Nigeria Trip Reflection
An ATI MissionWorks therapist reflects on a recent trip to Nigeria...
As I reflect on my MissionWorks experience in Nigeria, the first thing that comes to mind is the great need for adequate medical treatment and supplies. It was an enlightening experience – the challenge was always to do more with less. Luckily, we had ample shipments of surgical supplies sent ahead of time, but the limitations had more to do with basic “necessities,” such as electricity and air conditioning – things that are taken for granted in the U.S. The need there is so great and there are such limited options for care. As a result, our patients were all so resilient, motivated, and grateful for any and all medical care provided.
Our plan was to complete as many surgeries as possible and the hope was to complete 5-6 surgeries daily between two surgical teams. Our first day of surgery was a perfect example of how circumstances outside one’s control can significantly change a plan for care. Initially, we were without equipment that had been promised, and there was a delay waiting for an individual to deliver the required supplies. As soon as we had everything needed and the patient was set up, the power went out and the back-up generator also malfunctioned. This took about two hours to address. Once the power was back on, we relied on a back-up generator smaller than those used by most small houses. As a result, we stopped using air conditioning to avoid another potential power outage. Our first surgery turned into an 8-hour affair in 97 degree heat with intermittent power loss. I was impressed by the surgeon’s resilience and stamina as the team worked through all these obstacles and persevered through that difficult first day. Luckily the next several days of surgery went much more smoothly.
This was a unique experience for me as a physical therapist. Initially, we didn’t have any patients until the first surgeries were completed, so we had the opportunity to help with anything and everything. We were able to scrub into surgeries, assist the nurses, circulate throughout the operating rooms, and observe the surgical procedures first-hand. I was thrust into many circumstances that were challenging simply because they were outside my comfort zone. Looking back, I can appreciate that the circumstances facilitated professional growth in a way I would never have experienced at home. It’s also a unique opportunity to see your patient throughout the surgical process, and also through every stage of recovery post operatively. In my normal setting, I see patients one month following joint replacements, and there’s very little direct communication from the surgeon regarding the procedure and any potential complications. It also seemed that none of these surgeries was “straight-forward” because the patients’ arthritis was so advanced. The surgeons often commented that they rarely see hips or knees in this state because they’re addressed in the U.S. decades before they get to that point. In Nigeria, they don’t have that luxury, so their only option is to live in pain and continue as best they can.
As far as the physical therapy itself, I was incredibly impressed by the mental toughness and motivation exhibited by our patients. The primary limitation I’ve seen following knee replacements in the U.S. is significant pain, which makes it hard for patients to do the necessary therapy. In Nigeria, there were reports of pain, but typically patients would report it was “mild,” and they would happily comply with anything asked of them. Also, keep in mind that these patients were using mild over-the-counter pain killers, such as Tylenol, versus the stronger narcotics American patients take after surgery. It was a great reminder of what the human body is capable of when required.
This trip was one of the hardest weeks of my life for a lot of reasons. For one thing, we were working extremely long days – we would typically start at 7 am, and wouldn’t leave the hospital until 11:30 pm to go home for dinner. Aside from that, it was unique in that I didn’t know any of the other group members until meeting them at the airport in Houston. Of course, it was a great group of people, but it’s a little unnerving heading solo into the unknown. It was a different environment with different food, a different culture, and a different way of doing things borne of necessity. Despite these things, the actual physical therapy process remained the same, and that was a comforting constant.
This trip opened my eyes to how great the need is for physical therapy around the world, and how much it is taken for granted at home. Working in Nigeria pushed me beyond what I perceived to be my limits, and I realized how much more I’m able to give. I look forward to more trips in the future to continue making a difference for those in need around the world.