Clinic Day #2: Clear Eyes, Full Hearts, Can't Lose
- Emily Graves
- May 8, 2018
- 7 min read
Location: Kitwara (about 1.5 hours away from hotel)
Patients Served: 220 people!!!!!
Today was a much different location than yesterday's! It was still at a school, but there was a lot of room in our buildings..probably 2x as big as yesterday's. We still had the same set-up: check-in at triage --> providers --> lab --> providers --> therapy/glasses/wound care --> spiritual healing/prayer --> pharmacy.
First of all, I would like to address lower back pain. It's a VERY common issue here in Uganda because of what they do for a living...gardening, herding cattle, farming, cutting down weeds and sugar cane, etc. We have to also remember that they carry very large objects on top of their heads long distances. For these patients, we would teach exercises, fit them for shoes, & then we would hold a "class" to be more productive. The class would teach them what to do and what not to do in relation to using a hoe/raking/sweeping & to pick up large items and carry them. We would usually wait until 3-4 people with back pain would come in so we could do the classes together and serve more people. The patients would be super receptive to the classes, especially once we got the interpreters into it. We would make them demonstrate the techniques that would help them and it was really cool and interesting to see how much a difference just changing their posture could make on their back pain. (My favorite part of the back pain classes would be holding their babies as they demonstrated proper techniques, if I'm being honest). If the back pain was extremely severe, we would also look into getting a back brace for the patient as well and rule out other issues such as nerve entrapment or spinal cord injuries. Shoes helped them because of the impact their feet were taking on the hard ground. Having that cushion there under their feet could help multiple things such as their feet, ankles, knees, hips, etc. If you are wondering why OTs were teaching classes on back pain, knees and ankles, trust me, it was quite the switch up for us, too. But in relation to therapy, we only had 2 physical therapists and 10 occupational therapists, so the PTs couldn't do all of the back pain, knees, ankles and feet by themselves. Luckily for us OTs, the two PTs and PT professor (shoutout to Taylor and Gerry and Cindy) were EXTREMELY helpful and taught us so well.
The first patient I had was lower back pain in an arthritis sense. We can't do much in a therapy sense rather than show some different stretches for relieving some of the pain and stiffness, but we did get her some shoes and took her to get some tablets & she was incredibly grateful. On her way out, she wouldn't leave. I was unsure why, but she talked to my translator for a while and he walked away. He left and went to talk to another translator who was standing by the door. When he got done talking to him, that translator moved away from the door. Once he moved, the lady urged me forward, telling me she was able to go now. I took her to pharmacy and then asked the interpreter what that was all about. He explained to me that they were in-laws that didn't particularly get along. So just in case you thought only the in-law craziness was in America...I assure you it is not. It gave me a nice little laugh.
Sidenote (sorry, my journal is a little sporadic sometimes): Ugandans are very touchy people (it's adorable). So when they meet you or leave, they shake your hand, then pull it in, then bring it back out. Women will also sometimes kneel to a man, which I saw for the first time with a 15 year old girl to my teammate, Nick. They are extremely respectful, especially for being around new people who they know nothing about. It was super interesting to dive into a different culture and I have so much respect for these people.
(Up next is a wound, so prepare yourself!)
Next up: wound care!!! He was an older gentleman with 3 open wounds on his legs, 2 on his right and 1 on his left. He wasn't sure how he got them & neither were we really. We ruled out multiple things, but couldn't find a direct connection. One on his right was significantly bigger than the one on his left. We did the classic wound care routine and taught him how to take care of them himself with the supplies we gave them. We also used an ace bandage on his legs to decrease the swelling he was seeing in his feet. We then gave him some new shoes and he looked great! He was extremely thankful for all the help and the shoes and wouldn't stop saying thank you!
Carpal tunnel, carpal tunnel. This was the only personal experience I had with carpal tunnel throughout the trip, but I think there were a handful more. We were able to figure out that it was carpal tunnel because she had pain radiating through her arms. It was worse in the morning due to the way she slept. She also had some tightness in her neck so we did some stretches for that and taught her about them. We got her two carpal tunnel braces for her wrist, taught her how to use them, and then she went to get glasses and some medication!
Towards the end of the day we had an older woman who had lots of knee pain and swelling due to arthritis. We checked her range of motion and pain and found that she had good range in her left leg and poor range in her right. However, the pain was greater in the left leg. We wrapped both of her knees in ace wraps and taught her how to do it in order to decrease the swelling. We then got her socks and shoes to help with the ground impact. She LOVED them. Then it was time to figure out what assistive device would work best for her. We tried a walker, but she told us it was too bulky to fit into her garden. Then, we moved on to a quad cane and she fell IN LOVE. She walked all around with it and said she could definitely see herself with that in her garden with a huge smile on her face. She was so happy and grateful. She told us that she has been wanting and praying for this for 20 years. It's incredible the patience and faithfulness these people have.
One of our last patients was a 92 year old woman who complained of back pain. She walked in with a huge stick that she used as a cane (this was pretty common for older people in Uganda). I heard that she hit a few people in triage with that stick, actually. She kind of reminded me of my Mimi, LOL. Since her pain was more arthritis related. we didn't do the normal back classes with her. We got her a new pair of shoes and then tried to get her a cane, but she wanted to the cane to be as tall as her stick which wasn't going to happen. She was happy to walk away with her stick and new pair of shoes, though! The best part of the whole thing was that we tried to find her tennis shoes, but all we had that fit her were converses. She absolutely ADORED them. When we took her to pharmacy, she was showing all of her friends her new shoes and showed them off hardcore with a big smile on her face. It was definitely meant to be that she got the converses.
Last story of the day! We had a mom come in with her baby that had severe developmental delay. He also had vision trouble and was completely deaf. Developmental age was around 6 months old, but he was actually 1 year and 4 months old. A team worked with him for about an hour with Patty (shoutout to Taylor and Eme) on a device made out of pvc pipe and foam noodles with lots of duct tape. It had toys tied on it so he could practice laying on his back which is a developmental milestone. It was also made so that he could pull-to-stand and stand with support to work on his leg and trunk control and strengthen those muscles. He loved it! I jumped in at the end and helped create a base for the device to keep it sturdy so he could do all the standing and dancing that he wanted. The mom was so excited to see her baby be independent for the first time in his life and stand and dance. It was awesome!!
A heartwarming part of the day was when a 7 year old child came in with CP (cerebral palsy) & couldn't walk on her own. She was being carried everywhere by her caregiver. We learned that it wasn't even her family member. She had been abandoned because of her disability and a man found her and decided she was now his to love and care for. I MEAN COME ON. We didn't have a special wheelchair for her, but we are going to raise money in the states to get her a power wheelchair & send it back to her when OneWorld Health comes back in August. So although they have to wait a little longer, they were so appreciative and I'm sure these next few months will go by quickly for them.
We then left the site & came back to the Masindi Hotel where we hung out for about an hour, ate dinner, shared life stories again, and talked about the plan for tomorrow. We also exchanged our money for shillings which I still don't exactly understand the exchange rate.
I'm falling more in love with this place, its people, and my team every day!!
Comments