North Africa Team Member Reflections: Part II

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Today I am excited to welcome my third teammate, Ryan Carrick, to the blog. He has some wonderful insights on working together and team collaboration that really impacted him from his time in N. Africa. Ryan is an Occupational Therapist with a history of work in home health and neurological rehab but is currently working as a professor in the OT department at Augusta University. I hope you enjoy his perspective!

"When a healthcare provider thinks of the term interdisciplinary or even collaboration, mental imagery is often based on prior experiences. Positive or negative, a healthcare provider moves forward in clinical practice working with other disciplines to an extent the paradigm of collaboration allows. A frame of reference for working as a team has the potential for exponential client benefit, whether side by side or even in silos. My own preference for collaboration leans towards interdisciplinary versus multidisciplinary or working together to solve a puzzle rather than simply side by side with another professional. I am an Occupational Therapist (OT) and absolutely value other health professionals’ experiences and knowledge. Unique expertise is cumulatively valuable with an interdisciplinary team. I’ve experienced this phenomenon both locally and internationally. Most recently, I was privileged to join two physical therapists in North Africa.

Before North Africa, I’m thankful to have experiences in Rwanda and Peru to foster the positivity towards teamwork. Additionally, working with fantastic teams in clinical and academic settings in the United States gives credibility to the attitude of gratitude. Working in non-sharing, non-communal environments have also occurred, however they’re growing and learning opportunities just the same. Various experiences as a healthcare provider create a personal story, and therefore, attitude towards collaboration. These attitudes and experiences can be documented and studied by counting or by quoting. If I were to study what occurred in North Africa, I’d reflect on the qualities of the experiences. For example, both qualitative and quantitative research have their complimentary purposes; but it is hard to overlook the vast opportunity of storytelling to grasp the full picture of a lived experience without appreciating the qualities of a healthcare team.
 
The story of the 2023 North Africa rehabilitation team began with a divine appointment between a doctor* and a physical therapist (PT). Both men shared a passion for helping people who are overlooked or even looked away from. Jason was the PT who was obedient to a call for service. He said, “Yes, I am here. Send me.” Then, he prayed some more. He saw the value with interdisciplinary care as well. He knew me and a few others that shared a desire for teamwork and for serving. Including Jason, three men said yes – 2 PTs and 1 OT. These three therapists chose to travel to an area of the world where most people would ask, “Why there?!” Well, a simple reply of “Why not?” suffices. We wanted to build bridges as a team of physical and occupational therapists coming from the United States, where, oddly enough, traditions can sometimes override knowledge and desire, causing anything but bridges. Speaking from experience, sometimes it takes stepping outside of a normal life flow to recognize what one may be overlooking. Let’s just start there with the theme “collaboration abroad.”

Collaboration started before we left on a jet plane. Teamwork building doesn’t simply happen with a scheduled protocol or tested theory. Teamwork truly happened when all members intentionally leaned in. We committed flexibility and intentionality to each other and to the work ahead of us. We were also thankful for a committed physician as “boots on the ground” in North Africa. Thankfully, this physician was fluent in the native language, understood the culture context and educated all three of us with regular meetings to prepare for North Africa. We came to a consensus on potential patient, caregiver, and healthcare provider materials to produce and send ahead electronically. Then we sought support.
 
Serving in a foreign country requires sacrifice. The sacrifice was a welcomed burden carried by us and by our families at home. Yet, the sacrifice us three therapists thought we experienced were microscopic compared to the healthcare providers we met living in North Africa.  Arriving in North Africa, we were met with new smells, lack of personal space and a massive culture shift. That’s just the perception of 3 tired, privileged Americans operating out of exhaustion. We were also met with smiles, handshakes (all with the right hand) and communal plates for eating without utensils. Those smiles. Those smiles were simply part of the affirmation of obedience with the sending. Operating with an awareness of power greater than ourselves, smiles became less necessary for external confirmation of why we were there.

We knew (some) why we were there – to serve. The rest we didn’t find out until we took more steps forward. A 14-hour plane flight was no longer on our mind when we heard more about the needs of the local people groups. We saw poverty, yet resilience. We saw ignorance, yet thanksgiving and joy. Imagine a 14- or 15-year-old mom who loves her baby boy so much, her joy radiates. She just knows she loves him, but why can he not sit up? She’s been holding him. The proceeding conversations (through a translator) helped me to understand a deeper level about the dominant religion and culture. She had been abandoned and didn’t want the same for her son. She wondered why he was different, even as an infant. So, she hid him away from others; he hid in her arms.
 
Keep in mind, all three therapists now in North Africa have spent their whole careers with the adult population. Pediatric theories, reflexive patterns, normal development, and intervention strategies were distant educational memories. This mom was in front of me with this 18-month-old child.  What do I do? I had traveled halfway around the world. Give me an 80-year-old patient who had a stroke, and I can write a plan of care (I was equally excited to see those patients too.); however, an 18-month-old? It was not my ability or skill that spoke for me or the translator. The next 20 minutes walked through some developmental and motor learning education that surprised me as it came off my lips. Even more surprising was this mom’s receptiveness. She soaked it up and was immediately positioning her child in strategies that facilitated his development through normal play. She also felt comfortable allowing him out of her safe embrace. He stretched and made his presence known. I later found out that this same mom had come to the other physician’s clinic* in hopes of answers, months before we showed up. The day the mom was at the clinic, other moms had their children with disabilities present. The physician told me, this mom immediately started weeping. Her tears were due to a year of hiding and fear of rejection and denial. She finally, literally, let go. She knew she was not alone.
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There are many other stories to share. Suffice it to say, a single healthcare provider makes a difference. However, a collaborative team makes a difference in others and us. I have shared the pediatric story with people who serve in areas other than healthcare and have learned of similar phenomena where they became aware of power outside themselves. There is power in numbers and there is power in He who sends. I am thankful for our interdisciplinary team. I am thankful for the physicians who had conversations with patients and caregivers before us and the PTs and OT who found a bond greater than ourselves. Did I mention the translator present with me, and the young mom was an indigenous trained nurse? What a team!"

With all sincerity and veracity,

Ryan M. Carrick, PhD, MHS, OTR/L

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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