By Ivett de las Mercedes
HAVANA TIMES – In Cuba, physical therapy cannot be limited to a series of procedures and techniques. Yeney Guevara Garrido, 34, works at a rehabilitation center belonging to the Havana municipality of Cotorro. She studied this degree thanks to a call for students who had graduated high school. She is currently getting ready to pick up studying again.
HT: As a physical therapist, have you run into a physiatrist in your line of work?
Yeney Guevara: Of course, there are specialist doctors in this field, we both do the same work. The only differences are our wages and that they have more in-depth and detailed knowledge. In the time it takes a physical therapist to see 16 patients, a specialist will only see 13. Every day, approximately 40 people come in search of our services, even though we are only supposed to see 16. I enjoy what I do, I try to get the best results, even though conditions aren’t always ideal and I suffer as a result. Every day, I realize that even if I wanted to go to great lengths to help a patient, it’s useless, especially because the equipment we use is faulty and we don’t have any medicine to help relieve their pain.
HT: Is the rehabilitation center near your home?
Yeney Guevara: Yes, I arrive at 7 AM in the morning and I leave at 7 PM Monday to Friday. On Saturdays, we’re only there until 12 PM. We do that because there are people who have to go to work in the week but need to continue having treatment. We see patients on a first come first served basis, and they are already lining up at 6 AM. When I can’t go because of personal matters, some patients come by my house looking for me.
HT: Do your wages reflect the intensity of your work?
YG: I get 680 pesos (=27 USD) per month for belonging to the Ministry of Public Health, which is more than other fields, but my wages still don’t reflect the work I do. Sometimes, I look for a little extra cash because some patients come looking for my help. It’s extremely difficult to cover living costs with such a salary right now. Luckily, we are given lunch and even though it isn’t good quality, we save a little.
HT: Are there any health risks for employees working in patient rehabilitation? If there are, do you take protective measures?
YG: Every month, we rotate by department so risks are reduced. All of this equipment is dangerous because of the radiation they emit. We don’t even have the apron that protects women from getting breast cancer. Most of us have disrupted menstrual cycles. The head of department has gone to various other departments and spoken about the problem. There is also the risk of suffering rheumatism and arthritis as a result of changes in temperature: massaging generates heat and we only have cold water to wash our hands. This mostly happens when we have to give a massage with our hands because there isn’t any electricity, even though this is not recommended. Right now, one of our colleagues is pregnant and she only works twice a week so as to prevent any harm to her baby.
HT: You mentioned help from your patients, what is your relationship like with them?
YG: Our patients respect our work quite a bit, they are very grateful. It’s understandable that if you have pain and it goes away, you will want to give something, but they just give us coffee or a snack. I always keep an eye out because we aren’t allowed to receive gifts. The majority are old people and the first to arrive. Sometimes, it’s 6 AM in the morning and it’s very hard to deny them the satisfaction of giving us a cup of coffee, a sign that they are pleased with our work. As we work in a team, if a patient gives us a box of soaps as a gift, then we share it among all of us, for example. However, we don’t favor any patient over another. We also suffer here, there are people who don’t come in clean, especially the elderly who live alone or aren’t looked after properly, but we have to attend to them anyway.
HT: A few years ago, rehabilitation centers were renovated and modern equipment came.
YG: That’s true, this ensures quality treatment. However, we have many patients and we are given a very short time period as a team to treat our patients and in this job, it isn’t quality but quantity that counts, because if they were given the treatment they need it would take too much time and we wouldn’t be able to see every patient that needs to be seen.
HT: Was there a particular case that left a mark on you?
YG: Yes, many, especially women. But rather than a case, we should talk about disease. Some come with pain in their arm, it gets better, but the pain doesn’t disappear. This is called periarthritis of the shoulder or frozen shoulder. As I like to study, especially anatomy, I have recommended that many of these women go to see a breast specialist because breast cancer tends to give you frozen shoulder, affecting glands in the underarm; and they were diagnosed with cancer. Cancer hides behind any kind of pain. There is also cervical pain, which doesn’t get better with magnetic therapy or an electric current being applied.
HT: Which procedure do you use the most?
YG: Electric current and conductive gel for ultrasounds. There are many ointments that are missing such as lidocaine and mentolam which are very helpful. The polyclinic’s pharmacy dispatch these medicines and they have been missing for a long time now. It’s very difficult for us to relieve pain without these.
HT: When your working day finishes? What do you do?
YG: Being a mother is the first thing. That’s what my daily routine is based on: going to get my son from daycare. He depends on me still completely. I am lucky to still live with my mother, she helps me out a lot with the chores around the house, even though I try to make sure that she doesn’t have too much to do. My son is very calm, that gives me some time to study. I’m beat by the time I fall into my bed. Of course, it’s different on my days off, we have a lot of fun.
HT: Have you thought about looking for another job?
YG: We would all like to prosper, grow professionally. Now, the director of the polyclinic puts up with me when my son gets sick, that’s one of the reasons I’m still there. I also enjoy what I do, I have to confess that I am deeply saddened by the fact that we don’t have the conditions to offer quality physical therapy. When people go to the rehabilitation center, they do so because they want to get better, nobody likes to feel pain. I will continue to study, I have a lot of faith in the future, I know that life will reward me one day.