On the 19th May 2016, Fix Physio headed out to the Fijian Island of Tave Uni on a fact finding mission to see how we could assist the Californian based Charity Lo Loma Foundation in setting up a sustainable Physio service for the people of the South Pacific islands that currently don’t have access to this care.
What is the Lo Loma Foundation? – “Keeping Paradise Healthy”
Translation: Lo Loma- “From the Heart” or “A gift of love”. The Loloma Foundation’s mission is to provide sustainable medical, dental and infrastructure support to rural communities in the South Pacific who would otherwise have no access to basic healthcare.
The Loloma Foundation is a California-based 501(c)(3) non-profit corporation, established in 2001. The board members consist of six medical, dental and business professionals who share a common goal of improving the lives of the people of the South Pacific.
Results & Impact
In the last 15 years the Loloma Foundation has accomplished the following:
- Shipped and distributed $32M worth of medication and medical and dental supplies and equipment to Fiji and the Solomon Islands
- Organized and implemented 60 medical/dental missions in 150 Fijian and Solomon Island villages
- 90,000 patients have been treated by our volunteer physicians
- 382 cataract surgeries have been performed
- 520 general surgeries have been performed
- 8,700 dental patients have been seen
- The Loloma Foundation believes that it is also important to build a healthy community, beyond providing basic medical and dental care. We strive to enable people to do for themselves.
Welfare does not build character. To achieve that end, we are committed to the following:
Joint funding (co-financed with village participation) of sustainability projects:
- Village solarization
- Clean water through catchment and storage tanks
- Stocking libraries with children’s and adult books
- Building Kindergartens in rural villages
- Providing educational materials to Kindergartens
- Training teachers who are certified by the Fiji Kinde Project
- Scholarships for primary and secondary school students
- Village bakery businesses
In 2014 the Loloma Foundation has accomplished the following:
- Organized and implemented seven medical/dental and construction missions staffed by volunteer physicians, surgeons and dentists.
- Each mission team of 10-20 volunteers saw 2,000 patients during a week of clinic.
- 30 cataract surgeries were performed
- 122 surgeries were performed
- 1,000 dental patients were treated
- Shipped and distributed $2M worth of medication and medical and dental supplies and equipment to Fiji and The Solomon Islands (most of which was donation in kind, the rest was purchased)
- Our volunteer U.S. physicians and dentists mentored local medical/dental residents from The Fiji School of Dentistry and School of Medicine during each mission
Looking to the Future
There is still much work to be done. In 2011, the population of Fiji and Solomon Islands combined was more than 1.4 million people. Approximately 60% of this population lives in rural conditions and faces the greatest challenge accessing basic healthcare.
The Loloma Foundation has Seven missions scheduled for 2016 in Fiji . The cost of acquiring medical equipment and supplies and then moving them to the mission sites is our essential annual expenditure. Through donations from individuals and sponsors like you, the Loloma Foundation can complete these missions.
Fix Physio’s involvement
So as a business, Fix Physio has been looking to align itself with a deserving and appropriate charity since mid 2015 but had so far struggled to find the right charity. At the end of 2015, my wife Jayne and I headed to the Yassawa islands in Fiji for some much needed rest & relaxation after Fix Physio’s first year in business!
It was immediately apparent to Jayne and I just how incredibly special the people of Fiji were- always smiling, always laughing, so strong yet so very gentle and kind at the same time. The people had very few material possessions and lived in very basic accommodation but were the most happy and content of people.
It sounds a bit cliché and corny but we both felt an immediate connection with the locals and had the best holiday! It was while we were there that we heard amazing things about a charity called The Lo Loma Foundation that came over from the USA several times a year armed with a team of doctors, nurses, dentists & surgeons giving up their time and skills to help the people without medical access.
I contacted their Founding Board Member and Project Coordinator, Linda Kwansky to offer Fix Physio’s services and within a few days of being home, I’d booked my flights to go back out there to do a 5 day fact finding mission to see how we could help!
And so this is the story so far……Fix Physio has a full patient list on Friday and Saturday, several teaching sessions prepared for the hospital staff and plenty of meetings with all the right people to work out how Fix Physio can contribute to setting up a sustainable physio service in Paradise!!! It’s gonna be a whirlwind but Fix Physio can’t wait to roll up its sleeves and get stuck right in!!!!
Lo Loma Foundation Fix Physio – Tave Uni, Fiji- Day 1!
I’VE ARRIVED!!!! So after a 3am alarm clock call and a few dramas at Sydney airport check in (I had randomly been put on standby list by Fiji airways even though I booked my flights in January!), I arrived in Nadi, Fiji before jumping on a 10 seater propeller plane to Tave Uni (amazing scenery flying over the islands but a fair bit of turbulence too???!)
We basically landed into something out of the movies- total tropical paradise, we got off the plane and were guided into a small wooden hut the size of my father in laws shed and despite me trying, nobody seemed to want to see my passport or ticket!?!
I was met by Roberta who I’ve been organising a lot of this trip with. She is an occupational therapist from Hawaii but has lived in Tave Uni for the last 13 years and runs the resort where I would be staying.
We jumped in her pick up and headed to Roberta’s resort- the Makaira resort to drop my bags off. As we arrived, I was greeted by 5 of the hotel staff in their uniforms singing the most beautiful traditional Fijian welcome song with one of the guys playing a ukelele- ummmm #goosebumps!
We then jumped back into the pick up to drive half an hour to the hospital to set up the physio room. On the journey there, Roberta explained how the hospital mortality rate was so high. If anybody has a stroke or a heart attack they receive minimal medical intervention as they don’t have much in the way of medicines that we take for granted or the surgical procedures such as bypass graft surgery or stents. In effect, without the Lo Loma Foundations assistance, these people are basically left to die from conditions that we in Australia and the UK can usually treat very successfully often with a return to close to normal life. This fact was highlighted as we arrived at the hospital to be confronted with a family carrying their relative out of the main entrance in a coffin.
After that, we went in to the hospital find our physio treatment room and it actually exceeded my expectations (see @fixphysiosydneys Instagram account for before makeover shots)! The view from the treatment room window of palm trees, the ocean and islands was certainly better than anywhere I’d worked before! So we proceeded to set everything up- I’d brought a lot of stock, equipment and a physio bed over from Sydney and the Lo Loma Foundation had donated a few things. Some of which were somewhat interesting- not quite sure what I’m going to do with 6 bottles of sun tan lotion, 20 pairs of hospital grade Ted stockings and a tournequet!?! Ha ha- so we’ll see!
It’s now 8:45pm and I’m gonna hit the hay after a massive day! I’m looking forward to what tomorrow’s going to bring- all I know so far is that I’ve got a list of patients, most of whom won’t be able to speak any English. I’m being shadowed by Roberta, a Fijian lady who comes from a long line of Fijian masseuses and a male nurse who I was informed today is going to run the physio service after I’ve taught him all there is to know about physio…in 3 days!!! Pa- 3 years at uni and a thousand clinical hours- forget it! Ha ha- you’ve gotta love Fiji!!!
Anyway, night night from Fiji and don’t forget you can see all the photos so far on @fixphysiosydney on Instagram!!!
Today was the day that the clinic doors opened and it started with an interesting case of a guy in his mid 40’s who had come through from the Emergency room because of left shoulder pain. As I handed him the registration form to fill in, he looked at me blankly so I quickly realised that he couldn’t actually write. He had already seen the doctors and they had X-rayed his shoulder and injected something (the patient didn’t know and we couldn’t find out from the Emergency room despite our best efforts) into his lower back- we could only assume it was some sort of pain killer but nobody could confirm this? It became apparent very quickly that it seemed to be common practice for each patient to be injected and have an Xray of their effected area regardless of their injury as if it was step by step medicine rather than sound clinical reasoning for each case.
The problem with this approach is as follows:
- It Exposes patients to unnecessary radiation from the X-rays
- The risk of infection from the invasive procedure of injections in a country where the level of hospital hygeine doesn’t come close to the western world standards
- The extra unnecessary cost of the X-rays and the medicine going in to the injection in a country where the medical system is financially poor. This money could be spent far more appropriately
- The patient isn’t getting the best possible outcome from this care
On questioning our first patient it also became apparent that we weren’t actually dealing with a shoulder injury but more so a nerve root compression from his neck causing shoulder pain again proving that with correct diagnosis initially, the X-ray of his shoulder was totally unnecessary.
The day continued with a an elderly lady that we found in the waiting room who was complaining of knee pain and holding a prescription for an injection for her knee. She was attending the hospital with her 2 daughters who then proceeded to pretty much drag her into the treatment room as she was unable to walk independently. Whilst filling in the registration form I asked the elderly lady her date of birth. She looked at me puzzled and then looked at her daughters for support. They in turn looked at each other with an equally confused expression and after 30 seconds or so of debate one of the daughters answered “1930- 1940”!?!
On assessment, although the elderly lady did appear to have some wear and tear of her knees, her main issue was simple muscle weakness so we showed her some basic lower limb strengthening exercises to get started with. In the meantime, Roberta was searching the hospital for a walking frame to try as this lady had not really been walking independently for the last 5 years or so and had just been relying on her daughters. After initial resistance, the elderly lady agreed to try the frame and although a bit tentative at first, managed to walk the distance back to the waiting area- probably all of 70-80 metres away completely independently. She was exhausted by the end with beads of sweat running down the side of her face but her gummy smile as well as her daughters obvious delight was certainly worth this simple effort.
I saw more and more people throughout the day who had simple injuries that they had been putting up with and just thought this was how it was going to be now. One farmer that I saw had dislocated his left shoulder 10 years ago in a farming accident and he was just putting up with it. After treatment, he said that he felt more relaxed in his shoulder than he had done in years- this probably explains why he initially walked out of the clinic forgetting his shoes!
Once the first day of patients was done we headed back to the resort and spent the next hour or so going over core stability- anatomy, importance, assessment & activation with Roberta and Mary who were going to have to start teaching it from now on! And that was the end of a very productive, insightful first day!
What I’m learning very quick about Fiji is that nothing runs on time (20-30 mins late for any event is pretty standard!), people don’t turn up when they say they are going to and a lot of things seem to be left to chance. Case in point was at breakfast, when I was told that due to miscommunication, I had no patients booked in for the day! We couldn’t waste this opportunity to get the message out there about physiotherapy so Roberta and I jumped in her pick up and rounded up a group of local men & women with the promise of free physio which would make them better rugby players and of course a free ice pop!
Within no time we had got 6 patients in the back of the pick up truck and off we went. The first patient was one of the resort staff where I was staying who was in his early 20’s. He had 2 separate injuries. Injury one was a 3 year history of right neck/ shoulder pain following a heavy plank of timber falling on his shoulder from a height while he was helping to fix a roof! He had been in considerable pain ever since but had just been putting up with it. On assessment, it was clear that there was nothing structurally wrong with his neck or shoulder other than a bit of joint stiffness of his mid back, neck and shoulder as well as some considerable muscle imbalances- some muscles tight, some muscles weak following the trauma. If I’d have seen him at Fix Physio Sydney, I would be saying to him it might take him 3-4 months to get there as he has had the injury for so long but I would be confident that we could resolve this injury.
His second injury again happened at work when 2 years ago, he was stood on the jetty, guiding the fishing boat in and a freak wave drove the sharp front of the boat into his right thigh just above his knee cap and caused a laceration. Apart from stitches, he received no other rehabilitation and as such has struggled with his knee since. On assessment, all his ligament and cartilage testing was clear but again he did have considerable muscle imbalances as a result of the 50 cent piece sized lump of scar tissue sat in his quad muscle just above his knee. Once again, had I have seen him at Fix Physio Sydney, I would expect he would be back to playing the sports he loved within 2-3 months of regular treatment! The current issue we have is that I was only going to see him once but this is better than nothing!
Then we had a 20 year old football player who had sprained his ankle 5 times over the last 6 months- originally going over on it on a pot hole whilst playing football. The diagnosis was a simple chronic ankle ligament sprain and again another easy injury that with early intervention and the correct physio treatment is usually resolved completely within at best 3-4 weeks and at worst 6-8 weeks. Without treatment however, this process of reinjury would likely continue indefinitely until he did something more serious which could possibly stop him from playing the football he loves!
The day went on like this but the case load had a much higher percentage of shoulder injuries than I am used to seeing in Sydney- all of which bar none were sustained playing the game the Fijians truly do treat as a religion- rugby! The final patient of the day was a young lady of about 20 years old who had suffered from 5 years of left sided low back pain from an insidious onset. The diagnosis was of a left sided pelvis instability and gross muscle weakness of her lower weakness of her lower back and pelvic/ hip girdle. After some initial hands on treatment, taping (we didn’t have any stability belts available to us) and some core stability and glutes strengthening, I would generally in Sydney, progress these injuries onto a customised clinical pilates program but I think one step at a time! Fiji doesn’t really understand what physiotherapy is yet, so I’m not gonna start throwing in the word “pilates” too! Who knows though in future, we could aim to have Fiji’s first clinical pilates gym!!!! Ha ha!
Anyway, so after our second and unfortunately, final day of treating, we headed back to the resort to do a knee and shoulder teaching session with Roberta & Mary. Another insightful day, which was a whole lot of fun as well as a real education in how this could really work but equally quite how much work lies ahead!
What did I learn during this trip? Well, although it took some initial adjustment, it made me realise that you don’t necessarily always need all the equipment and machinery that I now use on a daily basis at Fix Physio Sydney- although it certainly does help to provide a better quality of service. Secondly, I also realised how hard it was not to have that support network of further investigation such as MRI scans and other medical professionals to refer to such as sports doctors, orthopaedic surgeons and podiatrists to improve the total care of a patient. Finally, what this trip did remind me of was how important a good physio service is to every population of people to improve their quality of life and generally make people happier. I can honestly say, I’ve never had a group of patients who were more appreciative of that one physio assessment and treatment session that we gave over those 2 days.
It was only two days of clinics but it’s certainly given me a lot to think over, in particular about how we can make this work in the long term and I’m excited about the prospect! Watch this space…….
Fix Physio Lo Loma Foundation- The vision from here?
The grand long term vision from here is that Fix Physio along with the Lo Loma Foundation can provide the only full time physiotherapy clinic in the whole of Fiji. This may be a bit ambitious and I am fully aware that nothing happens quickly in Fiji so I envisage this is likely to take at least 10-15 years before it resembles anything close to what I have in mind but we’ve got to start somewhere.
The first step is educating the people of Fiji, especially the hospital staff, exactly what physio is and how much it can help people live a much better quality of life- people don’t need to just “get on with it” after they’ve had a stroke or a leg amputated. Basic sports injuries such as a sprained ankle don’t need to prevent people from playing the sports they love and simple low back pain doesn’t need to make people quit their manual job for a poorer paid sedentary job!
The second step is getting more physios on board in all areas such as musculoskeletal and sports injuries, neurology- strokes in particular are a major health issue in Fiji due to the poor diet and the current situation is that when they are medically stable they’re often just sent home from hospital to their bed to die- physio can help these people. Other areas of physio such as respiratory, paediatric, women’s health and the list goes on are needed, whether it be for 2 days, 1 week, a fortnight, a month, whatever- every little bit makes a difference. If you know any physios that you think might be interested, please share this article with them!
The third step is generating some cash flow for the Fix Physio arm of the Lo Loma Foundation so that physios can donate their precious time to this charity in Fiji cost neutral to them (other than the cost of a few Fiji Gold beers when they arrive!!!) as well as funding for much needed equipment and stock. The long long term vision is that we can eventually get a local Fijian to run the service and paid a salary but this will likely be a long long time off but we are dreaming big here! I spoke at length with the head of the Lo Loma Foundation- Linda Kransky, earlier today and after the success of this trip, Fix Physio was offered the role of driving the Physio arm of the Lo Loma Foundation which I of course immediately accepted.
So how does Fix Physio intend to raise money for the Lo Loma Foundation? Well, several ways:
- Many people have generously asked how they could donate to the Physio mission of Lo Loma specifically- Linda advised me today, that you can now go to the Lo Loma foundation website www.lolomafoundation.org and when donating you can specify which mission you would like to donate to- in our case Linda advised me that you should write: “Fix Physio mission”. Seriously, any donation, no matter how big or small would be hugely appreciated- we currently have a budget of zero Australian dollars!!!!
- I will also be putting a link to the donation to Fix Physio mission on The Fix Physio website www.fixphysio.com.au and hopefully a section on the Lo Loma Foundation website.
- For Fix Physio patients, I will be putting a small donation box in the Sydney CBD clinic if you would like to donate.
I’m also currently looking into setting up a crowd funding page to generate funds ongoing so watch this space!
So there it is, if anyone has any questions, ideas, suggestions or potential contacts that may be interested then we would love to hear from you- Fix Physio can be contacted on email@example.com. As I said, we are fully aware that we are dreaming big here but as the saying goes: “Shoot for the moon. Even if you miss, you’ll land among the stars.” and for the people of Fiji, among the stars would be pretty fantastic!!!
GET FIXED…..STAY FIXED!!!!