Prosthetics & Orthotics Volunteers: A First For Samarthya

Last year, I was at Hodgson Orthotics in Coquitlam to collaborate on a shared client’s scoliosis brace. I mentioned that I was heading off to India to volunteer, and joking-not-jokingly said, “I’m heading to India, anyone feel like coming with me?”.

Before I knew it, the ball was rolling and Yvonne Jeffreys (instructor at the BCIT Prosthetics & Orthotics Program and orthotist extraordinaire) was arranging a student placement for the second year BCIT students. Shane Bates and Malena Rapaport jumped at the opportunity to travel and volunteer abroad, all while completing their required clinical hours!

We quickly realized that it would be best to have a team stationed in Koppal and one in Deodurg/Raichur to spread the knowledge and provide the best working conditions for all four volunteers. We soon recruited Jenny Billett, a prosthetist working on the east coast, to be the other supervisor for the placement.

Soon after arriving in Koppal, the teams split up: Yvonne and Malena stayed in Koppal, and Shane and Jenny made the bumpy 5-hour journey to Deodurg. This is the first time the workshops have ever had technically skilled volunteers, so their contributions, suggestions, and insights were invaluable. In short (but kinda long), here’s what they did over 4 jam-packed weeks:

  • The two teams observed their respective workshop processes and made suggestions to improve workflow and safety
  • Jenny and Malena created floorplan suggestions to renovate Koppal and Deodurg workshopsIMG_4785
  • Ashok, Basavaraj, and Muttana shared their knowledge so the team learned about how to create aids and appliances in rural India using available supplies
  • Shane gave an inservice on how to complete a thorough initial assessment, combining BCIT and Samarthya approachesIMG_4731
  • Malena facilitated a group brainstorming activity to discuss four categories of concerns in the workshop – procedures, layout, resources, topics for learning. These will be the foundation for future changesIMG_4768
  • Yvonne created a shared online folder and uploaded many resources for the staff to access, including device design flowcharts, manufacturing guidelines, and more
  • Lengthy discussions with the local workers helped come up with a training plan for new technicians and assistants
  • They identified equipment and tools that would improve efficiency, and last but certainly not least…
  • They contacted their generous networks and received bags of donated tools and raised an astounding $5635 that will be going toward workshop renovations, equipment, and training!

A massive ‘dhanyavadagalu’ to Yvonne, Jenny, Shane, and Malena for everything!

IMG_4765

Advertisements

Project Update – Training Manuals

It’s hard to believe that half of the project is already over!! Apologies for the lack of posts – It’s been hard to document exactly what I’ve been doing because much of my role hasn’t been tangible.

To summarize, I came to India at the beginning of October with rough ideas of how our team of 16 volunteers could contribute to Samuha Samarthya in a sustainable way. Don’t get me wrong – Samarthya is doing an INCREDIBLE job, helping hundreds of children through their various programs. They are one of the most dedicated organizations in the state of Karnataka (and won an award last year for it!).

As an international volunteer, it was so tempting to fly in, help a bunch of patients, get that happy feeling inside because you’re helping these super-cute amazing kids and lovely adults, and then fly out, but that would have left the organization no better than when we found it.

Here were our original goals:

  1. Improve the Community-Based Rehabilitation (CBR) training manuals (which haven’t been updated in 20 years!)
  2. Hold theoretical and practical educational sessions for the CBR workers to improve and standardize the level of care being provided in the Early Intervention Centres, the Spinal Cord Rehabilitation Unit, and other community outreach programs.
  3. Hold educational sessions for caregivers, school teachers, and other community members to maximize care and inclusion of people with disabilities in these rural communities.
  4. Increase efficiency of the organization by piloting and implementing new ventures such as a loan equipment program
  5. Teach the local CBR-Workers to be teachers, so they can continue to educate their colleagues and future newcomers to the field, and not rely on Canadian volunteers for education
  6. Raise awareness of Samuha Samarthya by facilitating Canadian volunteer experiences (physiotherapists and orthotists). There are a total of 17 other clinicians and students coming for 1-2 month stints throughout the project!
  7. Raise awareness for global health and create avenues for discussion about international volunteering in general, as I hope some of these volunteers may have the desire to contribute to other international projects. It is crucial to understand what type of volunteer work is beneficial for these types of NGOs, as we will be aiming to empower the local workers rather than doing the clinical work ourselves. We don’t want to parachute in, work, and leave, as that would leave the organization no different than when we found it.

Things changed from the second we hit the ground. It quickly became much more complicated as I peeled back the onion and found layers and layers of issues… and it took the whole first two months to really suss out what was happening at Samarthya. During that time, I really got to know the staff at a personal level and they shared their joys and challenges of their jobs. Through these conversations, I was able to gain their trust so they might be more open to our suggestions over the six month period.

Phase 1 (Oct-Nov): The first group of volunteers (Jen Tam and Julie Alexander) played vital roles in observing and inquiring about the technical skills, procedures, systems, and team dynamics. They asked why, why, why for each issue that came up, and found multiple levels which needed some work.

Here was the tricky part that applied to all goals: what level could we realistically affect in the 6 months to create a lasting change? Some issues were quick fixes (ie, implementing referral sheets to send clients to the workshop for splints) and some issues were stemmed as high as the board level. We couldn’t tackle it all.

Let’s look at goals number 1 & 2 for now – in October we started looking at the old training manuals and agreed that they needed to be updated. In addition, several junior workers had been hired recently and they hadn’t been trained formally yet in theory or practical skills. So as we were researching the information to update in the manuals, we were spending time observing and working with the CBR workers.

Challenge #1 – There wasn’t a standardized level of knowledge among the staff, so what was the appropriate level of difficulty to include in these manuals?

Challenge #2 – All CBR-workers were full to the brim with work and they wouldn’t have time to study these manuals. Why were they so busy?

Challenge #3 – Inefficiency. High-skilled people were doing low-skilled jobs; there was no designated administration person so the senior therapists were doing things like computer data entry, scheduling clients, and settling bills, and therefore clients couldn’t be seen. Additionally, it seemed like other processes were taking 2-3 steps more than required.

Because of this, seniors didn’t have time to train the juniors, and therefore the juniors weren’t capable to help with the high volume of clients.

NEW GOAL: Create a 6-month training schedules for the Early Intervention Center with set teaching modules for senior therapists to train the junior therapists in-house, so seniors could be free to do other much-needed work. Our goal is to streamline some Early Intervention processes = more free time for seniors = more opportunity to train juniors = spread out the workload and ensure a succession plan for the future.

Additionally, there were no therapists that were formally trained for the Spinal Cord Rehab unit. ADDED GOAL: Create a training manual and provide educational sessions about spinal cord injury to educate two new therapists who will run camps for men with spinal cord injuries.

Phase 2 (Dec): Physio Jen Waring observed and surveyed the junior workers, asked them what areas they wanted more knowledge in, updated a skeleton of the training manual and suggested a 6-month training plan. Physios Sarah Monsees and Larissa Vassos were based in the Spinal Cord Rehab Center and created a 30-page manual, starting with basic theory of spine anatomy, nervous systems, and more. They ran multiple evening teaching sessions a week that dramatically increased local workers Channappa and Meheboob’s knowledge and skills, and helped them run a 1-month camp for four men with spinal cord injuries. They also created exercise boards to help with compliance in the gym. IMG_4449

DSC05044 IMG_4428

The volunteers have exercised skills FAR beyond physiotherapy. We’ve been challenged with curriculum development, teaching, organizational development, people management, budgeting, and of course, doing all of the above across a language barrier.

Thanks Jen, Sarah, and Larissa for ensuring success in Phase 2!!

Next update: Scrapping goal #4, delaying goals #3 & 5, and adding very important goal #8!

On the Road Again

ad·ven·ture
adˈven(t)SHər, ədˈven(t)SHər/
noun
  1. an unusual and exciting, typically hazardous, experience or activity.
Last fall, I was getting an itch for adventure and a desire to take on a new big project. After exploring several options, I decided to head back to the place that so heavily influenced my career and my life – Samuha Samarthya in India! It will certainly be an exciting (but hopefully not too hazardous!) experience, and undoubtedly the largest venture I have ever undertaken to date.
samuha
This will be my third volunteer trip there, and my role is evolving once more as I’ll be staying for 6 months. In 2011 I was a physio student, in 2014 my role as clinical preceptor allowed me to take another physio student, and in October 2015 – March 2016 I will be focusing on the education piece and working as a coordinator to help facilitate Samuha Samarthya’s growth.
The main goal of this trip is to improve Samuha Samarthya’s sustainability. We hope to contribute to this by:
  1. Improve the Community-Based Rehabilitation (CBR) training manuals (which haven’t been updated in 20 years!)
  2. Hold theoretical and practical educational sessions for the CBR workers to improve and standardize the level of care being provided in the Early Intervention Centres, the Spinal Cord Rehabilitation Unit, and other community outreach programs.
  3. Hold educational sessions for caregivers, school teachers, and other community members to maximize care and inclusion of people with disabilities in these rural communities.
  4. Increase efficiency of the organization by piloting and implementing new ventures such as a loan equipment program
  5. Teach the local CBR-Workers to be teachers, so they can continue to educate their colleagues and future newcomers to the field, and not rely on Canadian volunteers for education
  6. Raise awareness of Samuha Samarthya by facilitating Canadian volunteer experiences (physiotherapists and orthotists). There are a total of 17 other clinicians and students coming for 1-2 month stints throughout the project!
  7. Raise awareness for global health and create avenues for discussion about international volunteering in general, as I hope some of these volunteers may have the desire to contribute to other international projects. It is crucial to understand what type of volunteer work is beneficial for these types of NGOs, as we will be aiming to empower the local workers rather than doing the clinical work ourselves. We don’t want to parachute in, work, and leave, as that would leave the organization no different than when we found it.
Stay tuned over the coming months for updates on volunteer profiles, details fundraising events, and play-by-play action while we’re there. Thank you to everyone for your support so far!
 global health image

S.O.D.A. – Annual Fundraiser

On November 1st, Samuha Overseas Development Association (S.O.D.A.) held the Annual Fundraiser Dinner. For those of you who are new to my work, please read more about what S.O.D.A. and Samuha are is here. I volunteered at Samuha in January of 2011 and 2014 and they were both such great experiences that changed my life and career path, and I’m excited to now be on the board of S.O.D.A!

After a bit of a flight fiasco due to the weather, I finally made it into Prince George to attend the event. I met the rest of the S.O.D.A. board, the faithful supporters and benefactors, and also the passionate physiotherapist who’s heading to Samuha this year, Phil Sheppard! He’s also taking four lovely ladies from the UBC Physio Program as his students to share his experience. Check out Phil’s blog to keep up to date on all the action at Samuha this coming January!

Guests were welcomed into the Hart Crown Banquet Hall greeted by smiling S.O.D.A. members and had an opportunity to check out the wide array of silent auction items, get mehndi on their hands, or even try turban wrapping!photo 3 craft table3photo 1 photo 2 craft table 2 silent auction 3 turban wrap 2 turban wrap 4 turban wrap 3

A singer serenaded us and our grumbling tummies just before we were served an incredible spread catered by Dana Mandi Indian Cuisine:

singer 3 food 2

After we were beyond full, founder and president of S.O.D.A. Hilary Crowley explained the history of the organization and shared the stories of the some of the children and adults she’s seen benefit from Samuha’s work. It was touching to see how these children (about 20 years ago) with disabilities have grown into happy adults and are strong members of their communities, since Samuha has empowered them to live a full life.

peeps

Next, I shared my experiences at Samuha and how the organization has spurred a Butterfly Effect:

The Butterfly Effect:

‘The phenomenon whereby a minute localized change in a complex system can have large effects elsewhere.’

Also explained as the concept where ‘the flap of a butterfly’s wings on this side of the world causes a hurricane on the other’.

Practically speaking:

– Five years ago, donors at this annual S.O.D.A. fundraiser generously gave, and the collective result enabled Samuha to continue operations for a few more years…

– In 2011, I went to Samuha for the first time as a Physio student, where a majority of my caseload turned out to be pediatric patients. I realized how I could harness my silly and creative side to make a difference in a whole family…

– I came back to Vancouver, landed a full-time position at Kids Physio Group, and now have serviced over 300 children in the lower mainland…

– My 2011 trip impacted me so much that I went back in 2014, with physio student Maegan Mak and over $9000 in donations that went straight to Samuha…

– Maegan Mak and Kailen Houle (both students on the 2014 trip) ended up starting their physio careers in pediatrics (which is a very underserved population in Canada!)…

– And now I’m hoping to go back in the near future to see how I can contribute again.

If you’re interested, you can watch the video of my presentation here in Part 1 and Part 2!

Andrea 1

Phil then topped of the set by introducing himself and sharing his passion for rural and global health, which he’s dedicating his career to. He also showed a video of the four UBC Physio students – Sara, Josina, Madison, and Krysta – who are going with him to Samuha this year, check that out on his blog here.

It was such a successful evening, and S.O.D.A. raised over $10,000 to continue to support Samuha Samarthya!! Thanks to everyone who came!

group 2