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Physiotherapy in Bolivia by Siobhan Ni Cheidigh

There isn't just one reason that made me decide on coming to Bolivia, it was a combination of having always wanted to do volunteer work, of having the opportunity to practice physiotherapy, travelling - particularly in Latin America and of experiencing a different culture.

With my pacient Maribel

I am currently studying physiotherapy with five months left before I graduate. With this experience I was fortunate enough to be given the placement in the Burns Unit at hospital Vediema. Also because I had experience I was given more responsibility. My placement involved doing physiotherapy with children aged from only a few months to 15 years of age.

On my first day of work one of the staff from the Projects Abroad office brought me into the hospital where I was introduced to Andrea, the head physiotherapist at the burns unit. She was my mentor for the 2.5 months that I was there. My working hours were from 8.30am to 12.30pm but more often than not I was finished work by 12pm. It was and can be a little daunting on the first day or week because I was given my patients and felt that I was on my own for a while. When you have experience already in physiotherapy expectations are a little higher which again can be a little daunting to begin with. Although Andrea is there and she is always there to help you if and when you need it, you have to appreciate that a lot of the time she is extremely busy and you have to be a little bit more independent. For me it was a lot to do with confidence and reassurance so that I felt that I was doing the right treatment.

With time my confidence grew and I carried out treatment with patients independently and confidently. So just give yourself time it will all fall into place. There are always students there so if in doubt they'll always help you out. I loved everything about my placement, the people I worked with, Andrea is also a volunteer at the hospital so the people that are there are all there because they have so much compassion and want to help the children. All of the children in the hospital were so amazing and although they were often in pain they never failed to smile and be happy, to laugh and to play. Every child there had something special about them. At first it is difficult to see the children in pain and to see some children with severe burns, however as the time passes and you spend more time with the children you just see the children and their personalities and what you need to do for them.

I had two main patients who I saw for the 2.5months that I was there; one in-patient and one out-patient. My in-patient was a little girl named Maribel who was 5 years old and with severe burns to her arms, back, chest and face. Her treatment sometimes took 2.5 to 3 hours. She like many of the children was from the country and got burns following an accident with hot water. Her treatment involved massaging, hydrotherapy (not your normal hydro pool), active and passive range of motion exercises, splinting, and pressure suits. At first I was very timid with Maribel and she was quite good at not wanting to do treatment and sometimes crying a lot, but after a little while I learnt a few phrases that made her participate with treatment a little better. Telling them that you will have to speak with the doctor is always a good one.

It is so important that you do the treatment with the children and although they might sometimes not want to, it is necessary. Making it fun for them by using Swiss balls and playing games that gets them to use all joints is great for helping with participation. My out-patient was a little boy with bi-lateral club food. The patients are not all suffering with burns. His treatment focused primarily on getting him walking with massage, stretching and splinting. Unlike in Europe sometimes equipment like splinting material isn't available so you have to improvise a little bit.

Other times you just play with the children. It's important that you give them your time and patience. That you also explain that the treatment is important and that you reassure them because many of the children will not have their parents or family visiting them as often as you would expect. This is usually because the family cannot afford to travel in from the countryside. Therefore it's really important that you give them the time and the attention that they need. There will be times that you will also be asked to do non typical physio duties, for example when the children need to go to the bathroom sometimes you will take them, or get a pan for them if they are bed bound. Some children might need to be changed and fed. But at the end of the day you are there to help so you do whatever you can.

In summary from my experience on a physiotherapy level I learnt how to treat patients with burns, make and fit splints, do exercises for burns, hydrotherapy, work with children, and the use and fitting of pressure suits. It was such a great experience and if this is your placement I have no doubt that you will love it too. I will truly miss working there, all the great people I met and of course all those children.

Bolivia is a fantastic country. There are loads of places to travel so take advantage of the time you have there and see all those places. Make an effort to contact other volunteers that are there and have your nights out because it has great places to eat, drink and dance and all very cheap. I really can't say enough about the place, so really enjoy your time there and try not to miss your home country because nothing will have changed when you go back.

Siobhan Ni Cheidigh

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