Baby steps: learning to walk again

small_carmeneWith their brilliant smiles and frequent bouts of laughter, Carmene Guerrier, 16, and Julmiste Shelove, 25, light up the medical ward. Their friends come to visit often, sitting on the edges of their beds. They gossip, tease each other and teach simple Haitian Creole phrases to the English speaking clinicians. Although both girls have lived in the hospital for the past two months, where there’s few forms of entertainment, the near constant hair maintenance they partake in—braiding, corn rows, combing knots out and complaining about the lack of shampoo—never ceases to absorb them. When the physical and occupational therapists arrive to interrupt their fun, just like typical teens, they try distraction techniques to avoid what they know is coming. “Pa mal, pa mal,” says Shelove, as she points to her leg. Guerrier grabs the hologram stickers she received earlier and mimics that she wants more.

Shelove conquers the steep hill, with help from Michael Felber.

“If you walk up the hill, I’ll get you some,” says Annette Correia, a Children’s occupational therapist, motioning for them to grab their crutches. The girls groan playfully. Nicknamed the princesses because of their doting followers and impeccable attention to their outfits and hairstyles, the two girls are both recent amputees. And after two months of strength and mobility training from Ketlie, a physical therapist at the hospital, they are moving about confidently on their prosthetic legs—a testament to the value of the physical therapy.

“Before the earthquake, we mostly worked with bed ridden patients who were very weak, and stroke patients,” says Ketlie. Since the earthquake, with the large number of amputees and post operative patients, there’s been a constant need for physical therapy, “I haven’t had a break since,” she says.

When Ketlie found out Carmene and Shelove would be receiving prosthetic limbs, she gave them exercises to practice to strengthen their arms. Part of the struggle was convincing the girls that they would eventually be okay. “Carmene thought the prosthetic was ugly, she felt like her life was over, but I explained to her that she would gain her strength and eventually she wouldn’t even need a cane,” she recalls.

Carmene's prosthetic legs come with pretty shoes.

For Correia and Chris Ploski, Ketlie’s work is absolutely crucial to patients getting better after traumatic injury. “There are a huge variety of needs here,” says Ploski. “Many patients have had heavy objects fall on them during the earthquake. That pressure caused compartment syndromes, which can result in weakness or paralysis.”

After surgery or an injury, people are usually reluctant to move about because of pain. But if you don’t move, explains Ploski, you can get muscle atrophy, which causes weakness and can limit your range of motion. It can also cause other complications, such as blood clots. “Getting someone moving after injury or surgery is both preventive as well as rehabilitative,” says Ploski.

In the immediate aftermath of the earthquake, many injured patients were depressed and had little desire to work with her, says Ketlie. “I needed to do a lot of coaxing and talking before they finally accepted physical therapy.” But now, a few months later, and after witnessing countless patients getting better, moving about and returning to some semblance of a normal existence, most are eager to learn exercises to improve their flexibility, balance and strength.

Finding goals that are meaningful to each specific patient is a great way to engage them in their therapy, says Correia. “In occupational therapy,  we try and find an activity that they’re interested in, and make their goals around that. One of my patients is a woman who was under the rubble for two days and is learning to reuse both hands and both legs. Her goal is to be able to feed herself again.”

chair2Another patient Correia and Ploski have been working with each day is a little boy with cerebral palsy who was abandoned by his family. For this little boy, holding his head up is a challenge and he’s been lying flat, unable to move. In the United States, he would been custom fitted for a chair with braces. Here, Correia and Ploski built a chair with supplies found in the hospital.

“Everyone was so happy to see him sitting up for the first time,” says Michael Felber, who witnessed Correia and Ploski giving the boy his chair.