Within a day of arriving in Uganda last June, two professors and a group of 12 George Fox doctor of physical therapy students were hit with a harsh reality: Things were done differently here.
Among their first impressions: A young man tied to a tree, restrained there for four years because of his disabilities. “He hadn’t walked in years, and nobody knew how to deal with him,” says Tyler Cuddeford, director of George Fox’s Doctor of Physical Therapy program. “They were afraid he’d make bad decisions, so they tied him up. It just shows the lack of care for children with disabilities in the country. It’s hard to see and hard to prepare for.”
At another stop, an elderly man struggling for seven years with ataxia – a wobbling, uncoordinated gait – finally encountered someone who took the time to care. “He must have been 70 or older – with no access to health care, no shoes, no transportation,” recalls Jeff Houck, director of research for the physical therapy program. “He was still working as a gardener and hadn’t been seen by anybody. He was making around a dollar a day. I helped him the best I could. It reminds you how important it is to simply take care of people.”
Marisol Cardoza and Ryan Wiser teach a child with cerebral palsy how to stand and walk for the first time. Many of the children the George Fox group tended to had never been treated by a physical therapist.
Into that backdrop Cuddeford, Houck and a dozen third-year students tended to the needs of Ugandan children and adults stricken with disease and immobility. It was the first service trip for the program but won’t be the last, as plans call for an annual visit.
And while making the two-week trip isn’t a requirement to graduate from the three-year program, it more than meets the program’s “professional duty and social responsibility” component. It also embodies the department and university’s mission to “serve with passion.”
“Ultimately, being experts in mobility, our mission was to empower people to take care of themselves – to get them to function better, whether that means teaching someone to walk or just helping them move in a more efficient way,” Cuddeford says.
The George Fox team visited two rehabilitation clinics for disabled children, an adult clinic and the remote village of Kisowera. They also partnered with Uganda Christian University to conduct research on foot health, comparing Ugandans who grew up wearing shoes to those who’ve been walking barefoot all their lives. The data is still being analyzed.
“What was rewarding was seeing how grateful the people were. They were beautiful and kind.”
At the clinic in Kisowera, a man with a partially amputated foot was struggling with pain as he walked. Upon removing the brace that allowed him to ambulate, the George Fox visitors discovered all of the padding in the brace was worn out and the man was developing sores on the ball of his foot. Cuddeford decided to improvise.
“There was a local market down the street selling shoes, so I went and found a pair of shoes for a couple of dollars, removed the insole and cut it into the shape of his foot so that it would provide adequate cushioning for him,” he recalls. “Not only was he then able to walk without pain, he sold the shoes.”
For student Alex Grimsley, the Uganda experience won’t soon be forgotten. “I’d never been to a different country to do anything like this,” he says. “I was excited to use the knowledge I had to educate people and see them respond. It was a practical application of all we had been learning in the classroom.”
Third-year DPT students Alicia Martinez (left) and Marisol Cardoza assist Ivan, a child with cerebral palsy who attends the School for the Disabled in Kampala, Uganda. Cardoza and Martinez taught the boy how to walk with crutches instead of a wheeled walker.
Students treated patients with clubfoot, cerebral palsy, spina bifida and polio. Ailments ranged from dislocated shoulders and an inability to move arms to a complete breakdown of the legs. “The very first person we treated crawled in, legs rotated sideways, and his feet didn’t even resemble feet,” Cuddeford said. “He also had a shoulder that routinely subluxed [partially dislocated]. Still, even though he had significant post-polio challenges, we were able to help him by improving his mobility and strength.”
George Fox students assisted more than 50 children that first day. They would go on to treat 40 more at another school a few days later and another 40 individuals at the adult clinic. The reality of their surroundings was reinforced by the presence of a cemetery on one of the school grounds. “It’s hard to walk into a place and past a kid on the ground who isn’t moving – and you don’t know if he’s alive or dead,” Houck says. “It takes an emotional toll on you. I had to step away at one point and collect myself. What was rewarding was seeing how grateful the people were. They were beautiful and kind.”
For Houck, the significance of the visit was profound – and more clearly defined for him the importance of his profession. “When you see a group of people with absolutely no physical therapy and the negative impact [of that situation], the overall positive impact physical therapy has on society is clear,” he says.
Husband and wife duo Ryan and Lene MacKenzie work on trunk control/strengthening movements and exercises with a young girl.
Cuddeford will assess the trip and make modifications, primarily to improve efficiency. He also says there is a possibility of adding other service-related trips, perhaps to China.
“The average wage [in Uganda] is less than $2 a day, yet the people there love life and are wonderful to work with,” he says. “We’ll definitely be back.”