A Geriatric Physical Therapist’s Journey to Kenya
Guest blog by RMUoHP faculty Dr. Tamara Gravano.
I had never practiced physical therapy (PT) overseas. I had admired many of my colleagues who performed this kind of service, but I had not yet pursued it. So I didn’t hesitate when Dr. Richard Jackson of the Jackson Clinics, based in Virginia, contacted me in December to teach geriatric physical therapy for two weeks to physiotherapists in Nairobi, Kenya this spring. The opportunity to perform international service had all but fallen in my lap.
The Jackson Clinics Foundation (JCF) has been sending US-trained PTs to provide continuing education to the physiotherapists who enroll in their Higher Diploma program since 2012. Until now, they had only sent orthopedic PT specialists, and they wanted to broaden their curriculum to mirror the education received in other more developed countries. I represented the first PT sent to teach a geriatric course and to establish the course content for the program moving forward.
As a physical therapy faculty member, I had to cover my classes and receive the permission of the chair of my department. After that was taken care of, I began to make plans to fly out in February.
The education system in Kenya is vastly different in terms of PT preparation. In the US our entry-level degree is a Doctor of Physical Therapy and a passing score on the National Physical Therapy Examination. In Kenya, students take up to three years of courses in physiotherapy directly after high school, leaving very little room for exploration of specialty areas. Continuing education becomes a much valued experience and an asset for any physiotherapist who chooses to pursue it.
Teaching my Geriatric Physical Therapy course was not just a manner replicating my existing course, but I had to completely rethink it in terms of prerequisite preparation. Reviewing relevant anatomy, neuroanatomy, physiology, and other topics that US students have learned prior to stepping foot in a DPT program had to all be included as I introduced each system. My 80 content hours filled up quickly.
During this time, I had to get a visa in order to teach in Kenya. This was a simple, online process, which cost approximately $130, and required a letter of invitation from my host, the JCF. There may have been less expensive options, but this one was convenient enough for me.
The next part of preparation was the series of vaccinations—Yellow fever, Hepatitis A and B, Typhoid Fever, and Tetanus. I elected to get them all done the same day at the health clinic in Provo. Other than two days of feeling run-down, there were no problems with side effects. In addition, I got a prescription for antibiotics, just in case, and some antimalarial medications to take over the course of two-weeks.
Having never been to Kenya, I spoke to other US instructors that the JCF had sent over to get their perspective on the experience. I learned more about the cultural expectations, hotel logistics, and food, which put my mind at ease. The DPT department had a pile of extra RMUoHP DPT T-shirts that I packed as gifts for my 15 students and three hosts.
It was a long flight from Salt Lake City, Utah, to Nairobi, Kenya. In fact, the first leg took nine hours from Salt Lake City to Amsterdam, and then seven and a half hours from Amsterdam to Nairobi.
Once I arrived I found my driver who took me to my hotel. My first experience riding in a car in Kenya was quite unnerving because they drive on the right side of the car and on the left side of the road. However, I quickly adapted.
The hotel was accommodating and used to hosting the PT faculty instructors. The next day one of the teaching assistants met me for a brief review of the expectations and a tour of the school. There is extensive security everywhere, “as a precaution,” the teaching assistant added. Every building, including the hotel, had a guard or two to search your bag and inside your car or trunk. I never felt unsafe knowing there were guards everywhere. The classroom was a fairly large gymnasium with wooden floors and treadmills and other machines lining the room. The projector screen was the standup tripod type. The desks were treatment plinths lined in four rows to accommodate six students across. Class started at 8am Monday morning.
At 8:20am, there were seven students in the room, but I was expecting 15. I decided to start slowly by introducing myself and asking them to tell me about themselves. Over time, students trickled in and one by one and introduced themselves. Two of them had traveled eight hours overnight from Mombasa to attend the course, while others were local.
The experience of the students ranged from 6-30 years, and everyone was interested in furthering their education to provide better care for their patients. I enjoyed getting to know each student and their experience as a physiotherapist. Everyone spoke English, although not everyone was from the same tribe. There are 42 tribes in Kenya and I heard several different English accents in the room.
I explained to them that we would be learning from each other, that way I could determine what information would be most valuable to them. Throughout the course, we discussed the cultural differences in aging between Kenyan and US culture. For example, there is much more emphasis on intergenerational living and there are no nursing homes. I was pleased to learn that aging adults hold a significantly higher status in Kenya than in the US, where youth is valued over age.
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