"Haiti Birthday" is what my younger brother took to calling my medical volunteer trip to Haiti during July 2010. I had decided in April, after seeing another call for physical therapists to help with rehabilitation services needed in Haiti after the devastating earthquake, to stop making (or finding) excuses and pack my bags. I scoured my calendar for dates that might work: May was out of the question due to multiple work commitments; June was out due to a national conference…July it would have to be. And then I realized I would be spending my 40th birthday in Haiti delivering physical therapy. At first that was almost enough to make me put this type of trip off, but after graduating with my doctoral degree after seven grueling years, putting things off was something I was trying to quit. So I signed up. And boy, am I glad I did.
First, it was hard work. But very necessary work. I had done my best to prepare myself before the trip-for the weather, for the devastation, for the patients. But I realized about 10 minutes after my arrival (and again about 10 minutes after my first day at the clinic), there wasn't really anything I could do to prepare. Or rather, there wasn't anything to prepare me besides being flexible, being adaptable, being capable, and smiling. It was a great reminder of all the non-physical therapy 'stuff' that makes a great physical therapist!
I spent three weeks in a small village outside of Les Cayes, Haiti. Our clinic was located at a hospital, and my patient load consisted of both outpatients, most of whom were persons injured in the earthquake, some were recently injured persons and some were inpatients in the hospital. I had thought I would not be seeing many persons with earthquake-related injuries-the earthquake had been six months prior-but I was sadly mistaken. I knew that I would likely encounter many persons with amputation due to the earthquake, especially since our clinic had prothetists on staff. However, I had not anticipated all of the persons post-fracture or still with external fixation. The six-month anniversary of the earthquake happened while I was in Haiti, and a significant number of patients I saw had either not seen a physical therapist at all or since right after their fracture or surgery. I had multiple patients who still had their external fixators, metal rods located outside of the limb to hold the bones in place while they healed, still in place even six months later. When discussing why the extreme delay in removal of these devices, many indicated the delayed healing may have been due to stress, poor nutrition, infections, and a lack of organized follow up medical care. Many of these patients were being transitioned into increased weight bearing and to different walking aids, in the hopes of stimulating more bone growth that would allow safe removal of the external fixator. It was exciting to see many of these patients make progress and even get their fixators removed during my three-week stay!
One of the biggest challenges for me professionally during my time in Haiti involved the variety of patients I was responsible for screening, examining, and treating. At home, I am a Geriatric Clinical Specialist with expertise in acute care and neurology. While those skills and talents came in very handy-and I definitely used them-I also had to pull out my knowledge and skills in pediatrics, orthopedics, and wound care every day. Being flexible and resourceful, using our limited internet connection and library for information, as well as other onsite healthcare providers for consultation, reminded me of how variable my clinical skills really are. It also reminded me of how lucky I am to have been born and live in the United States. And that fact alone, coupled with some lucky breaks and some very hard work, has given me a profession where I'm privileged to be able to give others the gift of healing. I have learned to see how giving back with my skills and knowledge is an integral part of my professional responsibility but also extremely rewarding.
Being in Haiti was also a very international experience for me. We had the luxury of having two orthotists/ prothetists from Nicaragua volunteering to work for a whole year at the clinic. We also had a consulting physical therapist specializing in pediatrics who lives in Haiti as a missionary and is German. Given the Creole and French spoken in Haiti, it made for a vibrant and multi-lingual experience. Some of our multiple string of translations made for some good laughs, it also invigorated our clinic. Our translators were spectacular, moving between Spanish and English and Creole while making sure our patients got the best interdisciplinary care we could provide. It was also exciting to see people from all over pulling together to deliver much needed services to the Haitian people.
I think the most exciting thing about this experience, aside from the fabulous healthcare providers and patients I was privileged to meet and work with, was that I've got the bug. I'm finding interesting ways to use this experience in my teaching. I'm exposing my students to some of the complex issues and patient cases I worked on and struggled with first hand. I'm also planning to return to Haiti this year, this time for four weeks. I'm going back to Cayes, but also to Hôpital Albert Schweitzer in Deschapplles. And I'm excited. Well, not for the hot and humid weather so much, but for everything else. The challenges, the patients, the creativity often required to create helpful and meaningful rehabilitation happen without all the bells and whistles. For the smiles and the smells and the hardships. But mostly for the opportunity to give back to a people and a profession I care about so deeply.
Sharon Gorman, PT, DPTSc, MS, GCS
Sharon graduated with a bachelor's degree in Physical Therapy from Mt. St. Mary's College in Los Angeles, has her masters in health education from San Francisco State University, and earned her doctor of physical therapy science degree from the University of San Francisco/San Francisco State University. Dr. Gorman is an avid traveler, starting when she spent a summer as an exchange student in France during high school. Her trip to Haiti was the first time she had delivered physical therapy in a developing country. She is currently Associate Professor in the Dept. of Physical Therapy at Samuel Merritt University in Oakland, Calif., and serves as the Communications Chair of the Acute Care Section-APTA (@acutecarept on Twitter and on Facebook at AcuteCareAPTA).