Tuesday, 8 December 2015

Giving back to the community in Siem Reap

COUNTRY: Cambodia
PROJECT: Physiotherapy
WRITTEN BY: Jess Garner

Week 3

We have now surpassed the halfway mark, and are at the end of our third week here in beautiful Cambodia. Most of this week was spent partaking in the annual water festival that ran from Tuesday to Thursday. The usually quiet river was inundated with boats racing down the river, and people from all around flooded the streets. It turns out nobody knows quite how to party like Cambodians! The number of street vendors seemed to triple almost overnight, fireworks went off daily, and once dusk hit the pubs exploded and people were dancing in the streets (us included!). We did manage to get a few days of placement in as well however, and met with patients Monday and Friday.

Mr. C, an elderly gentleman who had had a trans tibial below knee amputation (due to an accident with a land mine during his time in the army, kindly volunteered to be our first patient (and model!) for the home exercise program for the physical rehab centre (PRC). These exercises included hip, leg, arm and core strengthening. Although most of the amputees assessed at the PRC are highly functional, we believe this will be beneficial to new patients, as well as help maintain the strength and prevent secondary complications in current patients also.

At the CDA, the main focus was again assessment, exercise prescription and education. Patients were willing to sit and talk with us briefly after their CDA appointment concluded, where we determined main physical limitations, and prescribed exercise based on findings. Like at PRC, a variety of conditions were seen, ranging from patella femoral pain to stroke. All received education about how nutrition and exercise can help with the management of their diabetes. A lot of patients had little understanding of their diabetes, or how diet and exercise could help, and were quite grateful to learn more. We then tailored exercises to suit each patient. For Mr. T for example, we gave a variety of upper limb reach to grasp exercises, as he had suffered a stroke one year previously, and mainly had difficulty with his right arm.

At the school, the guys started teaching the kids some basic anatomy and assessments. They got the kids to trace the outline of their hands on paper, then draw in the bones, so they could start to have more idea of what the body is made of. A lesson on pulse taking was also included, and the kids learnt how to measure their heart rate before and after exercise, and why it is good for you. We also played games, such as handball, in order to help with basic developmental motor skills.

At the military clinic, patients that had previously been referred from the home visits had started arriving. A surprising amount of problems reported turned out to be related to back or neck pain, and where we could we implemented a variety of treatment options, including massage, trigger point and combine and repeated movement patterns to help elevate pain and improve functional and quality of life where possible.

All up, I feel that although we are all getting so much out of this experience, we are hopefully giving a little back as well, and helping patients to manage their conditions in order to get the best outcomes possible.

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