Physical therapists’ interest in international volunteering schemes has exploded in the past two decades. As Health Volunteers Overseas celebrates the organisation’s 25th anniversary, its Executive Director Nancy Kelly says the profession has always been instrumental in international projects bringing sustainable change.
Health Volunteers Overseas (HVO) was founded by physicians in 1986 to improve the availability and quality of health care in developing countries by training and educating local health care providers. As soon as it began, it became clear that there was a need for post-surgical rehabilitation in orthopaedic projects. It also became clear, says Nancy Kelly, that physical therapists were among the most ready and willing of professions to offer their services overseas for free.
“From the very start, there seemed to be a lot of enthusiasm from physical therapists, so we started to work with the American Physical Therapy Association, which became an official sponsor in 1995,” says Nancy Kelly.
HVO volunteers provide professional support to health care providers in more than 25 resource-poor nations, in the fields of child health, primary care, trauma and rehabilitation, essential surgical care, oral health, infectious disease, nursing education and burn management.
The US-based organisation began with a medical emphasis, but over 25 years around 15% of its volunteers have been physical therapists – the largest profession after physicians (58%). Other professions participating include dentists and oral surgeons (11%), nurses (8%) and nurse anaesthetists (4%).
The proportion of physical therapists involved has been increasing. Last year, for the first time ever, HVO sent more physical therapists abroad than any other group.
“This has been a surprising trend,” says Nancy Kelly. “We’ve had an amazing amount of interest from physical therapists in international work, particularly from students. They seem to have a very global perspective.”
Nancy Kelly explains that though education and training of local health care providers is fundamental to HVO’s work, the definition of “education and training” has always been broad. “It includes hands-on work, demonstrating what you’re doing to colleagues. But volunteers never forget that they are passing on a skill, and the care that a patient is getting at that moment is an added benefit.”
“Physical therapists really buy into this colleague-to-colleague focus, whereas other professions find it more difficult,” she says. “They’re very good at making working relationships with each other.” Although HVO typically recruits from the US and Canada, in physical therapy it has expanded its volunteer pool to include anyone licensed or trained in an English-speaking country. Recent volunteers have come from Europe and Australasia.
There have been recent physical therapy projects in Suriname, Guatemala and Ethiopia.
HVO has had a physical therapy programme in Suriname since 1999, run in collaboration with the Faculty of Medical Science at the Anton de Kom University in Paramaribo. A military coup in 1980 and a declining economy resulted in an exodus of health care professionals and by 1983 there were only nine physical therapists still practising in Paramaribo.
Pressure from the Surinaamse Vereniging Voor Fysiotherapie (Surinamese physical therapy association) resulted in a physical therapy programme being established in 1996, but it hit problems when national health budgets were slashed. At this point, Tony Chang, coordinator of the physical therapy programme, contacted HVO member and physical therapist Frits Hunsel for assistance in developing instructors, curriculum content upgrades and specific content area instruction.
HVO helped in delivering quality education to students by recruiting volunteers with the right expertise to match the needs of the PT programme’s academic faculty.
The first HVO volunteer to serve in Suriname arrived in May, 1999. Since then, a total of 27 physical therapists have graduated, with another 34 presently studying. The number of active professionals in the country has increased to 45, a five-fold increase from 1983. All three hospitals in Paramaribo and the rehabilitation centre are now participating as clinical instruction sites for the programme.
Another recent initiative has been in Ethiopia, where HVO is helping physical therapists implement a four-year doctor of physical therapy curriculum, recognised by the Ministry of Education. This has developed from an advanced studies/residency programme at Black Lion Hospital in Addis Ababa, which has aimed to raise the education and clinical performance of physical therapists at the hospital to an advanced level of clinical competency. The programme is run by HVO jointly with the Jackson Clinics of Northern Virginia, USA and Regis University, Denver USA.
“There does seem to be more of a global focus on providing good rehabilitation services these days,” says HVO’s volunteer coordinator April Pinner. “After a lot of emphasis on surgery in the early days, a lot of sites now want an emphasis on rehabilitation, so that patients can get home.”
Nancy Kelly says she’s seen a major change in the profile of global health issues over 25 years: the AIDS crisis, the threat of infectious disease, and the work of Bill Gates have all increased awareness, she says.
With so much interest in volunteering now, the challenge is to ensure that the work carried out by volunteers is sustainable, and has long-term benefits. That is why the emphasis will always continue to be on education and training rather than providing short-term assistance, says Nancy Kelly.
“Around 40% of our volunteers have volunteered before, and what’s great is that they can see things changing as a result of what they’ve done. When they go back, and see that the technique they taught someone three years ago is being widely used and making a difference to many people – that’s wonderful.”