By Laura Gueron, DPT, MPH
Laura is the physical therapy advisor for CVT’s work in Kenya. She volunteered as a physical therapist at the St. Paul Healing Center for more than 20 years.
Photo: Laura Gueron, Stephen Agwata, Jennifer Chepkemoi, Collins Acheta, Jepkemoi Kibet
Last November, I made my fourth trip to Nairobi to visit our CVT project. As a physical therapy advisor to our Kenya staff, I serve as a consultant, supervisor and colleague to Jepkemoi Kibet, our physical therapist/trainer in Kenya. Jep, in turn, supervises and trains our local physical therapists, Stephen, Jennifer and Collins.
We have four treatment sites where we lead physical therapy sessions: at our main offices in the Westlands neighborhood we work with young women; in the Eastleigh neighborhood we work with Somali refugees; and in the Riruta and Kayole areas we see mixed groups of refugees from Rwanda, Burundi and the Congo.
At one of the groups I visited, several women brought their babies. It was heartwarming to see these women who have endured so much trauma and abuse interact with their babies in such loving and tender ways. If a baby was fussy, Stephen or Collins would walk the baby so the mother could continue with her therapy. A toddler who also came with his mother played and tried to do the exercises, amusing everyone.
It is a major commitment for survivors to attend the physical therapy groups. They may travel one to two hours each way walking, or perhaps traveling in a matatu. They also typically have counseling appointments and spend time learning English.
In the physical therapy groups, Stephen, Collins and Jennifer lead the survivors through a wide range of exercises and activities to promote relaxation and reduce pain. For survivors, their bodies often become perceived as the enemy because of the pain. By reducing the pain, we’re helping people become more comfortable in their bodies again. We also know that as pain levels go down, emotions become more positive which promotes better relationships and more meaningful lives.
In addition to providing in-group work, we teach the men and women techniques they can use at home to improve balance, posture, flexibility and strength. We also teach breathing, relaxation and grounding techniques they can use throughout their lives to manage stress and pain.
My U.S. colleague, MaryAnn de Ruiter, and I have begun having Skype calls with the physical therapy staff in Nairobi and Amman to share ideas, successes and challenges. We’ll be using these calls to learn from each other and update treatment modules and curriculum as we continue developing the physical therapy groups and incorporating physical therapy into the counseling groups.
It is encouraging and moving when we see survivors improve – but even more so when they take pride in their own healing. One man who joined a physical therapy group suffered terribly from diabetes and gangrene. The staff worked together to connect him with a medical clinic that treated the gangrene. Through the medical treatment and physical therapy combination, he was able to avoid amputation. It was so moving to see his joy and relief at his expanded mobility and reduced pain.