Friday, 29 January 2016

It was supposed to be a month off...

Now that's a holiday
Three weeks of travelling through Sri Lanka’s highlands and jungles, before a week of surfing. Ten days before I left, my conscience got the better of me. Kathy Minchin had done a lot of volunteer work in Sri Lanka with Interplast, and was good enough to give me a contact. I emailed  Asha, the senior OT at the National Hospital in Colombo, and she asked if I wouldn’t mind doing a couple of hours work on splinting with some students. Perfect I thought, two hours and I’ve done my bit for the world. Asha however, had different plans. 

In case you need a recap
I prepared a basic talk about playing with plastic before I left, and loaded a couple of other things onto a USB stick. On arrival in Sri Lanka I received an email from Asha detailing the two days I would be spending at the hospital talking to surgeons, treating patients, lecturing to the Sri Lankan OT association, as well as those poor students. I would be talking extensively on shoulders, brachial plexus injuries and tendon transfers. Now, I can crap on with the best of them at any time about any number of issues related to the upper extremity, but brachial plexus injury? I was up the proverbial creek without the paddle in the barbed wire canoe. 

After a bit of negotiation, I was back on more comfortable ground. Sports and fractures, wrists and PIP joints. We scheduled it in for the last week of my trip, and I bundled my family onto a third class train carriage heading north and away from the city. I couldn’t escape Asha’s enthusiastic tentacles however. Within a week another day of talking had been added on, this time with the physios for the Sri Lankan cricket team. Some preparation needed to be done.
Borrowing a laptop from the 16 year old son of a woman we were staying with, I beefed up my talks and created a plan. Unfortunately, that laptop was infected with a virus, and the presentations couldn’t be opened. Ben Cunningham, Greg Hoy, and Sarah from the AHTA came to my rescue, uploading a variety of stuff onto Dropbox. My family left me for the rainforest, I put on my cleanest, most un-crinkled shirt, and headed off to work. 

Anyone I’ve ever talked to or heard talk about volunteering always emphasise how intense it is. I was assaulted (in a great way) from every angle by therapists who were desperate to learn more, patients desperate to get better, and doctors desperate to have their therapists help them achieve the results they expected. The hand therapy room in Colombo was crowded, with patients and families lined along the corridor outside waiting hours for their turn. I talked and talked and talked. I’m certain the students understood nothing in spite of their protestations, however the questions I received from the OT’s were insightful and challenging.

Hamish Highpants and the Sri Lankan cricket team physios
The cricket physios were also demanding. We discussed the usual suspects, then spent a lot of time problem solving how best to deal with metacarpal head bruising and finger web splits. I didn’t have a definitive answer, but as they say in the classics, before you find a solution you must understand what the problem actually is. I talked a lot about the role of the intrinsic muscles in the hand, as well as encouraging proprioceptive training. 

The impression I ultimately left Sri Lanka with was guilt. There was so much more I could have done if I’d been better prepared, if I’d had the inclination to offer help earlier than I did. I don’t believe I wasted anyone’s time, and I know I was able to pass on some of my knowledge, but I also know I could have done it more effectively. Volunteering in countries with developing hand therapists should not be done lightly or in the manner I initially approached it, because to do that creates a real risk of devaluing the intensity of the teaching that is required. Having said that, if you are an expert in some area, your time would be welcomed. All you need is the understanding that two hours will become more, which in turn, will make it worth so much more to you, and those you are helping.  

Look after those fingers,