Today was the last day at my physical therapy internship. Two months ago, I arrived at my internship at the Centre Talibou Dabo and was promptly given an ailing infant and told to teach him how to hold his head up on his own. It was a startling welcome into the world of physical therapy in Sénégal because without any real training as a physical therapist, I was expected to work my magic. Serving as an intern at a rehabilitation center in Sénégal has been a dream come true in many respects. It opened my eyes to the unknown world of therapy outside the West and began to answer a lot of the questions I have surrounding the intersection between rehabilitation, culture, and faith.
During my first week, my conversations with the therapists went something like this:
Therapist: You like to work with kids?
Therapist: Ok. [Then goes to get a child who cannot stand up on her own due to scoliosis or polio or something else] Here is a kid for you.
Me: Oh. Um, I haven't actually started my studies to become a therapist. I'm just studying neuroscience right now. I don't know what to do.
Therapist: Oh ok. [Promptly tells mother of child to go sit back down with the crowd of people who arrived at 6 this morning in order to be treated]
Along with a few children, I also spent 30 minutes talking with a man whose hand had been paralyzed for 30 years. I was supposed to be conducting a pre-therapy assessment, in French, with a guy who spoke Wolof, but I didn't know what kind of things to assess. His hand looked pretty paralyzed, that's about as much as I could gather.
Once all of the therapists realized that I wasn't actually a practicing therapist, things got more manageable. I got to shadow two therapists, ask questions, learn vital Wolof words like siggil [sit up] and dafa metti [it hurts], and see for myself the state of therapy in Sénégal. Here is what I have surmised:
- About 10 years ago the only physical therapist in Sénégal was the national soccer team's sports medicine dude. Now, the only physical therapy school in the country graduates about 10 students a year, most of whom are not actually Sénégalese.
- The lack of physical therapists means that those who are qualified are always running around. The therapists I shadowed were always working on three to four patients at one time.
- Unlike in the United States, therapy sessions are paid for entirely by the family of the patient. This means that, of the small percentage of people in Sénégal who have actually heard of physical therapy and accept it as an opportunity for their loved one with a disability to improve their condition, an even smaller percentage can actually afford paying for sessions, transportation, and materials. (I think each session costs around 20 American dollars)
- Therapy is seen as one of the last options on a hierarchy of solutions to one's medical ailment. For many Sénégalese, you first go to a marabout or healer, then a doctor, and finally, after many years of living with the condition you might seek out a therapist.
- Many of the patients I met over the course of my internship had hemipeligia (one side of the body paralyzed), diabeties and had to get a leg amputated, or other other conditions that developed over the course of their life. Not many patients had congenital disabilities and none of them had autism or other behavior disorders. It seems to me like only certain conditions are considered worthy of therapy in Sénégal.
- Materials are limited and often half broken, which calls for creativity and ingenuity. Many of the patients often mentioned how they looked up therapy options in Europe and found apparatuses and therapy regimens that never would be possible for them to find here.