Clinical rotations in Malawi prepare students to work in underserved areas


Candace Henson, DPT (’13), with children in Malawi

Rotations abroad put students in interprofessional collaborations, preparing them to provide health care in underserved areas at home, according to the Journal of Physician Assistant Education.

The mothers arrive on foot, carrying 4- and 5-year-olds on their backs.

The children, severely disabled by birth defects or malarial brain damage, cannot walk. Many can’t sit upright. "Some can’t even hold up their heads," says Candace Henson, DPT (’13).

This spring, she served a clinical rotation in a village in Malawi, one of the world’s poorest countries. She faced a roomful of 60 mothers and wailing children crowded on the floor. "The kids were crying because villagers tell children that if they misbehave, white people — like me — will come and take them away."

Henson knew what to do. Calling on her training in UNTHSC’s Doctor of Physical Therapy Program, she ramped up her cultural competency and professionalism under pressure – and started helping. "Like children everywhere, they were soothed with singing and rocking on bouncy balls, then we could start therapy."

"The most highly sought-after medical students are demanding a chance for international experience such as our Africa rotation." – John Podgore, DO, MPH

Henson is among several UNTHSC students and faculty preceptors to serve recent rotations in Africa. In addition to the Physical Therapy rotation, Lisa Tshuma, PA-C, MPAS, MPA, established the Physician Assistant Studies Program clinical-service elective practicum in the West Africa nation of Ghana; and the Texas College of Osteopathic Medicine regularly offers elective rotations in Malawi under the direction of John Podgore, DO, MPH, Professor of Pediatrics.

Henson described the mothers in the Malawi clinic as heroic. "They often have to hold the children on their lap to feed them. Their culture views disabled children as a stigma, so husbands usually abandon the family. The women get up early, gather firewood and carry water to meet their family’s daily needs, then walk to the clinic."

But with the help of the UNTHSC students serving with Henson, mothers leave left the clinic better able to care for their children. They learned to do therapy with their child; they’re they were given locally-crafted "corner chairs" to bolster the child so they no longer have to hold them for feeding and as well as special pillows that help a child learn to hold his head up.

John Podgore, DO, MPH, with 10 years’ service in Africa, on what students gain from international experience:
  • Work in impoverished countries makes them better equipped to handle whatever comes up in any underserved area, at home or abroad.
  • When you don’t have CAT scans, MRIs and other tests that often are unnecessary, you use the great skill of physical diagnosis.

Says Henson, "We empowered them to help their families."

Podgore invited the UNTHSC Physical Therapy Program to do elective clinical rotations with his medical elective program in Malawi, and they started their first overseas elective in March. "It was a great success," he says.

As an infectious-disease physician treating severely ill children in Malawi, he wanted to provide physical therapy to the many survivors of severe malaria and meningitis.

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