Living our Mission – A Therapists’ Experience in Central America

Mission trip to help deliver physical therapy services overseas.

A medical missionary….. what do think of when you hear that? I believed that it was going to an underprivileged area in the world and giving my time and talents. Well, I was partially right. Yes, I was able to demonstrate the skills that I have in my occupation as an OT and certified hand therapist. My time consisted of cleaning post-op wounds, changing bandages, making splints to protect newly repaired tendons, nerves, and fractures, and teaching exercises. However this care was different in so many ways. It has taught me a lot about myself and how I will continue to serve others. Before I get more into that, I’ll start at the beginning of our medical mission week’s adventure.

Our Honduras medical mission team was made up of five groups, each with its own unique purpose. Some individuals served on multiple groups during the week to experience a greater perspective of the team’s overall impact. These five groups included the prayer team, mountain team, hand team, spine team, and medic team. The prayer team went throughout the hospital Escuela and prayed with individuals. Some patients were healing from illnesses or surgeries; others were mothers who had lost babies or other family members. The mountain team went out in a remote area each day and worked in this region. They built a home for an individual while we were there and also led a vacation Bible school for the children in the area with arts/crafts, songs, games, and Bible lessons. We had a spine surgeon on the team along with his implant representative as well as two hand surgical teams including two hand therapists, one of which being myself. The medic team was comprised of a primary care physician and he was busy in many areas of the hospital, but mainly the ER.

Serving as one of the hand therapists on the team, our first job was to help with the initial screening of patients on the first day. Since we are familiar with the hand lingo, if you will, the Honduran surgeon would introduce the patient to the American surgeon and give the age of the patient and then assign them a number. The Honduran surgeon would then translate the injury and current complaints. It was my job to write all this down for each patient and then to also write objective findings that the American doctor would say as well as surgical plan including any equipment he may need for the surgery. A picture was taken by another team member and the patient was given a day that the surgery would be performed. We scheduled around 17 patients per hand surgeon for the week, but we were told there would be add-on’s during the week. Little did the other hand therapist and I realize how much of a role we would play in getting additional hand injuries into the right hands of our hand surgeons.

During the first day of surgery, we weren’t too busy splinting patients since we would get them the following day following surgery. We had initially thought we would observe some hand surgeries. Well, there was another plan….the surgical room was very small so we teamed up with a medical school graduate and quickly connected. She embraced our skills and started taking us to every floor in the hospital including neuro, pediatric, orthopedic, general surgery, and the burn unit to ask the nurses if they had any patients on their floors with any upper extremity injury or need. We were then directed to their rooms and learned how we could help. Usually their x-rays were bedside so we could take a look at them too to see if they should be evaluated by our surgeons between surgical cases. This turned out to be a busy day for us. Some needed our surgery. Others needed splinting or exercises for contracture prevention that were identified in the burn and neuro unit.

So, for anyone that is a therapist, you can already see how the care was atypical for a therapist as compared to our work back home. First, the injuries for the most part were extreme. Many tendon and nerve lacerations due to machete injuries. We also saw horrific burns and multiple fractures/ dislocations due to explosions, motorcycle accidents, or falls. We see extreme trauma in the United States, but nearly EVERY patient that we saw this week would be classified as trauma in our normal setting in the states.

Second, I don’t speak a lot of Spanish so I not only relied heavily on our translator, but I also relied on the communication through ones eyes and facial expressions. The eyes can tell you so much regarding tolerance to an exercise or pain. Oddly enough, the patients did not express pain like I am accustomed to seeing in the states. The individuals were very focused on our faces as well. So a smile or a hand on theirs was a simple universal sign of love and compassion equally expressed. Another huge difference was the way in which we could help. We were in the burn unit when a lady in her early 30’s sustained chest, arm, and facial burns. She was in much discomfort, but forced a smile when she saw us. She told the medical student how she could not move her arms due to the burns. We went back to our supplies and issued her shoulder pulleys. We hooked them up above her bed so she could stretch her arms. We didn’t have an order or have to worry if she could pay for it. We could give her what she needed on the spot. She was moving slowly that day, but looked at us with grateful eyes and through the burns, all I could see was her hope. Two days later, we came back to deliver another set to her friend in the bed next to her that was in the same explosion. This woman was equally grateful. The first woman was also doing so much better and with a huge smile that I will never forget……”gracias, gracias, gracias!”

Many times the care was different in that it was helping in a way that wasn’t our intended purpose. For example, I was splinting a hand of a severely burned patient in the burn unit. He was shivering as most burn patients do as a result of the body trying to regulate temperature. As I was making the splint to position his fingers to prevent contracture, I turned and looked at his face to ask if he was doing ok. The translator said, “He says thank you because the splint is making him warm.” His smile was grateful. For in that moment, it was about a basic need being met…….warmth provided by this custom splint that required heat to mold it.

Through this experience, I’ve witnessed nothing short of true gratitude. This was hands up giving praise, not hands out with expectation. So many examples of this occurred this week, but one very powerful example came when we directed one of our hand surgeons to evaluate a patient that had a brachial plexus injury. After evaluating, our doctor explained with the translator that this injury will take time before anything is done because it can get better in 3 to 6 months. The patient had a lot of questions and after several minutes of explaining back and forth, the patient acknowledged that he understood. Before leaving the room, our surgeon asked him if we could pray with him. As our translator began to pray, I can’t quite explain in words what happened during this prayer. The entire room filled with patients (four patients per hospital room plus family) began singing the prayer with the translator. I have no idea what they were saying, but then the mother of the patient started praying with great authority of gratitude and the son (patient) started sobbing. I don’t think there was a dry eye in the room. It was in that moment that I could see that, sometimes, our faith is all we can give. Showing love is the most important thing we can offer to one another. Performing my duties as a hand therapist on a medical mission was amazing, but I was merely a vessel in order to share God’s faithfulness and love. All I did was say yes to the invitation.

About the Author: Julie Freiner, OTR/L, CHT, is a practicing certified hand therapist in the O’Fallon and Wentzville, MO region. She is a mother, wife and gives of herself regularly to those in need.