Wednesday, April 29, 2015

Day 7 - April 27, 2015

¡Gracias por visitor nuestro sitio de blog!

Today marked our second to last day in the clinic at Las Obras. It is hard to believe that we arrived in Guatemala only six short days ago! Despite our fun and exciting, but slightly exhausting weekend, we all woke up bright and early to begin another full day of PT treatment in the morning at Las Obras and community health efforts at a nearby medical clinic later in the afternoon.

Sabina and Jessica started the day off working in the nursery with children between 10 months and 8 years. They enjoyed treating some of the same patients they had interacted with during the week prior, and were pleasantly surprised to find that a few of the babies seemed to have slightly progressed in a very short time since last being seen. Deidra enjoyed another educational morning working with older adults. Gary began his day working in orthopedics and met up with Joe, Sabina, and Jess in pediatrics. It has been exciting to build on our skills in each of these areas throughout our time here.

During our “break time” at 10/10:30am, we had the opportunity to participate in a group dancing session. It was exciting to see how happy all of the patients were to get to listen to music and dance in a big group. All of the individuals had the biggest smiles on their faces, and we were amazed to see how much the activity motivated them to mueva! During lunch, Jessica had the opportunity to present her Capstone project to the physical therapists and physical therapy students at Las Obras. Her presentation was on “Cardiovascular Health: Assessment and Intervention for Patients with Physical and/or Cognitive Disabilities,” and was well received by the therapists at Las Obras. Jessica did her best to provide the therapists with useful and appropriate assessment tools and intervention ideas that the therapists may be able to incorporate into practice.
Deidra dancing with one of the abuelas.

Group dancing at Las Obras! ¡Muy divertido!

Jessica delivering her Capstone project with the help of a translator to therapists at Las Obras.

After a busy morning at Las Obras, all of the students and the UNC leadership team headed to the nearby town of Pastores where another health fair had been organized for the afternoon. The students did a great job communicating with patients – in Spanish, I might add – and offering appropriate advice for nutrition, hand washing, blood pressure, back pain, and baby care. Following an interesting afternoon of interacting with community members who requested advice on a variety of PT-related topics, we returned to Antigua for a little bit of shopping. We rounded out our evening with more touristy photos and a delicious dinner at Café Sky.

The Health Fair location, Clinicas Medicas, in Pastores.

Acting the part of tourists - and realizing that we had "celebrities" in our midst!

We are looking very much forward to our last full day in Antigua, Guatemala tomorrow!

Written By: Jessica Skeeter

Monday, April 27, 2015

Day 6 - April 26, 2015

¡El fin de semana!

For the weekend we decided to do a photo blog of our weekend excursions. Today, we visited the Mayan ruins of Iximche and we even got to see a mayan ceremony taking place. After our visit to the Mayan ruins we went to Reserva Natural Atitlán in Panajachel, Guatemala and completed the Cables X-Tremos tour which consisted of a hike and a zip line and ropes course. 

A huge thanks to our good friend Hugo Suarez from Expeditions Guatemala for leading our action packed day of adventure and FUN! 

Model of the city 

This platform was used for human sacrifices

Altar showing the remnants of an earlier ceremony 
A shaman preparing for a ritual ceremony.  Those are cigars - the prayers were for a person with a smoking problem.

Gary ziplining

Joe ziplining

Jessica ziplining
Deidra ziplining
Ropes course

Day 5 - April 25, 2015

¡El fin de semana!

For the weekend we decided to do a photo blog of our weekend excursions. Today, we hiked Volcan de Pacaya and went on a detailed tour of a local coffee farm learning the process of making coffee from the farm to the coffee cup. Yes, we even got to enjoy the freshly brewed coffee at the end of the tour. 

Special thanks to our friends from Expeditions Guatemala for leading our tour of Pacaya National Park.

Volcan Pacaya

Roasting marshmallows over hot lava
Roasting marshmallows over hot lava

Lava Store - where we could buy jewelry made from lava

Coffee farmer and his faithful dog 

Coffee beans

Roasting over fire

Ready for grinding

Sunday, April 26, 2015

Day 4 - April 24, 2015


Things are going great in Guatemala! It was another full day for us, beginning with treating patients at Las Obras. Jessica and Sabina worked in the nursery and in pediatrics. Gary also got some experience working in pediatrics.  Joe worked with young adults, and I worked in ortho. In addition to treating ailments such as neck, shoulder and low back pain, I also had my first experience treating a patient with spina bifida. Gary got to participate in a procession in and around Las Obras that was a part of a week long celebration for Santo Hermano Pedro. Gary was originally working with older adults, but when treatments stopped because of the procession he got to transport one of the patients in his wheelchair around the hospital. Gary also got to see the fireworks outside the hospital which were a part of the procession. Joe and Lisa helped with an aquatic therapy session at Las Obras. For Joe, it was his first time ever doing aquatic therapy and he immediately recognized the therapeutic effects of water to improve range of motion and reduce spasticity.

After our morning at Las Obras we returned to Enseñame a Pescar, the school where we conducted a health fair at the previous day, to treat patients from the local community. Children and adults both came and our groups of physical therapists and physical therapy students evaluated and treated patients with neurological and musculoskeletal conditions. One thing we all recognized throughout our interactions with the families that came was the amount of devotion the mothers displayed. Each woman demonstrated a high level of dedication to providing the best for their child and took very seriously the advice and recommendations we provided them – some even indicated that they come every year to the clinics ran by UNC DPT to get medical care and advice. During the clinic, one group spent a great deal of time treating a patient with an amputated limb who was preparing to get a prosthetic leg in a few months. He specifically came to the clinic because his doctor told him that he needed to utilize an exercise program and lose weight before receiving his prosthesis. While we were able to provide him with a detailed exercise program, he also provided us and others with a heartwarming example of a selfless act of kindness. Following his session with us, the patient went home and later returned to the school to personally give his own wheelchair to a young patient whose family did not have the resources to obtain a wheelchair. This man’s generosity touched the hearts of everyone present.

All work and no play is no fun, so after I saw my last patient at Enseñame a Pescar I noticed several kids outside playing on the school’s playground. I recognized one of the kids from earlier because I treated his brother during the clinic. I spent about 30 minutes playing with these three kids – helping them get across the monkey bars, chatting (great practice for my Spanish), and letting them take silly photos with my camera. When I finally had to say good bye to each of them, I got three big hugs. For me, it was the perfect way to end a busy day.

Written by: Deidra Debnam

Aquatic Therapy at Las Obras

Procession Outside of Las Obras

Patient Who Donated His Wheelchair to a Younger Patient

Playing with the Kids Outside of Ensename a Pescar

Day 3 - April 23, 2015


Greetings from Guatemala! Today we began our day with a full morning at Las Obras. While one group ventured to the young adults to work with some of the residents, another group spent some time with the abuelas (the grandmothers). A large group of us also headed to pediatrics for a morning of playing and lots of therapy. The morning concluded with a wonderful presentation by our faculty on proprioceptive neuromuscular facilitation (PNF) as a way to increase range of motion. This presentation focused on strategies to gain more movement in joints and strengthen muscles through stretching and active techniques. Great interactions took place between physical therapy students from UNC, Duke, and the local Universidad Rafael Landívar as well as the faculty and staff from UNC and Las Obras.


After our morning of many unique experiences and opportunities to learn we left on another adventure to Enseñame a Pescar which is the school we have the opportunity to work with while in Guatemala. The school is for children with special needs including cerebral palsy, down syndrome, autism, and other developmental delays. When we arrived, a couple of us had the opportunity to visit one of the families in their home while the rest of the group began setting up and running a community health fair at the school. At the health fair we were able to provide information on back pain and proper lifting techniques, nutrition, blood pressure, the importance of hand washing, and tummy-time for babies. Overall the afternoon was filled with practicing Spanish and engaging with community members. We look forward to another day in Guatemala tomorrow!

Written by: Sabina Beckler 

Thursday, April 23, 2015

Day 2 - April 22, 2015

Hi everyone,

April 22nd was our first full day in Guatemala, and we are all having a blast!  We started our day out reviewing our Español skills at a local language school (Ixchel Spanish School).  Necesitamos mas ayuda con Español.  Some of us received our first official Spanish lesson while others unearthed some old vocabulary. 

After Spanish training, we headed over to Las Obras, the main clinic we will be volunteering at during our trip.  Las Obras is a hospital/long-term care facility for individuals across the lifespan. However, many of the physical therapists and staff think of Las Obras has “home” for the patients. We met up with Sadye Errickson and some students from Duke’s PT program as they were providing an interactive presentation on positioning.  The presentation incorporated some recent evidence on evaluating and treating positional impairments for individuals with cerebral palsy.  Given the number of residents with contractures, this information will definitely be helpful for the local therapists. 

We also had the opportunity to tour Las Obras today, and we were astonished at the distinct differences between their facility and a typical American hospital.  For one thing, the nurses either work a 10-hour shift during the day or a 14-hour shift at night.  Despite these long shifts, the considerable number of patients, and the lack of medical resources and technology, we observed how well the patients are taken care of.  The residents are frequently fed and changed, and we could tell how much the staff cared for the residents by their warm interactions.  Several in our group were also stunned at the severity of disease progression seen throughout Las Obras. We observed the natural progression of disease processes when appropriate interventions are not accessible in the early stages. We look forward to working with the therapists at Las Obras as we problem-solve through some of the cases. 

We finished our day by taking a taxi up to a local tourist spot that overlooks the city (see picture below).  There is a cross at this location that you can see from everywhere in the city.  Needless to say it offers a stunning view that is matched only by an awing photo. 


Written by: Joe Miller


UNC DPT Service Learning Trip to Guatemala - 2015


We are third-year UNC physical therapy students participating in a service-learning trip to Guatemala. We will be in Guatemala from April 21 – 29 and will be keeping a blog to document our experiences.

We hope you enjoy!

Gary Johnson, Joe Miller, Sabina Beckler, Jessica Skeeter, Deidra Debnam (L-R)