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Georgia to Georgia: Through USAID grant, OTD alumna opening pathways to rehabilitation in Eurasian nation

Since Traci Swartz, OTD’07, moved earlier this year, she finds she often has some explaining to do.

That’s because Swartz, a longtime resident of the U.S. State of Georgia, moved in January to the country of Georgia, a small nation between Turkey and Russia in the Eurasian sphere.

“It’s kind of funny telling people,” the Creighton University School of Pharmacy and Health Professions alumna, living in Georgia’s capital city of Tbilisi, said. “They look at you for a second and then you have to go into the explanation. Most people have never heard of this Georgia. Especially if you’re from the Georgia in the United States. If I hear something about Georgia now, I have to stop and think, ‘Which one is it?’”

An occupational therapist by training and most recently the Program Director of an Occupational Therapy Assistant program in the metro Atlanta area, Swartz is in the country of Georgia as part of a four-year, $4.5-million grant from the United States Agency for International Development (USAID) to Emory University to open more avenues for occupational and physical therapy in a place where it doesn’t get much traction among adults seeking rehabilitation health services.

Through Emory, the Georgia-to-Georgia connection has been running for more than 25 years, dating back to the efforts of a physician and professor, the late H. Kenneth Walker, MD. Dr. Walker started traveling to Georgia shortly after it broke away from the crumbling Soviet Union to help provide medical care for people in the fledgling country. He continued going back regularly until his death earlier this year at the age of 81.

“This grant essentially stems from that work Dr. Walker started in the early 1990s,” Swartz said. “From there, it’s evolved into working with marginalized and vulnerable populations which includes individuals with disabilities.”

Swartz said rehabilitation services for adults in the country are practically nonexistent. Outside of massage and some physical agent modalities performed by physical therapists, most adults with disabilities, chronic conditions, or recovering from major injuries do not have options for rehabilitation. Only about two dozen occupational therapists practice in a country with a population of 3.7 million, and all OTs currently practice in pediatrics.

Moreover, children can get rehabilitation services through a government medical voucher system, but few adults are able to take advantage of the program. There’s no therapy in acute hospital settings and no in-patient rehabilitation facilities for adults or children.

“So there’s basically physical therapy, but not in the way we think of physical therapy in the U.S.,” Swartz said. “The PTs have been trained by physicians, so they’re not learning the more specific skills they’d get in the U.S. There’s some exercise, but it’s mostly passive treatments, and it’s all outpatient. If you get injured, you recuperate in the hospital, but there’s no rehab after that. You’re kind of on your own.”

With the USAID grant and help from partners at Tbilisi State Medical University and the Coalition for Independent Living, Swartz and a physical therapist have been charged with teaching and training a new, first generation of dedicated practitioners and creating new clinics for adult rehabilitation. They are starting with an effort to train practitioners who can then train subsequent classes of therapists or rehabilitation assistants.

The inaugural class involves some of the nation’s few OTs, a handful of physical therapists and a few physicians and other health care professionals. Coursework is aimed at improving clinical skills and introducing new methods, treatments and reasoning.

With a language, alphabet and phoneme structure that is unique to the country, language has been a bit of a barrier, Swartz said.

“But we hope this first group will be able to pick up on the terminology and teach the next class in Georgian and broaden the reach,” she said. “It’s day-to-day training, but we’ve made some good progress and our partners have been excellent throughout the process.”

Gradually building a larger, more specifically trained network of providers, the grant — officially called Strengthening Physical Rehabilitation in Georgia (SPRING) — hopes to modernize physical therapy and occupational therapy in the country.

Swartz, who has worked in occupational therapy education, as well as university and teaching hospital settings for two decades, will be in Georgia at least through the end of the year. She said she’s found the experience rewarding and enlarging, especially taking in the Georgian culture, a capacious, gregarious way of life that includes hours-long dinners with multiple courses and robust conversation.

Completing her Creighton degree through the distance program, Swartz said she still gained an appreciation for the University’s emphasis on service and self-discovery, elements that also led her to Georgia.

“This grant and what we’re doing, I think it fits with a lot of what Creighton does,” Swartz said. “Creighton is known in the field for being a place that gives back and its students take what they learn and try to apply it elsewhere. To be here and expanding these therapies for the people of Georgia, I’m glad that I’m getting that Creighton name a little further out there and doing some good in another corner of the world.”

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