Creating The Problem List

We put no obstacle in anyone’s way, so that no fault may be found with our ministry (2 Corinthians 6:3 ESV).

As I read this verse again this week, I was reminded of the obstacles faced by people with disabilities in Guatemala and around the world. How can we remove these obstacles so they can live life to their fullest? I started thinking again about why we do what we do. Here is the first of a three-part series behind why we train local people in developing nations to provide basic therapy services for people with disabilities in their own communities. The series follows the steps I take as a physical therapist when I evaluate a patient. 

What’s the first step to fixing a problem or implementing change? What do you usually do?

As a physical therapist, part of my job in evaluating a patient is to come up with a problem list. These are things such as decreased strength or movement that a person is experiencing which keeps him from doing something he needs to do. From this list, the therapist creates a treatment plan to address the problems and help the person regain function to achieve his goals. Sometimes this goal is returning to participate in the activities he was doing before as he did them in the past.  Other times, it is helping him adjust to a new way of doing things because his injury doesn’t allow him to do things as he did before. Regardless, if we don’t identify these problems, our treatment plan will not be effective in reaching the goals. 

We do the same in our work with Therapy Clinics International. We make an accurate assessment of the problem before providing a solution. What would you do if you had a family member who suffered from a stroke or a child with cerebral palsy who couldn’t walk? What would you do? Where would you go for services? 

Now imagine you live in the mountains of Guatemala. Your husband works on a local coffee plantation, but because of a hurricane you’re not sure there will be much of a crop. Even if there is, the owner won’t need as many people to work the harvest. Your husband may not be chosen to work. The closest doctor is over an hour away, after you walk for thirty minutes up and down the narrow mountain passes to get to the road to catch the bus.  The nearest hospital is over five hours away, requiring three bus transfers. If you need physical therapy services, you have to go all the way to Guatemala City, a twelve-hour trip. If you can get there, where will you stay? Prices in the city are much higher than in your village. A tamale you’d pay 1Q for in the village will cost at least 5Q in the city, but some places may charge more. With employment this would be nearly impossible, but now with the potential loss of work, getting help doesn’t seem possible. 

Here are what some other organizations have determined to be some of the problems faced by people with disabilities in Guatemala: 

  • CONADI says adults with disabilities in Guatemala are less likely to have work this week, as compared to people without disabilities.
  • The WHO says people with disabilities encounter the following barriers when they attempt to access health care: limited services, lack of transportation, and high cost. 
  • According to UNICEF, about 1 in 4 people with a disability will face at least one incident of discrimination every day.
  • According to a study by USAC in Guatemala, people with disabilities have difficulty getting around in rural areas when they have to use a wheelchair, crutches, or a walker because the streets are not wide enough, are made of dirt, and are not flat. 
  • The WHO says that 80% of children with disabilities live in developing nations.

From our experience, this research and more, one of the problems faced by people with disabilities in developing countries is a lack of needed rehabilitation services in their area, but as we assessed the situation, we realized there was more to address. 

Come back next week to discover what we learned in our assessment.