One Year. One Physical Therapist in Trujillo, Peru.

Combining passions of global public health with travel and cultural immersion... With the help of the Catholic Medical Mission Board, I was afforded the opportunity to live outside of Trujillo, Peru for one year's time (2010-2011). Check out old posts about my experiences as a PT working in hospitals, a school, an outpatient clinic, doing research/community based rehabilitation, and a little teaching too. And my experiences with an entire calendar year of holidays, cultural customs and new culinary experiences!

I make it back about once a year with university students/CMMB projects, so I will periodically provide updates :)

Wednesday, September 29, 2010

Adios Alaska!

4 checked bags are going to be a pain but hopefully worth it to get some PT supplies down there. We'll see how it goes at Customs...

I have a long trip ahead, starting tomorrow night...

3 hour layover
Seattle-Mexico City
8 hour layover
Mexico City-Lima
12 hour layover

All in all, 38 hours...ugh. Prayers for a safe journey / bags making it / not getting robbed are very much appreciated :)

A little nervous, especially for finding my housing, and overcoming the initial Spanish language shock. But otherwise really excited! 

Monday, September 27, 2010

Fundraising Results!

First of all, MUCHAS GRACIAS to all of you who have supported me through the last several weeks- financially, through equipment donations, Spanish tutoring, or in any other way. I cannot begin to express my gratitude to the enormous outpouring from my family, friends and parishioners at St. Pat’s.

There’s been so much enthusiasm that a number of individuals have approached me inquiring about sending down short-term volunteers to where I will be working during my year of service. I am not sure about the feasibility of this idea yet, but will update on this in the future!

The fundraising efforts were a huge success. At one weekend of masses, St. Patrick’s Parish contributed $3188 in cash/checks alone! The online donations surpassed my goal of 8,000 at $8,750, thus bringing the total to $11,938.00!!!

I’d specifically like to thank the incredibly gracious gift of one anonymous donor, who has pledged a very large amount to help make this trip possible → I would not have felt financially able to commit to one year without your initiative, I’m very humbled and touched by your contribution, and promise that I won’t let you down!

The equipment donations have also been extremely successful. I’d specifically like to thank:
Eric and Lisa Reimer
Robert McClune, Robin Wahto and UAA Allied Health
Grace who connected me with Michael Friend / Access Alaska
Tom Bruce
Anonymous donor of pediatric equipment
Sports Authority
Alec Kay / United Physical Therapy
Boyd Esplin and Heather Brown / Chugach Physical Therapy
Linda Rose Weppner, Esther Petrie and Providence Hospital

And, the many anonymous donors who left items in my collection box!

Also, my excellent Spanish tutor:
Cecilia Plascencia

I am still blown away by how supportive my community has been with this endeavor. The monetary donations will help tremendously with the aims of improving the access, education and quality of healthcare in the community. The physical donations will provide a solid foundation for fostering evidence-based PT care in the La Esperanza area.

Thursday, September 23, 2010

Lists.. lists.. and more lists!

I’m a list person (this may be an under-statement…), and the last few weeks have been especially full of lists as I get close to departure date. Unfortunately my to-do-before-Peru list seems to just keep growing larger by the day! It’s definitely a lot more work than I expected to get ready for living abroad for one year.
The vaccinations alone are daunting:

-Yellow Fever
-Hepatitis A series
-Hepatitis B series

Fortunately a recent trip to Africa made this easy and I only had to get one additional vaccine.

I also discover how expensive one year’s worth of medications, just-in-case prescriptions like antibiotics, anti-malaria pills, and over the counter drugs can be. While I’ll be living in a large city it sounds like over-the-counter meds are particularly hard to find, so I stocked up on those. Add in a year’s supply of daily contacts (argh..) and my carry-on is already full!

A trip to REI and some online shopping helped with some other basic items:
-Steri-pen (makes water safe to drink)
-water tablets
-mosquito net
-motion sickness bands for long bus rides
-bug-repellant sleep sack
-waterproof shoes
-water repellant pants
-long underwear (while hot in the summer, most buildings are un-heated year-round)
-camping towel
-outlet adaptors, convertor
-hidden passport pouch
-first aid kit
-slash-proof bags (

I had fun raiding the dollar store for kid toys/games that can be used in therapy… UNO, cards, foam letter, balls, bubbles, crayons/markers, coloring books, etc.

The most time consuming part of my preparations have been in getting documents ready. All passports, photo IDs, licenses, diplomas, immunization records, etc. are recommended to be carried as notarized copies in case originals are lost/stolen.
I’ve also been working on bringing down electronic copies of physical therapy resources I can use, such as:
-patient education materials (in Spanish)
-home exercise program pictures/instructions (in Spanish)
-commonly used outcome tools (in Spanish)
-research articles
-intake/eval forms (in Spanish)

It’s been very time consuming to try and locate all of these materials in Spanish, but I think it will be worthwhile to have some of these things ready in advance.

Lastly, I’ve been trying to get my hands on as many books as possible. Here’s my reading list:
-Half the Sky by Kristof and WuDunn – great read for anyone! Excellent book*
-Where there is no doctor (Donde no hay doctor)
-501 Spanish Verbs
-Lonely Planet- Peru
-1001 Pitfalls in Spanish
-Culture smart: Peru
-Physical Therapy for Children
-Women’s Health in Physical Therapy
-Essentials of Global Community Health

If you have any recommendations for other resources please let me know!

Saturday, September 18, 2010

Orientation Week!

 The countdown is on – less than two weeks to departure, and I just returned from a 5-day orientation session in New York/New Jersey. It was really fun to meet the other volunteers and create some support networks. About half of the other volunteers were also new graduates in their respective fields, which made me feel a little better! There are a number of nurses, one PA, one other PT, one psychologist, one speech pathologist, and one attorney that will be departing soon. Locations include different parts of Africa, Central America and South America. I met a nurse who will be working in a town about 2 hours away from mine, so I’m excited to have someone to travel with on vacation days! J

The highlight of the week involved spending a day in NYC at the headquarters. It just so happened that the board of directors were meeting that day, so we were able to have lunch with them which was a great experience. I got to meet a number of influential leaders, and we also had a guest lecture by Dr. Cahill who is a specialist in infectious diseases. They were filming a TV-based special on the CMMB while we were there, so we even went to the “make-up” room and then had on-screen interviews.

The most memorable part of the day was the tour of the United Nations building. I don’t normally get that excited about tours, but this one was exceptional if you ever get the chance to go. At the end we were able to sit in the room where the UN meets for part of the year – as shown in the photograph (we missed seeing a live meeting by only about 30 minutes!)

The display portion of the tour discussed the roles of the UN, but also included a large presentation on the Millenium Development Goals (MDG) which I thought was fantastic. If you are not familiar with the MDG’s, definitely check them out- this website is a good resource:

The MDG’s still have a long way to go, and the UN is sometimes criticized about it’s slow progress. As a volunteer at the grassroots level, it’s important to educate oneself about the big picture, to see some of the ideas for solutions to the identified problems, and to understand how we as volunteers can move from simply working in the field to becoming activists and advocates for the root of the problems.

Wednesday, September 15, 2010

What is the CMMB?

The Catholic Medical Mission Board is a non-profit organization that began its work in 1912 and was officially founded in 1928. The CMMB Mission reads, “Rooted in the healing ministry of Jesus, CMMB works collaboratively to provide quality healthcare programs and services – without discrimination – to people in need around the world.” The organizations’ primary values include social justice, integrity, leadership, accountability, quality collaboration, compassion, courage and risk taking, self-reliance, sustainable development, and building individual and community capacity.

Approximately 98% of the CMMB’s funds go directly to serving those in need, which makes it an excellent non-profit with low administrative costs. The organization has three main focus areas: healthcare programs, medical supply/pharmaceutical donations, and volunteer placement programs such as the one I will be embarking on soon. In 2009, 73 long-term and 475 short-term licensed healthcare professionals served in 27 different countries through the CMMB. In addition, the Healing Help program has distributed over 1 billion dollars worth of pharmaceuticals to over 100 countries since 2005.

I was particularly drawn to this organization because of their non-discriminatory characteristics. The CMMB serves people and communities of all religious backgrounds and beliefs, and likewise accepts volunteers from any type of faith. They accept a number of different types of volunteers, including nurses, MD’s, occupational/speech/physical therapists, psychologists, pharmacists, physician assistants, and people with law, finance or public health backgrounds.

I also like the fact that the organization strives to create self-sustainable programs with long-term impacts. This is such an important piece of improving health needs globally, and it can often be lost on short-term mission trips. A large part of what I will be doing will not simply be working as a PT in a clinic, but as a person striving to solve the root of local health issues in order to create an effective solution program.

I recently attended a lecture by Richard Garfield, who is a professor at Columbia and an expert in public health and the UN data collection. He pointed out that today, we are actually making gains at reducing AIDS, malaria and maternal/infant mortality when it comes to global statistics. However, the latest trend at the forefront of mortality rates in developing nations are turning out to be due to non-communicable diseases… cardiovascular diseases, lung diseases, cancer and diabetes. The number of deaths in children under age 5 are actually decreasing, but the number of deaths in those ages 15-60 are on the rise.

This is not to say that malnutrition, HIV and other issues should not be the aims of humanitarian action. However, we are still not addressing an important piece of the solution. As a PT I’m really excited to be able to try to create a program that will target these preventable non-communicable diseases, but I also know there will be many cultural challenges. In Peru in particular, cigarette smoking is a large contributing factor, and a high amount of disability is caused by motor vehicle crashes and lack of helmet use on motorcycles. Also, interestingly, the body weight of a child is seen as a social indicator of status. A skinny child is viewed as poor, whereas a child who is overweight or obese is considered better off, so the presence of a higher body mass index is actually something that is culturally desired. These are only a handful of the potential factors that may make it difficult to attack these issues from the root of the problem.

I am grateful for the support of the CMMB and for this opportunity to serve through them with the goal of creating sustainable change. I hope that you will continue to support their mission. More information can be found at their website:

Tuesday, September 7, 2010

Living SIMPLY!

I think that one of the most challenging yet rewarding aspects of the next year will be in living simply. On a very modest (by American standards) stipend of monthly money for food, I will by no means be “roughing it” but will definitely have to carefully plan what I buy, particularly if I intend to visit some of the other areas including desired trips to Ecuador, Lake Titicaca or Machu Picchu.

Since my return from one month in Africa this spring, I’ve been more and more disgusted with how much waste and excess are present in America. It’s hard to watch reality shows, overhear some people’s ideas of “problems,” or watch people dish out $400 on a Prada bag. Dollar amounts are now translated into miscellaneous quantities… The cost of one month’s rent, one year’s food, etc. in Addis Ababa. The cost of a custom-molded orthotic that changes the ability to walk in a patient who has hemiplegia. The cost of a bus fare to make the trek to the fistula hospital for a woman whose life is threatened during labor/delivery. The trip changed the way I view things, sometimes overwhelmingly, and I found the transition back into American culture significantly harder than the initial culture shock when I first arrived.

I am definitely not trying to say that I am a good model of living simply; I definitely get caught up my own life and drama frequently. As middle to upper class Americans, we are really fortunate to have such an incredibly high quality of life. This should not necessarily constitute guilt every time we do something fun or beyond our basic survival needs, and I’m constantly reminding myself to stop making comparisons to my experiences in Africa and to instead give thanks for my many blessings.

So what would YOU really miss if you were going abroad for a year?

While I consider myself pretty low-maintenance compared to many people I know, I imagine it will nonetheless be a drastic lifestyle change. I don’t watch TV regularly (aside from the occasional LOST or -(guilty pleasure)- Grey’s Anatomy). I don’t particularly enjoy shopping for clothes, and get a rare bi-yearly pedicure if I’m lucky. Not the biggest fan of talking on the phone or text messaging either. I think that the parts of my daily routine that I will miss the most will revolve around using a gym or the outdoors for exercise/running/swimming laps and the possible lack of internet. Of course, I’ll also really miss the food. Specifically, my comfort foods- mac ‘n cheese being one of them. For those of you who know me well, you know to stay away when I’m hungry or haven’t exercised in awhile, so it could get ugly as I’m adjusting! I’ll make a post later on the common cuisine of this area. I know that some forms of gyms exist in Trujillo but I’m not sure if I will have the time, transportation, or money to experience them. (The bigger cities in Peru have a very stark contrast between the facilities available to the upper and lower class.) Plus, I truly want to experience daily life through the eyes of the people I will be serving, which will mean making many sacrifices.

While I will definitely miss these aspects of my current life, I also think I’ll really savor and embrace living more simply in a new culture, which I anticipate to be strongly based on family values and spending time together. This doesn’t mean I won’t occasionally fantasize about giant cheeseburgers, Wifi or elliptical machines!

Wednesday, September 1, 2010

Trujillo, Peru

      Peru, a country with population over 23 million, is bordered by Ecuador, Colombia, Argentina, Bolivia and Chile. It’s roughly the size of Alaska. The country has a regular flow of tourists in certain areas secondary to a rich and interesting history combined with a number of archaeological sites of interests, such as Machu Picchu and a number of pyramid structures. The climate and culture can vary widely by location. The official languages are Spanish and Quechua.

      Trujillo is the 4th largest city in the country, with just over 800,000 inhabitants. It’s about 6 hours north of Lima, on the coast in the La Libertad region. I won’t give a lot of details about exactly where I’m working except to say that I’ll be working with a mission organization in a notoriously poor area of the city.

      The healthcare needs of this country are vast, and are more pronounced in the rural areas; 90% of people living in rural areas do not have potable drinking water, and tropical/infectious diseases are more common due to location. Peru has one of the highest rates of maternal mortality in all of Latin America, and its’ infant morality rate is also high. Cervical cancer has been reported to be a large problem due to lack of access to screening tools. There’s a large gap between the wealthy and the “next” class - severe poverty and malnutrition are also big problems in most areas. The life expectancies are in the 60’s. In general, disability does not appear to be socially accepted and many people may be neglected and marginalized in this culture.

      During my year of service, I’ll split my time working in three different areas: outpatient and inpatient care at a hospital, pediatrics at a school for individuals with developmental disabilities, and on the creation and implementation of a public health program with recently acquired government funding. I feel pretty under-qualified for some aspects of this job, but nonetheless am very excited and know I will learn so much from it.

      Currently, there are no trained physical therapists at the medical facility or school. Peru does have a number of physical therapy schools, but from what I’ve gathered, the curriculum is much less thorough than what you may find in the U.S., and the focus appears to be more on electrochemical modalities. In fact, as I was inquiring about what types of equipment I could bring down with me, Ultrasound, Diathermy, Infra-red (etc.) were at the top of the list. I anticipate it will be challenging to move the current standards of care toward a more hands-on functional approach. Fortunately, I will have one year’s time to build a relationship with the community.

      I’m getting pretty nervous about my Spanish-speaking abilities as it’s apparent that no-one in Trujillo knows any English! Hopefully I’ll become fluent very quickly (well, won’t have a choice)! So, I’m getting really excited to head down there. I have a few ideas for possible holiday excursions, as I’d like to see some of the sights if I get time off. However, on a modest stipend I also will embrace the idea of “living simply” and trying to blend in like a local.