Six of us students and three faculty members took part in the trip. We students worked in several different hospitals around Addis Ababa, the capital city of Ethiopia. One other classmate and I worked in an outpatient clinic at Yekatit Twelve Hospital, a government-run hospital near the center of the city. In Ethiopia, inpatient physical therapy and initial mobility work is far less common than it is in the US, so most PT is outpatient PT. The Yekatit 12 clinic sees a huge variety of patients: post-stroke, spinal cord injury, low back pain, post-fracture contracture, post-burn contracture, Guillaine-Barré syndrome, and many others. Several things jumped out to me about the clinic: the small space available (coupled with a ton of patients), the lack of clinic resources, and the positive mindsets of the patients.
The small clinic was very crowded from the time we arrived at work in the morning until the time we left the clinic at noon. Because physical therapy is not the most lucrative career in Ethiopia, many PTs only work 3-4 hours per day in the morning and work other jobs in the evening. As such, every patient with a prescription for physical therapy would come to the clinic early in the morning and wait—sometimes up to 2-3 hours—to be seen. Naturally, this meant we had very limited space to use for treatment in the clinic.
Also, the clinic lacked many resources that we take for granted in outpatient clinics in the US; we learn to expect high-low tables/mat tables, exercise equipment, private rooms, a large selection of weights, and space to do a variety of PT interventions. I believe every student on the trip learned to be significantly more creative through the process. For example, several times we used a makeshift combination of theraband, a dumbbell, and an ankle cable attachment cuff to create a forefoot weight, along with many other techniques that can only be described as “winging it.”
In any event, we made the small space and relative lack of resources work. And, despite the shortage of space and equipment, patients managed to maintain a very positive attitude and constantly work towards their goals. These attributes, coupled with an unwavering respect for healthcare practitioners, undoubtedly contributed to improving their outcomes.
Because of our short clinic hours during the mornings, we worked with many Non-Government Organizations in the afternoons. Our work included teaching basic nutrition, basic first aid, and performing PT at several different aid organizations. We also collaborated with students from the Regis-sponsored DPT program at Addis Ababa University—the first program of its kind in the country. Between our work and simply exploring the city, it was an incredibly busy and transformative trip.
Ultimately, my greatest takeaway from our trip to Ethiopia was the importance of communication. I started the trip assuming that many of our patients would understand English, at least to some extent. My first day in the clinic disproved that assumption, though, and I had to rapidly scramble to learn basic Amharic words so I could create some form of communication with my patients. In the end, I was not very successful during my short trip, but I learned to lean more on teaching through demonstration. I was reminded that, even in patients that do speak English, you can never underestimate the value of demonstrating a task to help a patient learn.
Beyond all else, my immersion trip to Ethiopia reminded me that communication is paramount. As PT students and future healthcare professionals, we often are focused entirely on providing the most optimal care as efficiently as possible. However, without effective communication and rapport, that optimal care will likely never be delivered effectively. This program was a tangible reminder that sometimes strong communication can trump every piece of optimal practice that research can provide. I believe I can speak for every student and faculty member on my trip in saying that the Ethiopia immersion trip was a fantastic and informative experience. I highly recommend it to anyone in the program—even if you don’t necessarily have an interest in travel. Each trip is an invaluable experience to work with populations you rarely get to work with and is a unique opportunity to hone your clinical skills, communication skills, and intercultural awareness.