Nicole – Cross Cultural Perspectives on Health and Physical Therapy

I stepped off the plane in Jinotega, Nicaragua with the wide eyes of a tourist. I was eager to help but uncertain about what I could do. The culture and the language of this new country fascinated me; I wanted to see and experience as much as I could during my short stay in Nicaragua. It was not until the end of our week in Los Robles when the effects of all that had transpired caused me to realize my naiveté.  I had no idea how profoundly Nicaragua would change my heart and the way I understand acts of service and community involvement.

Nicaragua had originally been about gaining professional experience. I am a student in the Doctor of Physical Therapy program at Georgia State University. Nearing the end of my tenure as a student, I feel confident treating patients in the American healthcare system. Within this system, I can expect patients to have a general understanding about healthy living. I trust my patients know what constitutes clean drinking water and minimum personal hygiene habits. I was eager to learn how to treat patients outside of our sterile clinics to gain more experience as a physical therapist. But I had no knowledge about how healthcare itself would work in this developing country and about how severe the knowledge deficits would be.  I frequently found myself supplementing physical therapy treatments with education about clean water, basic healthy nutrition, and regular exercise. Nicaragua was pushing me to expand myself as a professional; it was forcing me to think about my patients not only as individuals, but as members of a community striving to develop into a safer, more modern village.

My team baking in the home kitchen of a Nicaraguan family. They taught us how to make a traditional pastry out of cheese and crisco.

My team baking in the home kitchen of a Nicaraguan family. They taught us how to make a traditional pastry out of cheese and crisco.

Even these observations about professional growth, though, are seen through my tourist eyes. I had imagined the exchange would be unilateral. I, the educated American, was traveling into a third world country to provide healthcare to impoverished farm workers. How ignorant and foolish I was. The farmworkers that I met may have lived in humble homes, but they had a fierce pride in the work that they did and the homes they provided for their families. As part of our international experience, we were expected to participate in community service projects requiring a small measure of physical labor. The community members came together, unafraid to roll up their sleeves and dig in the mud to build a new oven for a neighbor and friend.  I was given a shovel and felt real shame. I had not used a shovel in over a decade, let alone used one to manually mix concrete. This was when I realized that the community was helping me as much as I was attempting to help them. I could congratulate myself for a short hour of service, or I could humble myself and acknowledge the mutual gifts we gave to each other. The Nicaraguan families trusted me not to botch up the concrete we laid in their home just so I could have an international experience. And in return, I shared what I could of my knowledge of healthcare and physical therapy.

I was not the only one whose heart was changed in Nicaragua. Fifteen of my classmates, who I have worked with in school nearly every day for the past two years, were also on the trip to Nicaragua. It was immensely pleasurable to witness my friends overcome fears and obstacles in Nicaragua. One friend overcame her fear of interacting with children. By the end of the week she was leading games and playing with the energetic Nicaraguan children more than anyone else in our group. Another friend who had initially been afraid of the language barrier was exercising his Spanish at every opportunity. Friends who had been anxious about treating patients from a different culture were able to confidently evaluate and treat our Nicaraguan patients.

Our final evening in Los Robles was spent at a community party. There was music and dancing and a piñata. We sang arm in arm with friends, classmates, and patients. We were each thankful for each other and the gifts we could mutually share. I realized then that missions to improve a community are never accomplished singlehandedly and are never unilateral. I participated in this mission for a week, just as other Americans would participate in future weeks. The community of Los Robles gave back to me so much more than I could give to them. I was reminded of the value of a closer-knit community and a sense of united purpose that is lacking between me and those living just opposite my thin apartment walls. We saw what united people could accomplish through the power of slow, yet consistent change. Together, I think both students and Nicaraguans were all changed and made better.