Physiotherapist Keith Jackson
Filling the physiotherapy position at Billy Riordan Memorial Clinic was a challenging and rewarding experience for me.
My time was split between the physiotherapy office and, when it was not busy, the main part of the clinic where I assisted the nurses on dispensing medicine. I found it was a nice mix. Although the physiotherapy clinic was not as busy as a typical physiotherapy clinic would be at home, the opportunity to jump from one scope of medicine to another was a good way to pick up new information.
My style of practice altered a good deal during my stay here. The rural environment created challenges so I had to come up with creative solutions for therapy techniques. There are no advanced modalities here--even ice is hard to come by for many locals. Educating the villagers about techniques that allowed the patients to continue with daily life in spite of their pains seems to be my prime role. Rest was not an option for many of the villagers since they still had to perform the difficult daily tasks of collecting water and firewood for cooking and cleaning.
In addition to different physiotherapy techniques used, the language barrier added another difficulty. Although translators do work full time at the clinic, I still found I had to adjust treatment time since the translators were used a good deal throughout the clinic. Making the typical small talk and picking up subtle cues about the patient’s condition was not possible. The lack of a common language made my diagnosis a more direct process, such as watching for nonverbal responses. I relied on giving home exercises and I made personal visits to patients’ homes.
During my work with patients, I came across a variety of conditions. Some villagers had traumatic musculoskeletal injuries from football or motor vehicle accidents. Others had long-term chronic back and knee conditions. A few had experienced a cerebrovascular accident (stroke). Due to the relatively recent arrival of the clinic in the village, I found gait patterns and conditions that would have been addressed long ago in the western world for those with healthcare access.
While these patients received more personal attention from me than if they had been in the western world, I had very little equipment with which to diagnose their ailments and my patients did not have the luxury of resting the affected part of their body. I had to lower my expectations about the recovery possibilities for these villagers. I realized, though, that I did have the mind-broadening opportunity to do the best I could for them with the tools available.
I believe working at the Billy Riordan Memorial clinic was a unique and unusual situation. I gained the experience of working in a rural clinic and a sense of living in a remote Malawian village. Yet, the clinic sits at the edge of Lake Malawi--a tropical paradise setting. One can spend free time with wonderful people--swimming, tanning, scuba diving, hiking, and so forth. People from the world beyond Malawi come through on a regular basis because it is such a beautiful area so I could make new friends over a meal or drink at local food places. I would call my time at Camp Maclear a working-vacation that I am so glad I experienced.
Enjoy it all,
Keith Jackson (October 2005 - January 2006)