Meghan Andrews DPT Student Spotlight

"I Bless the Rains Down in Africa"

On April 22nd me, 7 other MUSC colleagues, my pediatric professor, and a wheelchair specialist headed out on the 36 hour journey to Uganda, Africa. We were going on a medical mission trip to provide a free wheelchair clinic at the Masindi Kitara Medical Center in Uganda to people with disabilities. We left on an early Friday afternoon and officially got into Masindi Sunday afternoon. The entire time spent traveling is now a blur in my mind due to the constant changes in time zones, the in and out of consciousness on planes, and the never-ending lines we stood in at different airports. Nevertheless, after finally settling into the Masindi hotel, we were all eager to walk over to the medical center to check out the facility and start learning how to put together wheelchairs! You see, a big part of our mission involved measuring people for appropriately sized wheelchairs and then actually putting the different sized wheelchairs together. I will be honest, on that Sunday as I watched Jack (our wheelchair specialist) assemble a wheelchair from all its different parts I was thinking to myself there is no way in heck I am going to be able to do that. I didn't even know how to use half of the tools laid out in front of me. Moreover, once he had the first wheelchair made I decided to be the one to take it for a test drive... let me tell you, maneuvering around in a wheelchair is NO easy task. I wheeled myself out the door and began going up a little hill... and then proceeded to start rolling backwards down the hill. I tried to stop the wheelchair but instead ended up flipping straight off the back of it! Don't worry, I came out of that crash with just a couple scrapes and bruises. :)

Our official wheelchair clinic dates were Monday-Friday of that week. Each morning we got up and had breakfast at the hotel at 7am and then left at 7:45 to walk over to the medical center. Our morning and evening walks consisted of lots of chickens wandering aimlessly across our dirt path and little kids running to see us from their homes waving excitedly and yelling "hello!". I got so used to constantly waving at complete strangers, I feel like I'm going to accidentally do that now as I walk the streets of Charleston. Once at the clinic we split up into groups of 2-3 and either began building wheelchairs or measuring patients to be fit for one. On Monday we had all children patients which was right up my ally because I love working with kids! I spent the majority of that day playing games with the little kiddos as they waited for their wheelchairs to be set up and then I later helped instruct them and their parent(s) on how to properly use the wheelchairs (I still wasn't feeling quite confident with building one myself yet). Most children we saw that day and throughout the week were children who either lacked oxygen at birth causing disabilities or got sick with malaria as a baby causing disabilities. It was hard not to get frustrated and upset knowing that if they just had better access to health care many of those disabilities could have been prevented or at least better treated. However, being able to give those children wheelchairs was still a wonderful improvement in their quality of life, greatly increasing their mobility around the community and decreasing caregiver burden on their families. The little kiddos would get SO excited being placed in a wheelchair and their mothers were ecstatic with joy and thankfulness.

Tuesday-Friday continued in similar fashion as the first day except we treated majority adult patients. Adults were easier to care for in regard to fitting them appropriately in wheelchairs and instructing on proper use, but in other ways it was even more heartbreaking due to discovering that a lot of these people had never walked in their lives or had a bad accident at some point causing an amputation or fractured limb that prevented them from walking anymore. My professor, Dr. Dodds, cited a quote one day that at first sounded crazy to me but I later realized to be very true. She stated, "a fractured femur is the worst thing that can happen to a person in Africa"~ Margaret Mead. It became evident that for the citizens of Uganda, any sort of fracture in the leg caused instant disability. I constantly thought to myself how different things would be for them if those accidents had occurred in America instead. They would be put in a cast for 6-8 weeks, immediately start on physical therapy, and then be walking again in less than two months. Wow, the things we take for granted. However, us being PT students and all, we were able to provide PT exercises and training for a couple of the patients during the week who had the potential to be able to walk again. One patient in particular who was carried into the clinic on Tuesday ended up coming back every day that week to get two hours of physical therapy and by Friday we had him walking on crutches!

This patient was only 24 years old and originally thought he was never going to be able to walk again. It is truly remarkable the difference that can be made in these people's lives. Another difficult thing to see throughout the week was large pressure wounds on the legs, feet, and butts of many of the patients (children and adults alike) due to sitting, scooting, or crawling all day every day. The skin in those areas is put under constant pressure causing gradual deterioration and injury. One child I saw had a wound on his bottom so deep that I could see his bone. These injuries are just further proof of the lack of health care knowledge and access to prevention, management and treatment that is available for people in Uganda. Many patients really needed surgery to be healed but we did the best we could through cleaning the wounds and providing proper education and cleaning supplies for them to take home. Something else that we provided to each patient we saw that week was tennis shoes! Every single patient that came into the clinic was not wearing shoes. It is my guess that due to being disabled and carried around everywhere, no one ever supplied them with their own shoes. Both the children and adults got SO excited when presented with their very own tennis shoes. Even if they didn't fit perfectly, it did not matter at all to them. Giving each patient shoes was honestly one of my favorite things I did that week because of how happy it made them. Plus, shoes can help prevent pressure sores on their feet!

To wrap up my week in Masindi I will tell you a couple things I learned about wheelchairs, food in Uganda, and some of the day-to-day struggles that come with the territory. In regard to the wheelchairs (which I can confidently say I now know how to put together entirely by myself), my whole team and I learned just how easy it can be for screws to become stripped and also how unfortunate it is if that happens! We lost at least four wheelchairs due to stripped screws that caused unfixable issues in the wheelchair assembly... rip. I also learned so many different ways to problem solve and fix or create new parts for the wheelchairs to better fit each individual patient. It was awesome getting to work as a group and bounce ideas off each other to figure out the best possible solutions for all our patients! Regarding the food in Uganda, most everything we ate was actually so yummy! We had breakfast and dinner at the hotel each day which was always a big buffet of food and our lunch each day was rice and beans served at the medical center. Something I really enjoyed was the fruit salad bowls we got for dessert each night. I ate SO much pineapple, mango, watermelon, and banana! It was great! At lunch they would also sometime serve us avocado with our rice and beans and the avocados there are MASSIVE. Seriously the biggest avocados I'll ever see in my life. I wish they could be that big in the US. Something I was not a fan of and was very surprised by was the amount of butter put into various foods... One night at dinner we had pumpkin soup and it tasted exactly like butter. My whole group agreed that the ingredients for that soup had to be 90% butter and 10% pumpkin. Another evening we were given avocado smoothies and... let's just say the only two ingredients we could taste were butter and flour- in a smoothie!!! Wild. I don't think I'll be using butter in my food for a while. Speaking of overkill, we were served potatoes with breakfast and dinner every single day. I have never eaten so many potatoes in my life. I definitely need a break from those. Lastly, some day-to-day things to note are that I will never again take air conditioning for granted (especially in airports) and I don't think there will ever be another time in my life where a chicken will lay eggs in the PT clinic I'm working at. Yes, a chicken, whom we all called en kuku (Swahili for chicken) had made her own little nest in the corner of our clinic and her eggs hatched during that week! The chicken ran in and out of the clinic each morning and every time she ran back in we would all yell "en kuku!" which caused all our patients to laugh. Just Africa things I guess!

Okay, so after my week at the med clinic we then got to spend the weekend at a national park and go on a safari! That was hands-down the coolest thing I have done and probably ever will do in my life. I don't know how else to describe it except by saying it was like I stepped into the movie, The Lion King. We rode in a big jeep all across the savanna and even got to ride along the Nile River. My safari sights included seeing hundreds of antelope of all different types, herds of water buffalo, groups of giraffes, scattered warthogs, bunches of hippos in the water, a couple elephants, a lioness with her cubs, two male lions, and even a leopard! Gosh it was just so cool. I had the biggest smile on my face that entire 4.5 hours. If going on safari isn't already on your bucket list, you better put it there. That's all I can say.

I would like to end this blogpost the same way we ended dinner each night in Uganda- by giving shout-outs to people! So, shout-out to...

• everyone who helped support me for this trip whether it be through donations, encouragement, or anything in between!

• my professor, Dr. Dodds, for her great mentorship and selfless heart throughout the process of going on this trip

• Jack, our incredible wheelchair mechanic who taught me everything I now know about how to put a wheelchair together and use tons of different tools I'd never used before.

• My amazing classmates that I journeyed to Africa with, their positive spirits throughout each day, and the endless laughs we shared along the way.

• Patrick, Anthony, and Simon for translating to each patient for us, helping build the wheelchairs, and finding disabled people in Masindi to come to the clinic.

• My sweet roommate, Katelyn, who always let me borrow her things that I'd forgotten to bring, who put the fly nets down over my bed each evening to keep the bugs away, and who made sure to get me awake each morning.

• Finally, to the wonderful people in Uganda who helped make this trip so memorable and had the biggest hearts and the purest smiles.

Meghan Andrews, SPT
Doctor of Physical Therapy Class of 2023