PT Classroom - Opening the Window of Opportunity: Volunteering Abroad in Physical Therapy ׀ by Jennifer Werwie, DPT

Albert Einstein once said, “Only a life lived for others is a life worthwhile.” I can say with confidence that I have chosen a career in which I can find fulfillment in serving others by utilizing my talents and passions on a day-to-day basis. We as physical therapists are fortunate to not only have opportunities to serve our local communities through our workplaces, but can take our social responsibility a step further by looking outside our immediate world and embarking on global outreach initiatives. Over a billion people are estimated to live with some form of disability (1). This corresponds to about 15% of the world's population, of which represent the most marginalized groups in the world. They have poorer health outcomes, lower education achievements, less economic participation and higher rates of poverty than people without disabilities (1). These staggering statistics prove the need for rehabilitation services in every corner of the world in order to start to meet the needs of this global health burden.

Back in 2008 as a undergrad student at the University of Wisconsin-Madison, I was fortunate enough to participate in a study abroad experience that allowed me the opportunity to volunteer at physical therapy clinics across the Dominican Republic. Even as a student, I found myself providing a certain sense of hope to patients and therapists. I found myself gaining a growing sense of overwhelming duty and commitment to the unmet needs for higher-quality services and physical therapy education. From the connections I made, I was able to make two return trips to continue providing volunteer efforts and coordinated a personal fundraising campaign to provide shoes to children in one of the poorest communities in the country's capitol. Once a graduate student in the physical therapy program at the UW, I served as a coordinator of our student-run pro bono medical clinic. I was able to take full advantage of my global perspective, bilingual skills, and leadership experience to make the clinic a positive learning experience for all volunteers and an effective source of healthcare for community members in Madison. Although not a volunteer experience, I was able to travel to Puerto Rico for one of my 8-week clinical internships, where I continued to cultivate my global perspective and bilingual skills. Now as a licensed physical therapist, I can only imagine how much more impact I will be able to have in volunteering my services in my local and global communities.

Now more than ever, physical therapists can serve a vital role in aiding the global health burden. In particular, the area of disaster relief has opened up it's doors to physical therapists in an even greater way throughout the past decade. Initially, physical therapists often served in nonclinical or nontraditional roles in disaster response such as logistics, operations, or liaison officers, but rarely did they work autonomously in a clinical role (2). Since Hurricane Katrina, there has been an overall increase in therapists being utilized as part of the multidisciplinary team conducting specific clinical roles such as neuromusculoskeletal evaluations, amputee training, and wound care. PTs' skills may have been underused because other health professionals were unaware of the high level of musculoskeletal assessment and management skill sets that PTs bring to the field (2). Now with greater recognition and demand, PTs are able to utilize their specialized skills to best meet the health care demands abroad.

Indeed, there are countless opportunities and avenues through which to volunteer. Physical therapists should ask themselves the following questions when deciding whether to volunteer abroad and when choosing a specific volunteer opportunity:

1. Why do I want to volunteer abroad? What are my main motivations and goals for volunteering?
By understanding what drives your desire to volunteer, you will better be able to live out that purpose while abroad. Having specific goals will help you better align yourself with the appropriate volunteer organization.

2. How willing am I to put myself out there? To be open-minded, committed, flexible and patient?
Being honest with yourself is essential. Knowing your comfort level and your limits will help you to choose the right type of volunteer experience for you.

3. What therapeutic services would I like to provide while abroad?
By understanding where your talents and passions lie, you will best be able to find an fitting volunteer opportunity. Areas of need in the realm of physical therapy are a plenty: delivery of rehab services (general musculoskeletal and neurological assessments, critical care/intensive care, pediatrics, maternity, wound care, amputee gait training), equipment consultation and development, delivery of continuing professional development programs, creation and implementation of emergency preparedness plans, and the list goes on.

4. For what extent of time am I able to (or would I like to) volunteer?
This question is important for not only figuring out which volunteer opportunities would suit you best, but will also help with the initial planning stages of your trip, such as getting coverage at your work, setting up necessary vaccinations, and packing appropriately. Volunteer opportunities can range anywhere from as brief as one week to as extensive as an entire year.

5. Is volunteering abroad expensive? If there is a placement fee involved, what does that go towards?
Indeed, volunteering abroad can incur a lot of cost. That is why it is essential to begin early in planning out and calculating estimated expenses. For people working with Health Volunteers Overseas (HVO) for example, an assignment can be as short as 2 weeks or as long as 4 months or more. The average cost of a one-month assignment with HVO is $2,300, from which a majority of the expense covers your plane ticket (3). Housing is usually a nominal, or sometimes even free, expense. Know that all honest, forthright companies should be able to provide a break down of placement fee allocation. Often it will include a donation to the volunteer project, and then external costs such as marketing, product development, staff costs and overhead (4).

6. How can I go about getting a trip funded?
Once you've decided on a volunteer project and location, the next step is to brainstorm ways to fund your trip. I have found successful fundraising occurs when started in an early, proactive manner and when various approaches are taken. The following are different avenues from which you can fund a volunteer trip (3):
· Networking: Your social network (friends, family, coworkers) can be a great supportive resource to you in your volunteering endeavours. There are many vehicles of communication you can use to get the word out about your volunteer endeavour: in person, emails, letters, social networking (Facebook, Twitter), etc. Many volunteer organizations help facilitate fundraising by providing web-based programs and fundraising web pages.
· Fundraisers: Sometimes a good old-fashioned bake sale or car wash can go a long way! Other ideas include t-shirt sales, restaurant nights, walk-a-thons, rummage sales, and even silent auctions.
· Large Organizations: Therapists can often apply for financial aid throgh larger hospital systems, corporations, or academic institutions that they are connected with. Places to start include foundations, charitable organizations, outreach departments, research grant writing departments at academic institutions, and even Fulbright scholarships (for more extended 4-5 month trips). Remember to always present a mission statement, fact sheets, and photos to create a clearer, more personalized vision of what you are setting out to do.
· Service and Faith-based Organizations: Making presentations to service-related organizations such as the Rotary Club or Kiwanis can turn into a great source of financial aid. Church groups are also very willing to lend support to members with a mission.
· Independent Funding: Many therapists do not feel comfortable asking others for financial assistance. In this case, you may find yourself using your own income or working more hours and weekends to fund your trip.

7. Will I be able to talk with other volunteers who’ve volunteered through this organization or taken part in this particular project?
It is so important to be able to gain some perspective and realistic expectations from experienced volunteers. Most honest, quality volunteer organizations will be able to provide you with a contact list of return volunteers. Some companies even have online travel communities where you can talk to past volunteers and check out pictures from their trips (4).

Opportunities abroad are boundless. By acquainting yourself with all that is out there and available, you will best be able to find the right volunteer opportunity for you. Volunteering abroad can often be a win-win situation. You have the opportunity to make a positive difference and lasting impact on an underserved community. In return, you will undoubtedly walk away with a broadened global perspective, which can easily spread throughout your local community and in your workplace, down to each patient interaction you have. You might even return from your first trip like I did, realizing you caught the volunteer bug, only to start planning a new or return trip abroad!

Check out the links below from the APTA website Pro Bono services (International Volunteer Opportunities & Organizations) section (5):
· Health Volunteers Overseas: http://www.hvousa.org/
· Project Hope International: http://www.projecthope.org/
· Global Giving: http://globalgiving.org
· Medical Teams International: http://medicalteams.org
· Doctors without Borders: http://www.doctorswithoutborders.org/
· Christian Physical Therapists International: http://www.cpti.org/
· Cure International: http://cure.org
· CARE USA: http://www.care.org/
· American International Health Alliance: http://www.aiha.com/en/
· African Medical Mission: http://ammsa.org/
· Healing Hands for Haiti Foundation, Inc:

http://www.healinghandsforhaiti.org/
· Haitian Relief Effort: http://www.apta.org/Haiti/