Group shot at Uxmal, Mayan Ruins
Whew! Back in the chilly Midwest after a service learning trip to Merida, (Yucatan) Mexico. An amazing trip to an amazing city; I don't even know how to start to recap. I'll start with a brief background about the trip.
Beginning in 2007, physical therapy students from The Ohio State University began what we hope will be annual trips to Merida to consult with physical therapists and staff at outpatient clinics, schools for children with disabilities, shelters and nursing homes. The trip originally was developed by Wheeling Jesuit University and 2007 was the first year that OSU participated.
My classmates fixing wheelchairs
In 2008, ten physical therapy students and five physical therapists along with two graduate engineering students and a teacher with special education experience made the ten day trip. We worked at many facilities; I spent most of my time at a privately funded school for children with developmental disabilities who were not permitted to attend public school. The children worked with a physical therapist and a language teacher in addition to their academic curriculum. Although the non-inclusive setting may seem to be behind the times, the program was very progressive in terms of intensity and the expectations they held for the children. Interestingly, the school also provided physical therapy to children with developmental disabilities who attended public school following an outpatient clinic model.
Dancing at Grand Opening of school's new location
As an aside, in preparation for the trip, I read some articles about the health care and political systems in Mexico. However, 11 days in Mexico, was not enough time to fully understand the idiosyncrasies of either system. I found myself asking many questions: What are the criteria for a child to be accepted or denied admission to a public school? Who funds physical therapy for the children who attend the public school but receive services at the private school? Surely, I have become so accustomed to the laws and funding sources available in the USA that I had long neglected these fundamental qualms that affect services provision. The timing of the trip came shortly after I had completed a presentation detailing early intervention services so Help Me Grow, IDEA, and even Medicaid were still on my mind. Although the systems in our country leave much to be desired, my experience in Mexico made me more appreciative of the services and systems we do have. The PT who served as my mentor for most of the trip put all my thoughts into words, describing our days as "a history lesson." Being of the generation that I am, I never experienced pre-IDEA schools. I never knew institutionalization. I have always valued linking knowledge learning from text books, lectures, or research to personal experiences. My experiences in Mexico helped me do just that.
Me standing in the chapel window at Hacienda Teya
The other component of the trip that resonated with my LEND training was our immersion in the culture of the city. Cultural competence is a buzzword that has come about as America continues to diversify. It's a core competency of our LEND program at OSU, but this trip has made me reflect upon its meaning. Surely, every city, state or region, every school, hospital or clinic has a distinct culture. But they are all a part of a broader culture which is American. How can I achieve true cultural competence when I only practice in cultures of the same main branch? Perhaps living and working within a different culture, one outside my comfort zone, is a step. It is unrealistic to think I could ever practice in every culture so as to become competent in all cultures. But I'd like to think I learned a few things that can help me practice in a more culturally competent manner. First, never underestimate the value of non-verbal communication. I was fortunate to spend much of my work day with people who spoke excellent English. At other times, however, I had to communicate with the rusty Spanish I learned about 5 years ago! Also, in Mexico I began to understand home programming in the context of their culture. It is easy to get into the habit of recommending the same set of ideas (in PT, exercises or activities) to patients or clients. It is easy to take conveniences and customs for granted and make assumptions. I learned this one the hard way, recommending that a patient try an exercise at home lying on her back on a bed. She gave me an interesting look and responded that she slept in a hammock. Talk about feeling sheepish! From this, I learned not to assume to know a patient's home environment without asking. In class, I can remember reading about a home health therapist who made a very poor first impression by not removing her shoes at her patient's door. Again, linking the knowledge to my personal experience is what really made me think.
If could write for days about this trip and everything I did, saw, and learned. It was a very unique opportunity and I would encourage anyone who has the chance to practice in another county to take advantage it! It is an experience you simply cannot replicate practicing in our country.
Group shot at Uxmal, Mayan Ruins
