MOSOJ PHUNCHAY. BURNS REHABITATION CENTRE
From the start I wanted to split my physiotherapy project time between 2 places, one where working would be more familiar, aiming to provide some information about physio for special needs from the UK – but also gaining a new experience in a completely new environment.
After a day work experience and asking lots of questions at Chelsea and Westminster Hospital back in April, I tried to relate my new knowledge of scar management to working at Mosoj Punchay which is a burns rehabilitation unit for children on the outskirts of Cochabamba.
What is Mosoj Phunchay?
There are 12-14 internal patients there, ranging from 2 to 16 years old. It is a charity led organization meaning that these children do not need to pay for their care, as they otherwise normally would within the healthcare system here. The kids have to do physiotherapy sessions twice a day, along with psychology, doctor appointments, along with school and their cleaning duties - as it acts as a boarding school for the, where some have been there only a few months, and others for years.
The children sustain their burns in various different ways – the most common being kitchen accidents with big pans of hot water or hot oil – burning a lot more than any of the cases I saw back in the UK hospital. The majority of burns I have seen I suppose have been pretty horrific, facial, whole of chest, back, legs etc.
Some of my teenage girls I work with sustained their burns back when they were only about 3 years old- one´s clothes caught on fire too close to a fire, another girl´s mother set alight to a bottle of alcohol to provide light in the house (lack of education is evident with that one,) and there have been other accidents with alcohol, gasoline and candles in houses. I have heard of horrific cases of punishment as well involving hands put in flames amongst the countryside folk but none of the current children were subject to that. Recently on San Juan, a weekend festival which is reminiscent of Bonfire night resulted in 2 brothers getting severe burns – this was all over the news and the news team ended up coming to Mosoj Phunchay to interview the doctor and patients. Hello Clare ending up on National Television!
I absolutely love working at MP in the afternoons – when the students were still around I only ever had about 3-4 children to work with, really spending quality time getting to know them, doing their physio and inventing new stretching exercises which appear to be the only main thing lacking in a pretty comprehensive centre run and managed by “god” or Dr. Romero who is about 80 years old and has been in the “burns business” for a while. Since the students have been on holiday, this has rocketed up to about 7 children, topping it off with 9 today which was pretty intense. So normally my hours are about 2.30-6.30pm. Also working with another volunteer here with another organization called Kate – from Texas. She makes fun of my accent and likewise, so do I in a mock Texan drawl. She is great to work with and showed me the ropes about what to use and do during my first week.
Learning lots...
We use lots of different creams and greases – urea, vasolina, rifomacin and bagoderm for their wounds, and most importantly GRASA which all the children describe as “FEA.” It is pretty gross and I probably wouldn´t want the oils and grease fat from the ostriches of Uyuni smeared all over my scars but apparently there is some evidence for its use here anyway. It certainly took some time to get used to putting my hand in the little grasa pot as it’s not the most attractive looking thing, but then again it’s not being put on my face.
We do lots of scar management, stretching and exercises, good old Vaseline and cling film, along with persuading children to put on their compression garments. I really couldn´t praise or respect the kids any higher. Upon arrival at work, I get smothered by kisses my little 3 year old Ian who is full of beans and often a bit too hyperactive when you are trying to put Vanece on his face, little Luis and his brother Victor who often fall asleep after a while of lying down – making it VERY hard to do cling film or tug their compression garments into place while they are all floppy and about to fall off the bed. Ervin and Elsa who always want to learn English words and know what every English song on “RADIO DISNEY” means in Spanish – “que se significa?” which often is hard when some songs are so cheesy or have no real meaning…. And Rene and Alison who just want to go round the centre with my camera taking lots of photos of grass and the dogs and new puppies!! They are going to call one Clara (the girl puppy) or Silbadora (Whistler in Spanish, if it’s a boy.)
Is it bad to have favourites?
I would have to say working with Esmeralda and Ana, 2 of my teenage girls who then always want to plait my hair after each physio session or hang out, have really provided me somehow with some life lessons about perspective. We have a lot of laughs (a lot of ugly faces pulled) and even more hugs throughout my working day. Given the mindset of the majority of girls or women in the world, complaining about minor flaws when they are literally covered in burns, they are so positive and really are quite incredible.
I only have one more week at Mosoj Phunchay and I know I am really going to miss being there. Upon telling the children I only have one more week, they were also really disappointed telling me to stay which I found really touching too. I guess it’s because we spend so much time one on one with each child every day, you really develop a bond – but maybe they just like the difference of having a “gringa” to work with who is just a little bit weird, singing, dancing and larking around, alongside Kate, trying to keep both the children distracted and entertained, and sometimes even the liscenciadas as well… I just can´t believe I only have one week left now, its all gone so fast and I wish I´d been at Mosoj Phunchay just that little bit longer.
A short visit to Hospital Viedma
I have also managed to have 3 days at Hospital Viedma, where there is the main burns unit before they come to MP. I kind of just rocked up, after speaking to a doctor at work saying I wanted to go. I found the physio room, introduced myself was set to work straight away which was a bit daunting and very random as you could not just do that in the NHS. You would have to wait at least 6 months for a CRB check first…. It was a very insightful experience, and it was good managing to see both the other side of burns and also being in a Bolivian public hospital environment where I noted some very big and different management techniques but also the general running of a hospital between Bolivia and Cochabamba, (with the nurses, infection control etc etc) which I knew would exist but didn´t know in what way they would present themselves.
Managed to sneak into “hydrotherapy” but it turned out to literally be a corner bath. Apparently they use it to do stretches etc but also as a way to “clean wounds” which is a bit unhygienic. But I then got to help her with making a hand splint for this baby, sharing what I´d learnt at C and W about supporting the thumb and helping with some respiratory physio with a nebulizer – overall a good recap for when I come back home, but on reflection, very glad that I am working in Mosoj Phunchay which is a lot friendlier, happier environment!! (The nurses at the hospital were really grumpy.)
