Kara O'Malley's Adventura en Bolivia!

PT SLU alumni Kara O’Malley is currently working in Bolivia! You can follow her blog, “Aventuras en Bolivia,” at http://aventuraenbolivia.blogspot.com/. We interviewed Kara to see how she got involved in the Centro Medico Humberto Parra (the clinic she is working at), what she has been most challenged by, and how her SLU PT education has come in handy where she’s at – you might be surprised by what she says!  

When did you begin your stay in Bolivia? How long will you be there?

I came to Bolivia in July and the plan is to stay here until late May.

What do you plan on doing?

I came to work at Centro Medico Humberto Parra, a clinic located in Palacios, a very small pueblo (around 50 families) located 2 hours outside of Santa Cruz. The clinic serves about 15 neighboring pueblos. The clinic was started 10 years ago by a couple in Chicago, two doctors, and is staffed by Bolivians. Every year, 2-4 volunteers come down for 6-12 months to work as coordinators (doing such things as organizing other volunteers as they come down throughout the year, making sure things are running smoothly at the clinic, doing  programs in the communities, providing education to patients, doing health education with a group of women from neighboring communities, etc. For the past three years two medical students from Loyola Chicago have come down to work as the coordinators for the year. My boyfriend is currently at Loyola and when I heard about the program I spoke with previous coordinators who stated they saw a definite need for physical therapy. From there I spoke with the doctors in Chicago (and my boyfriend) and we worked it out for me to come for the year!

A little background about how the clinic works on a daily basis and what I do......clinic runs from 9-? Wednesday thru Saturday. Sometimes clinic ends by 1, other times it goes until 4:30. Different communities are scheduled to come on different days. Right now there is one full time physician and two medical students seeing patients. I have been seeing several therapy patients most days (after they see the doctor they are sent to me....we’re currently working on a better referral system that will broaden the number of patients I am able to see as the physicians understand more of the types of patients they can refer), often times they are patients with shoulder or back problems but then there are Aldo's everlasting patients who have had strokes and one patient with a broken hip. When I am not seeing patients at times I will help with educating patients on diabetes management and on properly taking their medicines according to the prescriptions. There is also down time where I am able to do some studying. This week, the coordinator and I are going to try to have short class during clinic hours to discuss exercise and diabetes management and to actually have everyone perform some light exercises while waiting for the physician. If it goes well we will try to continue it every week. I am also going to expand my abilities and try to do some grant searching/writing in the coming months.



Why did you decide to live in Bolivia?

When I decided to come to Bolivia I actually knew no Spanish. However I had had several Spanish speaking patients in the past and I always wished that I would be more able to work with them; it is great to have translators available but I find it is more difficult to build a relationship with your patients and to accurately explain things. So, one of the reasons I decided to do this was because I knew at this point the only way I would be able to learn Spanish was through immersion and I really wanted to know Spanish in order to expand my ability to work as a therapist.

Another reason I chose to come was that my whole life I have wanted to do some sort of trip such as this. I wanted to travel, but I wanted to have a purpose while traveling. For some reason, throughout high school and college there just never seemed to be the right opportunity. When I heard about this opportunity it just felt like it was the right thing at the right time; I would be able to come as a physical therapist and work with patients who otherwise would not receive therapy while I was also experiencing a new culture in a new place. And it sounded fun!

Kara and Fanny doing strength training – to see more pictures, go to Kara’s blog at http://aventuraenbolivia.blogspot.com/

What has your experience been like so far? What have some of your challenges been? How have you been working through them?

So far I have been here about two months; I'm returning to the states for Christmas and will then be back in Bolivia until at least late May. Two challenges I knew I would face here are the fact that I knew no Spanish and that many of my patients would have musculoskeletal problems (for the past year I had been working in a sub-acute rehab setting and therefore knew I would need to brush up on my special tests, etc.). Also, in the past there had never been a therapist at the clinic; although there are therapists in the country there are very few of them and many people don't realize all of the different types of work we can do. Therefore it has been a challenge finding the right patients and educating the physician, staff, and patients on what physical therapy is/does (in my broken Spanish).

Another, and possibly the most challenging thing thus far, has been the location of the clinic in relation to the communities it serves. Some of the communities are more than an hour away and most people must take public transportation because they don't have cars. If I were in the US I would want to see many of my patients at least twice a week, however because the distance, at best I am able to see patients every other week and at times once a month (I am seeing one patient 3-4 times a week because she lives in Palacios). This makes it very challenging to give patients HEPs and to decide on what is most important to work on during the short time I have with them.

Kara and Dave – to see more pictures, go to their blog at http://aventuraenbolivia.blogspot.com/

Speaking of HEP's another challenge is the lack of a program on the computer to print exercises from. Personally I find this story amusing.....because there is no program I have been drawing out all of the HEP's by hand. The first week we were at the clinic the two bosses from the US were in town visiting. One of them saw me drawing exercises and said, "I guess none of your classes prepared you for that." I had to laugh because I have such vivid memories of several assignments we had in school in which we HAD to draw exercises out. We all complained and said we'd never have to do this when we were working. Our teacher just said, "You never know." So, my SLU education definitely prepared me in more ways than I realized!

 I am thoroughly enjoying my time here and learning a lot. It's really nice because I spend several days each week in Santa Cruz (a rather large city very similar to the US in many ways) and several days in Palacios (as a said a very small community). I am now able to see patients on my own for much of the time (although there are still times I need to call someone in to help me out when I do not understand). People have been very understanding with my poor Spanish (at times too understanding, meaning they pretend they understand when I know they don't!) and very willing to help me learn. Another thing I have begun to do is ask every patient if they prefer pictures or words for HEPs because many of them cannot read, this is something I will take back with me to the US. It has been interesting working so closely with doctors and other members of the health field because I am able to see what a large role we have as therapists in providing the education to our patients; so many times doctors have so many patients to see they are not able to spend the time they would like with their patients and often it is the education that must be cut short (although I was already aware of this I am even more so now).