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Rehab in Romania: volunteering for the Life Foundation

Josh Plail Physiotherapy student

In 2013, Josh volunteered for Life Foundation in Romania. There, he was able to use the skills he had gained as a graduate physiotherapist to help others and make a substantial impact on their lives, while, at the same time, experiencing physiotherapy in an environment outside of the usual NHS placement. Physiotherapy is a huge part of healthcare in a vast number of settings, each with their individual challenges, and while Josh had already, through his various placements, seen how small interventions can really impact on a patients quality of life, he discovered that working in another country, where the people he was treating speak a completely different language, really does take the challenge to a whole new level!

I started studying physiotherapy in September 2011 at the University of Nottingham. After what can only be described as a fantastic two years, I am now mid-way through my nal year. With the expected challenges of the dreaded dissertation deadline, exam nals and concluding placements looming ever closer, I am looking forward to graduation day. My studying days have been brilliant, but it will be rewarding, nally, to put theory into practice. In August 2013, I had the privilege, along with 12 other healthcare professionals and students, to travel to Slatina, southern Romania, to represent the Life Foundation, an organisation set up in 2003 to support orphaned and abandoned children in Romania. Over the past 11 years, the foundation has grown and now has more than 400 volunteers who give up their time and use their knowledge to make sure the inuential work continues. Volunteers to the Life Foundation were, originally, non-specialist; however, those who specialise in the health, education and social care sectors are growing in number and, following an interview and various training days, I was lucky enough to be placed with a specialist group consisting of doctors, medical students, a nurse, a psychologist and, of course, physiotherapists, both qualied and students. The group was to focus primarily on constructing simple, yet achievable, treatment plans for people and training the carers who would eventually implement the programmes after our departure. The effort of our team was to have an immense inuence in the area, and signicantly contribute to Life Foundations aim of providing a lasting benet to health of the many babies, children and adults we worked with, improving their quality of life. In the weeks leading up to the trip, and, indeed, during the threehour journey from the airport through the glorious Romanian scenery, the mixture of anxiety, excitement and the degree of

fear I was feeling was changing hour by hour. The fact that, as a second year student, I had only a very limited clinical experience, combined with this new and challenging environment so far from the familiarity and comfort of any NHS ward, contributed to my anxiety. However, when we arrived in Slatina, the breathtaking golden sunset melted any fears away. Throughout the two weeks in Slatina, we were presented with a wide range of neurological, musculoskeletal and respiratory conditions, so the rst challenge was to learn to switch between neurological, musculoskeletal and holistic thinking. The conditions we encountered ranged from a fairly complex cerebral palsy case to something as simple as at feet. Whatever the condition, our main focus was to promote the persons functional wellbeing and prevent, or limit, any decline in ability. A great deal of our time was spent deliberating contracture prevention, sleep systems and exercise prescription. In comparison to the NHS, the physio interventions we carried out were fairly simple and basic. However, we were required to overcome other barriers and challenges to our work. While I had learned the standard hello and thank you, my feeble attempt at Romanian was extremely limited and, as the carers and children knew no English, even the basic, but important, elements such as exercise prescription and advice on technique proved a challenge. Non-verbal communication sometimes proved the only solution, but trying to teach basic core activation was near impossible! However, the language barrier became easier and we often learned to gain compliance with the help of play. It is surprising how much of a rapport you can build through bubbles! Another challenge was the limited equipment available for our use. There were no endless options to buy Therabands (which had become my next best friend on placement), no electromodalities;
Articles In Touch Spring 2014 No 146

the equipment we had at our disposal had to t into a suitcase, which was already crammed half-full of toys. For those people we were visiting in blocks of ats, the limited facilities fuelled our need to think outside the box and be creative when it came to traditional techniques. Physio-inuenced play was exactly what was called for as it guaranteed compliance and had signicant therapeutic effect. While constant time pressures are an issue for physiotherapists in the UK, the need to build an effective rapport, create and implement treatment plans, re-assess and gauge effectiveness with a vast caseload of patients, and then undertake the training of the carers, left us with no time to waste. My experience in Romania was extremely rewarding and, I believe, will inuence my personal approach to practising physiotherapy. The need to think outside the traditional approach and be creative is something I will denitely apply in my future work. The exercises we give our patients can often be perceived by many as boring and, therefore, we fail to achieve the level of compliance necessary for progression. However, simple achievable exercise, applicable to the patients lifestyle, would eliminate the perception of effort and hopefully encourage compliance. Another lesson

I learned with the Life Foundation is to be adaptable and that limited facilities, limited time and limited resources do not reect how successful a treatment plan can be. The need to make myself understood in another language has drastically helped my communication ability. The language barrier was a recurring challenge as every treatment idea required communication. So when communication is applied back to a situation where there is a mutual language being spoken, the clarity of my communication will be signicantly clearer due to the non-verbal contribution. The Life Foundation is making a difference to many lives in Romania. It is always on the lookout for healthcare professionals to continue its work, so see below for further correspondence. I had a fantastic time in Romania and the two-week experience was sincerely rewarding, one I will never forget.

For further information about the The Life Foundation contact Claire Wood: 07927 016111

In Touch Spring 2014 No 146 Articles