“Pangani chonchi.” “Do it like this.” Over the past decade Casey Nesbit, PT, DPT, DSc, PCS Director of Clinical Education and Assistant Professor of Physical Therapy has had many opportunities to use the phrase “pangani chonchi” as she trains healthcare workers in the Republic of Malawi, a landlocked country in southeast Africa. “I originally went to Malawi in 2006 with my daughter to volunteer at St. Gabriel’s Hospital,” shares Dr. Nesbit. “We both had an interest in global health.” In 2015 Dr. Nesbit was accompanied by Sarah Haga ’16, C.J. Mooneyham ’16 and Abby Sheats ’16, which marked her 11th trip. Pacific’s physical therapy (PT) students have been going to Malawi since 2013 and have a trip planned for 2016.
At St. Gabriel’s Hospital students face the challenges that come with working in a rural setting in a developing country. Dr. Nesbit shares, “The experience at St. Gabriel’s is full of uncertainties and unexpected events. I’m continually surprised by the students’ ability to deal with these conditions, bond as a team and adapt to the circumstances.” She adds, “The reasons why this experience is pivotal to the students varies. For each student there are unique challenges that they overcome. For some it is dealing with the unexpected. For others it is gaining a perspective different from their own [or] dealing with the limited resources in the environment. For others it is reconciling the level of poverty and suffering with our own comfortable world.”
Haga shares that despite studying about the culture and history of Malawi prior to her trip she still experienced culture shock. She explains that even though she “heard many stories, read books and attended weekly classes all in preparation for this exciting experience I was not prepared for interactions I would have with this country and its people that brought me to a place of humility and vulnerability.” In speaking of her experiences she shares, “The Malawian culture is very social, personal and kind. Every exchange we had with a person in the village, hospital or in surrounding areas felt as if we were exchanging with a long-time friend. There is an incredible sense of community there and the people are quick to make visitors and guests feel welcome.”
Dr. Nesbit expresses, “These experiences solidify a commitment to physical therapy in the global arena. Additionally, these experiences strengthen their commitment to the profession, build their capacity to deal with people from different cultural backgrounds, highlight the importance of educating others about our profession and develop a resilience to situations that are difficult or uncertain.”
Haga found that her view of the physical therapy profession changed as a result of going to Malawi. Haga shares, “Prior to going to Malawi, my view of physical therapy was focused on the patient’s impairment and what I could do as a healthcare provider to improve their PT diagnosis.” After spending time in Malawi her focus shifted to take into account the overall picture of the patient’s situation as well as their cultural background. She adds, “While on our trip, our goals were directed towards improving the patients’ quality of life, whatever that meant for each patient. For some it was helping them return to their previous functional status of walking so they could return to working in the fields. For others it was improving their ability to sit unsupported so they could participate in daily chores as they once did. As student physical therapists, we were challenged to find what each patient deemed as important and channeled our therapy goals towards those aspects of the patient’s life.”
Dr. Nesbit has observed that when students have the opportunity to interact with patients from a wide variety of cultural and economic backgrounds it contributes to them becoming practice-ready professionals. She said, “I encourage students to have the courage to take advantage of practice opportunities that let them serve vulnerable populations, [both] here and abroad. I guide them to opportunities to do so through our national association, the American Physical Therapy Association.”
Haga discovered that her experiences in Malawi have improved her ability to serve patients as a healthcare professional. She elaborates, “Having worked with the Malawian people, I have gained a greater insight about how cultural beliefs and perspectives contribute to overall health. Regardless of where I am practicing, I will be able to apply this understanding towards any patient population.”
To read about the students’ experiences in Malawi in their own words visit their blog beyondpacificblog.wordpress.com.
By Anne Marie H. Bergthold