Just a week earlier, I spent a fun weekend with family and friends in Galveston, Texas, celebrating the completion of my Doctorate in Physical Therapy.   Now in Kayebe, Uganda, I sat on a plastic chair in a small clay church with a dirt floor, tin roof, and glassless windows, looking into the faces of nearly a dozen Ugandan men and women, but mainly men. They came to learn and Erin and I were there to teach them.  At this point, neither of us knew what that really meant, but we’d soon find out.

Taking the knowledge of things I’d learned from my course work and my experiences in Guatemala, we decided the best place to start, after introductions, was a short explanation of the role of physical therapy.  Then, we questioned them about the health care needs and services in their community.  Initially, we received answers like tuberculosis, malaria, and other things more often treated by doctors.  With time, we soon discovered the biggest need we could help with this time was in education and treatment of patients with low back pain.  So we all agreed this would be the emphasis for the next week.

Each class experience was unique as we looked for ways to explain what we were teaching in the English our students would understand.  Yes, we all spoke English, but how we used it was not the same.  For example, instead of lying on your back, they said sleeping face up, log rolling became rolling uniformly, and treatments became solutions.  FYI, if someone says take care, they really mean WATCH OUT!

We also discovered new cultural issues.  Performing an assessment of a female patient would be a little different for our mainly male students, who would not be able to touch their female patients’ knees or thighs.  Females’ knees needed to remain covered at all times.  How could we modify some of the exercises for the floor when some families didn’t even have a chair in their home?

One day we spent the morning in the village learning how they made charcoal, worked in the fields, washed clothes, and carried water.  The point of the field trip was to learn from our students so we could better explain to them how to help people in their community with low back pain.

That afternoon a student with low back pain arrived late.  We went out to the brick pile to have his classmates show him how to lift the bricks.  “If I do it this way, it will take more time,” he protested.

“Yes,” I said.  As I paused and waited, he kept thinking.

“But, if I do it this way, I may live longer and I’ll be able to work more,” he concluded.

And so after a couple days of talking about back pain, the causes, the methods of evaluating a patient with low back pain, and ways to change some of the local activities, our student arrived at this conclusion on his own.  The initial “It is impossible or we can’t do it that way” responses were put to rest by the student who had “got it.”

By the end of our training, not only were they convinced because of their own synthesis of the information about what they could now do with the new information, but  also they had come up with amazing ways to put it to practice.  Without any prompting or ideas from us, they talked about creating a local association, working with the small community health department, working with people in the fields, making announcements on the radio, and visiting people in their homes.

I can’t wait to go back and see what they’ve done and what else we can learn from one another.