Saturday, March 17, 2012

Function

Cheri Blauwet, MD
PGY-3, Physical Medicine and Rehabilitation
St. Marc, Haiti
Comprehensive Rehabilitation Program - Zanmi Lasante/Partners In Health

As a physician in the specialty of Physical Medicine and Rehabilitation, my primary focus is the promotion of function and quality of life for individuals with physical and cognitive disabilities such as stroke, brain injury, spinal cord injury, musculoskeletal injury, and pain that may result in disability. Of interest, I am also a wheelchair user due to having experienced a spinal cord injury when I was young. In this role and with an ongoing passion for global health work, I have no choice but to promote my own function and quality of life in order to maximize my ability to provide care, particularly in settings such as Haiti, where the built environment and natural landscape are predominantly inaccessible. This dichotomy is a familiar one to any medical resident. In this role and on a daily basis, we encounter trade offs between contributing to the well being of our patients while also preserving our own personal health and ability to thrive.

For me, this necessarily selfish quest actually began several months ago when the  Zanmi Lasante/Partners In Health (ZL/PIH) team in St. Marc and specifically my clinical mentor, Dr. Andree LeRoy, reached out to begin the conversation regarding a basic needs assessment.  Impressively, the team took the necessary steps to seek a contractor in St. Marc to build a ramp for the ZL/PIH house, and also purchased a shower chair that would be shipped to my house in Boston. I could then take it with me as a carry on when traveling to Haiti. In discussion, we felt that the hospital environment would certainly provide challenges, however because it had been retrofit with ramps after the Earthquake, would likely be at a level of accessibility to at least maintain a basic level of function. Now reaping the fruits of this labor, we are up and running. The ramp has been installed and in an almost endearing way is not quite up to code, however it is constructed beautifully and will soon be adjusted to a slope that is a bit more reasonable for a wheelchair user to use safely.

                     Dr. Andree LeRoy and Mede, ZL employee/friend check the ramp specs!

Of course, this is all put into perspective of our patients, for whom the day-to-day significance of living in this environment of barriers is invariably overwhelming. As a clinician in training and also a wheelchair user, it seems that working in a setting like Haiti affords the opportunity to even more sharply refine my skills in the clinical management of rehabilitation problems, but also in the tenets of empathy, cultural awareness, and true solidarity with my patients. As a member of the ZL/PIH Rehabilitation Team, I am thrilled to know that we will always consider health to be a human rights issue, and disability rights a pillar of our work.  With this, we understand that community inclusion, stigma reduction, and accessibility of the built environment are the foundation we stand upon when providing care to people with disabilities.  

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