Chester physio helps to change bed rest culture in Ethiopia
When Senior Physiotherapist Nicola Jarman travelled to Ethiopia earlier this year she had no idea how challenging, yet inspiring and heart-warming it would be.
Having been picked as one of two physios to represent the Northwest Orthopaedic Trauma Alliance for Africa (NOTAA) she arrived in Hawassa, via Istanbul and Addis Ababa, filled with enthusiasm and excitement.
Nicola joined forces with Laura Knowles from St Helens and Knowsley NHS Trust and Rebekah Laurenson from Perth, Australia, as a specialist team within a nine-strong specialist orthopaedic team sent to Hawassa Hospital to share best practice and ideas.
“At first nobody working at the hospital really knew what the role of a physiotherapist should be,” Nicola, who has worked at the Countess of Chester Hospital for four years, said. “They would tell patients to stay in bed and just rest after surgery because they hadn’t been taught when it was best to get people moving again.”
Stepping into an environment where no-one knew or shared the value of their speciality was tough at first as the team saw just how much of a difference could be made to patients.
Weaving around the busy streets of Hawassa by Tuk Tuk, surrounded by tall buildings being constructed with precarious wooden scaffolding, also made clear how important a well-rounded view towards orthopaedic care could be in an environment that is very different to the UK.
“Compared to what we have in the UK they have so little, but their dedication to providing the best possible care was so inspiring,” Nicola said. “They were so keen to learn from us and it inspired us to work long into the nights producing protocols and advice to give them as much as we could in the time we had.”
Previously, for any kind of limb injury, they would prescribe complete rest, so if someone fractured their arm they wouldn’t move their hand or fingers at all. This can cause the fingers to tighten up and it can be painful and lead to reduced or loss of function in the hand.
An 18-year-old patient called Richard, who was admitted with a broken leg, could have previously expected a three-to-six-week journey to getting back on his feet, but with the guidance of Nicola and the team he was independently mobile within just three days using crutches.
Thanks to donations from the NHS and other healthcare providers from across the world, the hospital already had some equipment such as air cast boots, poly slings and crutches, but they didn’t have the confidence to use them frequently before being shown by the NOTAA team.
“The difference from when we started to when we left was almost night and day,” Nicola added. “We’re returning to Hawassa next month and I stay in contact with a few of the nurses. They gave us such a lovely coffee ceremony as a thank you before we left and they’ve become friends and colleagues now so I enjoy getting updates from them and I can’t wait to go back.”
Milion, a nurse on the orthopaedic ward in Hawassa, said: “It’s so nice on the ward. We are doing Physiotherapy for all patients. The training was so important for patients to recover rapidly. There is a big difference before and after Physiotherapy.”
:: NOTAA has been established, with full charitable status, as a fully recognised sub group of World Orthopaedic Concern UK, to engage with all staff groups working in Orthopaedic Units in the Northwest enabling them to work together and support the development of sustainable Orthopaedic Trauma services in Africa. For more information please visit the website: https://nota4africa.org.uk