za best pt experience kevin_zambia.pdfkevin williams, spt. manguzi, south africa •small town in ne...
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![Page 1: ZA best PT experience Kevin_Zambia.pdfKevin Williams, SPT. Manguzi, South Africa •Small town in NE corner •1 tar road •~6,000 residents •Many more in homesteads scattered through](https://reader033.vdocuments.mx/reader033/viewer/2022042313/5edc21baad6a402d6666ab22/html5/thumbnails/1.jpg)
ZA best PT experience
Kevin Williams, SPT
![Page 2: ZA best PT experience Kevin_Zambia.pdfKevin Williams, SPT. Manguzi, South Africa •Small town in NE corner •1 tar road •~6,000 residents •Many more in homesteads scattered through](https://reader033.vdocuments.mx/reader033/viewer/2022042313/5edc21baad6a402d6666ab22/html5/thumbnails/2.jpg)
Manguzi, South Africa
• Small town in NE corner
• 1 tar road
• ~6,000 residents
• Many more in homesteads scattered through the area
• Subtropical climate• 90s and VERY humid
^ ^ ^ ^ ^ ^ ^ ^ ☺
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Site accommodation in rural South Africa
• Rondavel (ron/DAH/vel)
• Circular hut with thatch roof
• Room for 4 students
• Electricity, refrigerator, washing machine, shower, bathroom, small electric stove/oven, and fans (thank goodness!)
< outside of the rondavelcomplete with braai (BBQ firepit)
Lines for drying clothes and the always important mozzy nets >
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Manguzi Hospital
• Made up of Inpatient wards, Outpatient department, Therapies, Pharmacy, Dentistry, Optometry, etc.
• Wards are large rooms with anywhere from 8 to >20 patient beds
• Physicians and Therapists assigned to specific wards and work together treating patients in their ward.
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Objectives
• Provide quality therapy services in an underserved area of rural South Africa.
Barriers
• Cultural differences and effects on body mechanics• Long periods in lumbar flexion• Carrying heavy objects on top of head
• Transportation to medical services• Poor neonatal health secondary to variety of economic
and cultural issues• High incidence of CP and congenital HIV
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Solutions being implemented
• Work within cultural norms• Therapists must offer pacing suggestions and culturally acceptable lifting
techniques• Individuals must continue to plow and plant gardens, carry water, and maintain the
homestead
• Bring healthcare to the patient• Manguzi hospital has 10 satellite clinics to bring healthcare services closer to
patients – includes seating clinics for wheelchair users
• Community caregivers work with the hospital to go out into the community and keep track of known patients/screen for serious pathology
• Where staffing allows home visits may be done by Therapy staff
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Conclusions• Significant challenges exist, but the therapy team in Manguzi is
battling every day to provide quality care
Solutions Continued…• The therapy team has created a High Risk Baby Program which tracks
any child born with a risk factor• Risk factors include HIV exposure, low birth weight, low APGAR,
twins, seizures, physical abnormality, and young mothers• The program includes regular check-ups for every child in the
program allowing early detection and treatment of any pathology• HRBP has won national awards in SA therapy community
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Most profound clinical experience
• Working with patients using a take-home paper system in place of an Electronic Health Record. • Extremely difficult, as you can imagine
• Cards are meant to be taken to every healthcare encounter to keep all providers informed of unrelated visits
• Instead the cards often become damaged, contain poor documentation, or are completely illegible
• Remarkably they are rarely lost or forgotten
• I will never take our electronic documentation for granted again!
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Most profound cultural experience
• Tie between:
• hiking with a group of South Africans to a cave with a waterfall over the entrance and camping with hundreds of bats
• Walking a deserted beach at night with a group of people from 5 different cultures on a turtle tour. We saw hatchling sea turtles escape their nest and journey to the ocean
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References
• Manguzi Rehabilitation Department program description
• http://manguzirehab.blogspot.com/p/rehabilitation-programs.html
• Madden, V. J. (2013). ‘OUR TRAINING LEFT US UNPREPARED’ – TWO PHYSIOTHERAPISTS’ REFLECTIONS AFTER WORKING WITH WOMEN WITH LOW BACK PAIN IN A RURAL ZULU COMMUNITY IN SOUTH AFRICA. Journal of Community and Health Sciences, 8(2). Retrieved February 15, 2019, from https://www.bodyinmind.org/wp-content/uploads/Madden-et-al-2013-JCHS.pdf.
• My own experiences in Manguzi