La Casa

Here we are home, back in the Estados Unidos! ! I’m thinking in Spanish and English. It’s difficult to transition back to the states. JP, Mary Ann and Ryan were able to hold their own with their Spanish. They were all very helpful translating for me and helping me learn my Spanish with frequent corrections of my poor Spanish! So, I keep thinking in Spanish! I notice my pace. I’m slower- I’m on Nicaraguan time! We would start meetings at 1pm promptly- which really translates to 2:00 pm. I’m really not patient and do things quickly, so this is always an area for skill development for me!
This trip feels like it was easier for me. I’m sure a week is easier than 10 days. Having such a fabulous team makes it easier and it’s my third time going. Just think after 10 years!

Key Take home points for Mary Ann and I!

1. There is a tremendous amount of poverty present for many Nicaraguans and there are many rehabilitation needs for children and adults.
2. The resiliency of people is so powerful to me. So many of the people we have met are doing their jobs as parents and caregivers with so much less than we have.
3. We worked together as a true interdisciplinary team which taught us all so much. We learned and worked together. I am thinking the need for the medical doctors to be present for the translation created a link that sustained the interdisciplinary team. Mary Ann and I taught Ryan and JP so much about disability, function, and families. They taught us so much about delivering health care in developing countries.

Adios Manugua

We are leaving for the airport. We are soooo lucky. No gallo pinto – rice and beans for us this morning. We bought mangos in the market yesterday. They served them with yummy coffee and pancakes. How lucky are we?
It’s always bittersweet leaving. It’s nice to think of going home, but it’s always sad leaving the people and the country.
Adios!

La Finca

A trip to the outhouse requires a walk in the mud and a brush with the cows.

We have just returned from a visit to the countryside. We took a taxi to Rafael’s family farm, la Finca. We smoosh the four of us, Rafael and his son, Ralphy- an adorable 3 year old into a tiny taxi. It is about an hour and a half to the clinic. We have moms, dads, ninos and ninas waiting for us when we arrive. We have 5 evaluations we do on the kids and then run a mini version of our presentation to the parents. These are really needy kids for the most part. None of them are walking independently. One of the little girls in addition to her physical disability was so malnourished! She was 3 years old and barely weighed 20 pounds at best. The kids had terrible scabies, lice and lots of physical impairments.
We head out to Rafael family’s farm, la finca. It is a 45 minute walk to get to la finca from the medical clinic. Rafael and his brother offer Mary Ann and I their horses. We get to la finca on horse. It was fun to get back on a horse. The afternoon was filled with a home visit for a man with wounds and we left him a cane. JP and Ryan took care of a young boy with malaria. Mary Ann and I did another impromptu evaluation of a man with a leg deformity and a cardiac condition. The community does not have running water or electricity.
We stay at Rafael’s family’s farm. We had rice and beans for the 3rd time today and sat around in the dark. We talked about the needs and what how we could best meet the needs.
Mary Ann are a great traveling team- no complaining as we tromped through the mud, by the cows, in the rain to the outhouse!
After an evening of a cacaphony of animal noises, roosters, pigs, cows and ducks, we are up for a quick meal of quess- rice and beans back to Sinua for our airplane ride back to Managua. Certainly a wonderful experince staying with Rafael’s very gracious family and seeing the needs of the community.
As we are waiting at the airport, we do an evaluation of the wife of a friend, who had nerve damage during a surgery and is still having difficulty with walking and nerve pain. We have done so much in such a short period of time. How did it go so quickly?
We arrive back in the states in Sunday. Look for the last post with updates and photos.

Rock Stars

Mary Ann demonstrated range of motion exercises during the presentation.

What a success!!

There were over 32 families that attended the workshop. We designed it to be informational based on some basic topics of CP, Downs Syndrome and Intellectual Disabilities combined with interactive exercises, lifting and even some speech therapy and sign language! They loved the sign language! The four of us made quite the team, JP was a fabulous translator for me, and added medical information that we needed. He even translated my spanish into English, which everyone enjoyed. Mary Ann did alot of the exercises, Ryan helped out where ever was needed!  He was always able to apply his critical thinking and help us think objectively. Ryan and JP learned alot about physical therapy! Just think what great medical doctors they’ll be after be part of the PT extradinare presentation! A local nutritionist came and stayed for the presentation and then added some nutrition information! They loved that piece.  It was quite spectacular considering we were in an old shack that was like a sauna as we were all sweltering! The families loved it and what us to come back.

We celebrated our success with a few cervaza’s with dinner and lots of laughs. I’m amazed at how 4 people who didn’t know each other have had such a good working experience with such good fun! They are all helping me with my spanish as I’m the only one who doesn’t speak spanish…

Mas Manana

17 Junio

The guys leave in the morning for the country for a community meeting- Talking about how the community can work together on issues facing the community- water, health, education. Mary Ann and I meet the the woman leading the ANS, an organization for special needs families. During the middle of the meeting it was the monthly fumigation! Holy Cow talk about health hazards! They get everyone out of all the buildings and you stand in front of the building as they fumigate (mucho fuerte) and then you can go right back in. 

Our meeting went well. We found out alot of information. She gave us a presentation that she is spear heading to create a center for rehab for families.  In addition she gave us a financial pitch asking us to donate!  Some of the families came in the afternoon which gave us a sense of the organization and the needs of the families. We did a back in-service on back pain, lifting, etc. Many of these moms do not have wheelchairs and they carry these children along way.
We have alot of work to do for tommorrow. We are presenting a workshop tommorrow from 8-4 pm!

Hola Managua y Siuna

Our plane in the Sinua airport.

We were lucky to have real coffee with our breakfast. Most often the coffee they serve is instant. We were off first thing at 7 AM for the airport for a flight to Sinua. It´s a sunny, muy caliente, hot day for our flight. We fly over volcanos and Lake Managua for about an hour to Sinua. Sinua is a relatively large community in the northeast, very remote. Rafael who is the local person who works with JP has met us at the airport. We spend the day meeting with the vice director of the health center, local family advocate for kids with differences. We are trying to hear from the community how we can best help them. There are about 200 kids in the area without services, no school, regular therapy and volunteer support only for families. The doctors are learning alot from us about physical therapy.  We are eager to share our observations about the environment. Much of the street, stairs are not up to building codes that we are use to!

We think we are meeting with 25 families tommorrow and a small idea of the agenda.  Hopefully between tonight and tommorrow at 1PM the plan will be a bit clearer.

Hasta Luego

Buenas Dias Managua

The birds, the roosters, …. Welcome to Central America!

We left Boston at 9:30 AM and flew to Miami. We had a layover of 4 hours but it went fast! Between Mary Ann teaching me spanish and she and I planning our presentations. Before we knew it we were off to Managua. The plane got smaller each time.  A sense of bringing our focus.

We will be working with a medical doctor, JP and a medical student , Ryan during the week. They met us at the airport. We went through customs without a hitch. The mulateos (crutches) did not fair so well with the traveling.

We went out for a little snack for Salvadorian food.  Los pupusas con Maiz. They are little corn pancakes stufffed with cheese and beans.

We had no water last night. It was shut off! This is the capital of Manugua! This morning we have water (lukewarm) and Sun! We are staying at a hotel, Don Quiote in this little residential location. We will be flying out in the morning.

Adios Estados Unidos

Hóla,

Mary Ann and I met today to finish up planning. We are preparing presentations for families and physicians. És muy difícile! We are not sure what the physicians need for information and their background.  We are anticipating families having literacy of 6th grade- so we are trying to create information based on the literacy of the community. Los mulettos (crutches) do not fit in our bags! We are hoping for short people.  My mother and father called to wish us well! My father reminded us of the hokey pokey that was a big seller in Peru! Music is universal. We are spraying out clothing and bags for bugs before we leave.   We will try to be in touch as often as we can to keep you on the edge of your seats! Muchas Suerte!

Vamos a regresar a Nicaragua en cinco dias.

Mucho trabajo, poco tiempo

We are still translating, getting presentations ready, and packing. And yes, doing some research. I ask my students to research best practices and be familiar with the communities that they will be working with.  So, I am doing the same research that I would ask my students to do. And did I mention my attempts to habla espanol! Mucho difícle.

This is a similiar, but a  new adventure than Peru. The work will be similiar, but the community is different so the experience will be different. The country, the food and the culture will be different. Nicaragua is the second poorest country in the Western Hemisphere. 79.9% of the population live with less than $2 per day! ¿Qué piensas tú?

Many of you know I love to cook and eat! As a result many of you have asked about the food. Perhaps you are asking because it is an essential ingredient of culture! No cuy (guinea pig) on this trip. I think more rice and beans. The climate will be caliente as we near the equator!

I’m counting down the days and doing my preparation work. Last year I was glad to have the comments on my blog and have my peeps be with me. So, stay with me during my travels.

Planning and more planning…

Three weeks until we leave. I’m traveling with another physical therapist, Mary Ann. She’s a graduate of the UMass PT program and a fabulous person. It’s very different planning with someone. It’s nice to have someone to brainstorm and bounce around ideas! We met last weekend to talk about the manuals, trainings and presentations we will be doing and the equipment that we want to bring. We need to do translating. Actually, I don’t do translating. Yikes!!! That’s a scary thought. I need to practice some spanish. We will be able to use some student service-learning projects which we will be able incorporate into our trainings.

Despite things things apparently being a bit crazy with swine flu  in Nicaragua , they are very excited to have us come. The families with children with disabilities would to like to learn things they can do in their own house to help their kids and tips on how to make the children feel more empowered.  Sounds good to me! We have work to do! Mas trabajo!