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Community Engagement and Participation: My Personal Story
Taken from Moving Forward newsletter, American Physical Therapy Association, MN Chapter
Since 2005 I have been a faculty assistant in the DPT and PTA programs at St. Catherine University. I can proudly say that I love my work. I have always enjoyed working with students and sharing my passion for physical therapy. Two years ago I was given the opportunity to teach a local service learning course for PT and PTA students. It was then that my interest in community work began. Each year the students and I spend two weeks in the Twin Cities visiting different neighborhoods and learning about the diversity that exists in our own backyard. We learn about cultural and socioeconomic diversity. One experience we have is visiting the Cedar Riverside neighborhood which is part of the community in which our campus is located.
I want to be clear that what I am writing is my personal experience, reflection and feelings. It is not based on any formal research, only on what I have done and the people I have met. Over the past two years, I have started feeling a sense of “us” versus “them,” that even though we were in such close physical proximity, our two communities were worlds apart. This was the start of my interest in becoming more involved with the East African population in the Cedar Riverside neighborhood.
I have had the privilege of working with and being mentored by Katie Clark, RN MA who is a nursing instructor at Augsburg College and the Coordinator of the Health Commons. I asked her to describe the Health Commons which is where I currently volunteer once a week. According to Katie, “the Health Commons at Dar Ul-Quba is a drop-in center focused on health and healing while building lasting relationships. The center offers a welcoming space where people can gather for group activities, such as nutrition classes or exercise groups, as well as offer one-on-one consultations where discussions around health concerns, medication reviews, or community resources occur. The care is focused on preventive health and incorporating indigenous wisdom with health practices. We believe that our work is important to provide a community where people can work together to reduce health disparities and find a place to belong. All the services offered are free of charge. The center is supported by a collaboration effort between Augsburg College, Fairview Health Services, and the East African Health Project, which is funded by a grant from UCare.”
I participate with the Health Commons by leading a walking / exercise group. We have started calling ourselves the “fit and friendly” group. I am not providing physical therapy. I am simply building relationships and exercising with the women and children of the East African community. During the last few months I have learned a lot about their health needs. I have met many great people including Roda Hassan, College Health Corps VISTA / Community Health Intern and Hiba Sharif, Community Health Outreach Coordinator for Fairview, and Dr. Osman Ahmed, Director of East African Health Project. All three work at Health Commons and are East African. They graciously shared some of their insights with me in preparation for this article.
They have taught me that in Somalia, exercise is part of the lifestyle. They walk everywhere. Upon moving to Minnesota however, their physical activity significantly decreases because of all of our modern conveniences. The East African community has been experiencing an increase in diabetes and obesity, as well as other chronic diseases because of this decrease in physical activity the change in their diet. According to Roda and Hiba, many East Africans suffer from significant musculoskeletal pain because of the manual labor jobs many of them have in Minnesota and the lack of knowledge and education on proper body mechanics. East Africans tend to be very reliant on pain medication which can lead to other health problems. They also have a fear of surgery and many are unaware of other options, such as physical therapy, to deal with their musculoskeletal issues.
East Africans are often challenged by the complex healthcare system in Minnesota. They may encounter language barriers, transportation issues and financial constraints. As many of us know, physicians typically don’t have a lot of time to spend with patients on health education. For a culture that likes to share through stories and verbal dialogue, this lack of one-on-one time can be discouraging. It becomes hard to follow through on what the physician is telling them. They may not understand what he or she is saying and why they need to follow certain recommendations or referrals. This usually leads to worsening of their conditions.
This is where I think physical therapy can help. We often have more time to spend with our patients. We can get to know them on an individual basis. I see a need for increased education and participation. I think we have an opportunity to engage and educate. We need to be careful though, about how we engage with the community. There is a phobia amongst East Africans about "nonprofit organizations" that drop in into a community and claim that they are the experts. We need to learn from them; they are the experts of their own bodies. Trust needs to be built. I spent the first several weeks and months of my experience just getting to know people in the community and what their needs are. I was not the expert; I was the listener and learner.
I am including some tips I have learned that may be helpful in treating East Africans: it is important for East African women to be treated by and exercise with only women. They need a private space for exercise; an open gym in a physical therapy clinic would be extremely uncomfortable for them. Most do not exercise with or in the presence of men. Family is very important to them but one should ask the patient if they are comfortable performing exercise or receiving other PT interventions in front of family members of the opposite sex.
My goal is to continue to learn about this community and their health needs. I see an opportunity for PTs and PTAs to join me in this work. We can encourage exercise and healthy habits. We can educate about proper body mechanics. We can educate about physical therapy in general; what is physical therapy, how to access our services and typical treatments that might be provided. There is also an opportunity to educate and mentor the young people about physical therapy as a career choice. The opportunities are endless but it all starts with being present, listening and building relationships.