about 24 meters high, but the second one was 44 meters high. You couldnt see how far up you were until you were leaning halfway over the edge. Scaling down the slippery rock with a huge, beautiful waterfall right next to me was one of the most majestic and awesome experiences in my life. At one point, halfway down, just me all by myself and holding a rope- I stopped and looked over at this powerful waterfall and could only wonder "God, how great and awesome you are". Probably one of the most dangerous things I've done in my life, but one of the most rewarding. But I suppose that's how most things are in life- the things that impact us the most or treasure the most come with first taking a risk and trusting the God will be there whatever the outcomes may be.

Prayer Time

Hey all,
If you could pray for me and my group. A lot of us are getting sick (spreading rashes, intestinal cramping, stuffiness, colds, and over-reactions to the bug bites). I feel so sick which makes it hard to focus on what I'm doing. Thanks all. :)

El Campo

This weekend we all went to one of the Campos which is rural village up in the mountains of the DR and generally the poorer part of the country (the area looked like the movie Jurassic Park). Each campo has a coperador which is a leader in each community trained to help his or her people. Our group gave 5 lectures in Spanish on different important physical therapy related topics. My group taught on diabetes and wound care. In the afternoon, we treated people from all over the community. My group saw about 8 patients within a three hour period (usually with evals you take 45-60 minutes with each person).
We stayed with different families throughout the Campo for the whole weekend. Me and Janna stayed with a family (pictured above) who have 2 little boys. Our house had some electricity, but due to the DR's country wide power shortage, we primarily used oil lamps. There was no running water or bathroom (except the bowls placed under our beds and the wooden outhouse). At night, our 'mom' would take us out back were we'd brush our teeth with a bucket and hold each other's toothbrushes while our mom flashed the flashlight on us on the outhouse so we could see where we were going. Needless to say, me and Janna are going to be lifelong friends now since we watched each other pee. We took showers in a extension of the outhouse with a bucket and curtain to hide us.
Saturday night, the community threw a big dance for us. The marange and other dances involving only movement at the hips were done. It was so hard to communicate with our families due to the language barrier, but music has no language-it's universal.
Even though through most people's eyes, the Campo is poor and has nothing- these people have something that most people in the U.S. don't. They have a huge sense of community with one another and such welcoming hearts. Right when we walked in the community, the elders kissed our cheeks and the kids wrapped their arms around us and wouldn't let go. They took us in like we were one of their own and were so grateful for everything we were doing.

First Day on the Job

We toured all of each other's clinical sites yesterday and started today. We lucked out because our hospital is one of the only sites with air conditioning. What makes our site so challenging is that there are no physical therapists there except for the month that there are PT students. So, there is no 'organization' as to who we see or when. There are 3 main units that we will be working on, the orthopedic unit, the neurological unit and the burn unit. We spent all morning in the orthopedic unit. We primarily observed. we couldnt treat most of the children because they were mostly all pre-op (meaning that they were in to get casted for a fracture and we shouldnt be moving and doing exercises with them or we could make it worse). We did help a girl there who has osteogenesa imperfectia which is a condition where your bones are very brittle and break easily. She was 9 but only looked about 2 years old. Her arms were all swervy and her ribs flared due to multiple fractures. We spent a majority of our time in the casting room watching them cast for various fractures and clubfeet. The streets in the DR are crazy, there are no lanes and you go whenever, so almost all of the kids with fractures were from motor vehicle accidents. Tomorrow we are going to visit the neuroligical unit. This weekend, we are going to a rural village and teaching the community on various PT related health issues in spanish. My group will be focusing on wound care and foot care with diabetes. We are going to be paired up and stay with one of the families in the village. Pray for confidence and the ability to learn spanish and comminucate with those around me. Thank you all for your support and prayers!

I'm Here

Hey all,
We all (except 2 students stuck in Chicago) made it safely to the DR last night. It had been raining all day to the point where the water came up to your knees in the streets. Thankfully, the water had gone down a bit when we arrived. The plane landing was ruff (a few times it felt like we were dropping straight down for 3-4 seconds!), but we made it!
Our dormatory has about 40 bunkbeds with bug nets over us. Today, we are going to have orientation and a scavenger hunt of Santiago-and my family all knows how much I love scavenger hunts ;)

In attempt to show family and friends my experience in the Domincan Republic, I decided to come up with my own blog. In only 3 short weeks, I will be flying out to the Domincan Republic along with about 15 of my classmates and other physical therapists from around the country for four weeks. I will be working at a hospital called Hospital de los ninos, which is a hospital for children with musculoskeletal, integumentary, cardiopulmonary and other problems. Since the we are the only physical therapists that this facility will have all year, out primary focus is not only on treating children, but also educating physicians, nurses and other healthcare providers on proper positioning and exercises to optimize each child's abilities (all inservices are going to be in spanish, by the way).
So I'm hoping that this will give you all a glimpse of the Domincan and my journey there as well. Feel free to make little comments of encouragement, prayer, whatever. Please pray for my classmates that we all have safe travel to the Domincan in the first place. I will talk to you all soon...