Finished!

I have finished my internship at Toñito and am officially a Rehabilitation Assistant! I have learned a ton on my placement and I will continue to come as a volunteer as I love the people and the experiences as well as practicing my spanish.

The latest thing I wanted to highlight some that I have yet to mention is around body mechanics. We spent the better part of 2 years of classes learning about proper body mechanics. It has been hard for me to apply this knowledge here as the plynths do not adjust in height, and many of the positions we are in during therapies are awkward no matter how hard you try to maintain proper body mechanics. As a result I tweaked my back, and the main Rehab Assistant didn’t come to work on Friday because she also threw out her back. I think with more modern equipment, transfer belts, proper transfers of patients, this problem could be addressed.

I have met some great people one of whom invited me to her home in the mountains. The following is not therapy related, but about my time in Ayacucho and a child’s point of view of life there.

I learned a lot from my friend’s nephew who lives in the house where she lives in the mountains. He invited me to take his dog out for walk, and being a dog lover I accepted. I learned more about his family and this previously very dangerous region in our halfhour walk to the center square, than in an entire day with his mum and dad. (He really liked to talk!) The region is known for its problems with terrorism but as of late, the problems have settled somewhat. As the boy and I walked with his dog, he told me about his fears of terrorism. His father was in the military that helped fight the problems. Most problems are drug related and occur outside the city in the surrounding areas. I asked him if he gets scared and he said yes, all of Ayachucho is scared. It was interesting to get the point of view of an eight year old that is growing up in this atmosphere. He is obsessed with talking about terrorism and wanted to know about terrorism in Canada. Any chance he got to pull out his imaginary guns and make machine gun sound effects, he would take it (which I suppose is typical of many 8 year old).

With the mother who had invited me to the mountains, I helped her continue therapy with her daughter who is my favorite patient. Even though it was a vacation for all of us, the work still had to get done! I have been working with this 2 and a half year old and her mother on specific goals since I arrived here in Peru. I am happy to say that the patient is now crawling very well, and the next step is to focus on exercises for walking!!

Assessments

So many interesting things happened this week that I feel like I could write forever! But I will try to keep it short and will talk about the most exciting thing for me: the assessments. In my opinion the re-evaluations are the best part of the job as you get to see all the hard work paying off. This week we did many assessments on new children as well as re-evaluated several people and modified their treatment plans. The assessment tool used here at Toñito for many of the children is the Milani-Comparetti tool developed in 1967. What I like about the assessment is that it is simple to administer, quick, objective, and the results are clearly mapped out on a chart where progress can be clearly identified.

If a child cannot lift its head then all the exercises in the treatment plan focus on this goal. If they cannot sit or stand independently, then all exercises focus on developing these skills. It makes prescribing a treatment plan simple when using this method. I am dying to know if the Milani-Comparetti Assessment is used in Canada. It is very old, however many theories used today are based on research from long ago.

One girl we assessed had progressed significantly since her last test and I have noticed significant changes in my short time here. She could not walk independently when I arrived and had severe “atetosis” (uncontrolled movements), but now she can walk independently, count out loud, and her atetosis have diminished by a lot making it easier for her to develop more precise and planned movements. Not all the cases we evaluated were as progressed as this, but it definitely makes for a great reward!