Saturday, August 17, 2013

Medical Care Hermano Pedro Hospital Style

Back to my blog home page:

I need to update you on my activities!

For the first time in my travel career, I left an assignment early.

I wrote a separate blog about it, but I want to reiterate to you if you feel a sick knot in your gut about what you see in a building, call your recruiter and your clinical liaison immediately and tell him or her what you see. It is vital to start the process of communication between the two companies. My recruiter told me, "Tre, you have never complained in the years we have been working together, so I know something is not right."  Within a week or so, the travel PT and I were released on the same day. Until then, I dotted every "i" and crossed every "t."

Thank God!

Within a week of leaving this job, I was on a plane headed to Antigua, Guatemala. These transitions can be blessings in disguise!

Plaza Mayor, Antigua, Guatemala
I had the good fortune to complete two weeks of Spanish as a Second Language training and medical Spanish at Christian Spanish Academy  (CSA), which I highly recommend! My studies, which concluded yesterday, included five hours of 1:1 instruction with my teacher daily and about two hours of homework each night. I developed a list of many questions/cues I use during evaluations and treatment, got them translated (look for these on another blog article soon) and learned the parts of the body. I would actually recommend four hours of training a day because the fifth hour is really fatiguing!
Me and mi maestra, Cristina

Last week, I had the wonderful opportunity to tour Hermano Pedro Hospital as an extracurricular activity through  CSA. It is located at 6a Calle Oriente #20, between 3a and 4a Avenida Sur in Antigua.
I was so touched by what I saw that I immediately asked about volunteering. By the way, there are a few requirements to volunteer at Hermano Pedro, just so you know.


1) Take the tour, which is offered Tuesday/Thursday afternoon at 3pm
2) Provide two passport size photos of yourself for your ID
3) Complete an application to volunteer

Beautiful inside and out
4) If you are a licensed medical professional, you must submit a copy of your license.

Hermano Pedro Hospital houses almost 250 people from babies to ancianos (older people), most of whom have been abandoned, have severe physical or cognitive disabilities or who have outlived their relatives. The hospital has separate living areas for male and female adults and children.

What was amazing me to was the amount of great patient-specific equipment there due to donations from different groups in the US, especially the Knights of Columbia Wheelchair Foundation. Bravo, Knights! The wheelchairs below were donated by the K of C. I didn't get a chance to take a photo of the real specialty wheelchairs - the ones you fit during a seating clinic. There were more than I could count.

The wheelchairs I saw at this hospital that is run solely on donations were on average better than the wheelchairs I see in for-profit facilities in the United States.
 What does this say
about our for-profit skilled nursing facilities?

Just a thought.

I spent most of my time with the adults because that is what I do in the States. The women were housed in long dorm rooms with about 14 beds per room. Their beds were positioned so that each woman was just out of reach of being able to touch another. Their clothing was neatly folded on tall open shelves at the end of the room.

As I spoke with each of these women, I found that every one of them had one thing in common. They had no family. They were SOLA. My heart went out to each of them. In fact, I saw this picture on facebook yesterday, and it made me think of them:

So. I knew that the way of the Guatemalan therapists would be
different than the US. I wanted to integrate into their system. I was not there to teach them all I know. I wanted it to be the opposite. I was assigned to the PT gym for the adults. I never met the three OTs. I was told they did fine motor coordination activities and that they mostly worked with the kids. (I did meet a group of six OT/PT/ST students from University of Texas-El Paso on the street on my way to school and later in the pediatric area working on specialty wheelchairs.)

Let's strip away everything we know about the US rehab system:
  • efficiency
  • documentation/paperwork/charts
  • Medicare guidelines.
Hmmmm. What a change.

They weren't watching the clocks nonstop. They weren't pecking out documentation on a computer or writing in a soft chart. They weren't coding billing. They simply focused on treating patients.

They didn't have a standard mat to do matwork. They treated people on plinth tables. They didn't use gait belts to get them up on the tables, either. They hoisted them up onto the plinths.

Most of the ancianos I saw did not have knee contractures. They had pain and stiffness, but not contractures. "Why?", you may ask...
 ...I have to believe it is because of the way they begin every session. They begin every session with a 15 minute footrub.

LOVE it. It completely confirms what I learned in a reflexology CEU that the body can respond beautifully to treatment in other areas than where we normally see the symptoms.

The PT, Amanda, really surprised me when she had her 80+ year-old patients roll from supine to prone on the plinth and then do modified push ups for arm strengthening. Wow.

They did not have a plethora of therapy equipment other than their hands to do their treatments. If we want to get down to basics, let's acknowledge that the best tools we have are our hands and minds that can critically and clinically reason.

They do not have restorative aides to do range of motion (ROM) on their residents (which is especially needed for their adolescents with cerebral palsy). I spent one afternoon with Amanda in the adolescent unit doing Neuromuscular Re-education and passive range of motion (PROM), which was an entirely different world than the older ladies. These young ladies are mostly bedbound, nonverbal and locked in their own worlds. They need daily work, but there is just not enough staff to provide it.

The therapists had a lovely connection with their patients. They were respectful, playful and caring. By the time I left, I felt as if I was saying goodbye to a family.

My week at Hermano Pedro is simply a drop in the bucket of what I would know about the place if I stayed longer. I'm sure I'll learn more when I return next year. If any of you have visited or volunteered there, please drop me a line and tell me about your experience. It's an amazing place with a grand mission of service.

A tip:  If you are in Antigua and you wish to volunteer your OT or PT services, ask to work with the adolescents. They are the ones with severe contracture formation and appear to be a semi-forgotten population.

A request: if you work in a building that has a bunch of old Neuroflex-style splints laying in the closet or in storage under the mats, would you do me a favor? Ask your manager if you might donate a few of them to Hermano Pedro. Email me and I can get them sent to Amanda. They really need splints!


  1. I'm an OT and was in Guatemala in May, volunteering with Bethel Ministries International doing wheelchair clinics, and they also work with Hermano Pedro (they help out with some of those wheelchairs, I think primarily for the kids). We spent time with the adolescents and little kids...definitely a beautiful place doing incredible work. Your post made me miss that place!

  2. I love that you were there doing wheelchair clinics - I am amazed by how the wheelchairs are so well built to manage on the cobblestone streets. I saw a lot of men and women athletes in Quickie style wheelchairs with the small back wheel for stability - many of them had Rotary International emblems on the back.

    There is much work to do there - and I hope to get a team together next year to return for Spanish training and volunteer work. Let me know if you're interested!

  3. Yes--we saw that too; wheelchair basketball so so popular there! I would definitely consider if you got a team together, depending on when. Please email me (can you see my email address without me posting it here--if not, let me know) about it!

  4. Hi, I really loved what I read. I am a PTA and am wondering how I can get in touch with the PT dept to find information on volunteering. Thanks for your help!

  5. Here is their web address:
    I would recommend emailing them, and let me know that you are interested in volunteering. You'll need to show your state PTA license for your credential there, as well as your passport. They will make an ID for you and set up hours in which you can work with the therapists. Good luck!