June 2013 – The Impeded Stream is the One That Sings

PT student Jenna modeling inclusive play with two children

PT student Jenna modeling inclusive play with two children

The season of rainy afternoons and sweet, sticky mangoes has arrived in the Dominican Republic.  These last months have certainly felt seasonal for us, as our missionary lives seem to forever operate off project-oriented time frames vs. our previously regular hospital work hours in the US. 

Supervising Students & Encouraging Hospitals

Providing analysis of the structure and challenges of health care in the DR to Creighton's physical therapy students.

Providing analysis of the structure and challenges of health care in the DR to Creighton’s physical therapy students.

A sweet portion of this season has been the arrival of Creighton University´s physical therapy (PT) students for the month.  It was a breath of fresh air to have US PT colleagues to exchange ideas with.  We played roles in orienting and accompanying students in their clinical work, as well as taking advantage of the Creighton team to host a meeting of area hospitals and clinics to contemplate and discuss best practice health services.  It was a lively discussion, where the contrast in the quality of health services between countries was apparent, but the desire to serve was the same.

Promoting increased accesibility to PT services at a meeting with local rehab providers.

Promoting increased accesibility to PT services at a meeting with local rehab providers.

We had the opportunity to work with students providing therapy at our local orphanage, which houses about 80 children with a wide variety of disabilities.  Though by international standards, these children should have access to a handful of physical, occupational and speech therapists, they have difficulty even receiving regular visits from a pediatrician.   Despite receiving this short term PT team for around 15 years, this facility has not yet been able to make the break through to acquire their own regular rehabilitation services.

Laurie supervising as child practices walking with Creighton students.

Laurie supervising as child practices walking with Creighton students.

Instead of focusing only on the overwhelming need for the basic treatment of multiple contractures, wounds, and the unmet functional potential of the kids, our team tried to consider what might affect long term change. We grappled with the hard-to-grasp questions whose solutions seem to be elusive.  Why aren´t these kids in school, even though the Dominican laws say they can go? Why is everyone in diapers instead of using the restroom on their own? Why are there no pillows, to help prevent contractures?  With staff salaries at about $150 USD a month and no upward job ladder to climb, there is very little impetus to encourage caregivers to go the extra mile in their already exhausting jobs.  We spent a lot of time affirming and encouraging the staff, and students left excellent educational hand-outs taped high on the walls out of the kids´ reach.

Please pray for the work of physical therapy development in the Dominican Republic: for societal understanding and valuing of persons with disabilities, for increased quality in staff and services, and ethical behavior in public offices in the use of public funds.  Pray for wisdom as we meet this month with Lutheran and Catholic colleagues to better coordinate efforts and strategies to find answers to the sticky, complex challenges that these kids face.  Pray that the kingdom of God, in its healing and conquering of hardship, will be known yet on this earth as it is in heaven.

We leave you with the below Wendell Berry poem. It has been encouraging to us during times where the stickiness of the mango frustrates its sweetness.  All of our love,  Nick & Laurie

The Real Work
It may be that when we no longer know what to do
we have come to our real work,And that when we no longer know which way to go
we have come to our real journey.The mind that is not baffled is not employed.The impeded stream is the one that sings.

Two sets of feet with many different stories.

Two sets of feet with many different stories.

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