Departments
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Week of 22 October 1999 |
Vol. III, No. 11 |
Feature Article
Sargent College prof finds that badly needed physical therapy is stepchild in Central America
By David J. Craig
In the United States, physical therapists are usually regarded as professionals on a par with doctors and nurses. But in many countries, PTs are paid low wages and considered unessential. The losers are those who need rehabilitation after serious injury or surgery.
"When I visited El Salvador hospitals, I saw patients who needed therapy and didn't receive it," says Jean Peteet, a clinical assistant professor of physical therapy at Sargent College, who spent 10 days in Central America as a volunteer with Health Volunteers Overseas (HVO) this summer. "Some clinicians were sending patients home because the few physical therapy centers in the area didn't have adequate resources. So they would prioritize and treat only the most serious cases."
Peteet (SAR'83) was concerned by what she saw, and as a member of the Washington, D.C.-based nonprofit HVO, she was able to help improve El Salvador's health-care system. In July, she taught modern physical therapy methods to faculty at the University of El Salvador.
"I jumped at the chance to be a part of the HVO program," she says, "because the emphasis is on helping educators enrich and improve their own health-care system, rather than just providing manpower."
HVO places hundreds of health-care professionals in volunteer teaching and training positions in developing countries every year. Last year it sent 301 volunteers to 40 sites in 17 countries.
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Jean Peteet (seated, center), a
clinical assistant professor of physical therapy at
Sargent College, trained physical therapists and
university PT instructors in San Salvador in July.
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Physical therapists in the area, she found, were treating patients with injuries similar to those American therapists would handle, from athletes and workers needing short-term rehabilitation to amputees, stroke victims, and diabetes patients in need of long-term support. But providing adequate treatment was difficult.
"In a hospital you need some basic items like walkers, canes, wheelchairs, and crutches," Peteet says. "But they didn't have enough of those things. Even something as basic as weights, which are necessary to work on strengthening, were in short supply. There is a real lack of technology and basic equipment that we would consider absolutely necessary."
In addition, Peteet says, morale among some therapists was low because of poor pay and unemployment.
"Many people there have acquired the right skills but can't find work because the economy is so bad," she says. "And because they have been considered simply technicians or aides for so long, few therapists are invested in their jobs enough to work 50 hours per week."
The curriculum of the weeklong course Peteet taught at the university to 17 faculty and 33 area clinicians focused on modern ways of managing cases, including documenting injuries and treatments carefully.
She found that conditions at the university were similar to those in the hospitals. "What we take for granted, such as computers, up-to-date textbooks, current professional literature, they didn't have," she says. "But in the schools, things were very creatively organized so that faculty got large numbers of students into clinics to get some kind of hands-on experience."
The University of El Salvador used HVO volunteers with a background in physical therapy for the first time this year, according to Gay Lindley, program director at HVO. She agrees that in many developing countries physical therapy is a branch of medicine that is only now beginning to get the attention it should have.
"Physical therapy programs in developing countries had been lacking for a long time, but now they're beefing up," says Lindley. "This happens when they develop good orthopedic programs. When doctors fix or change something in the bones, the patients are then in desperate need of occupational and physical therapy."
Peteet is confident that the work of HVO volunteers will eventually make physical therapy a more respected and better financed aspect of El Salvador's health-care system. Months before HVO's involvement at the school, the university had created its first bachelor degree program in physical therapy. Other changes indicate that the country is moving in the right direction.
"The University of El Salvador is planning to build an on-site physical therapy clinic, similar to the facility at Sargent College, which shows that some people in developing countries recognize the need for more research and training in physical therapy," she says. "Over time, I think, therapists will gain visibility and make more of an impact on the government and hospitals. But PT still isn't valued in some hospitals, where it's clearly needed."