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Helping the Republic of Georgia

Emory graduate Cookie Freidhoff is improving physical therapy in an underserved country.

By Kevin Bloye

Story Photo

Cookie Freidhoff (left) with American Physical Therapy Professor Jae Choe and interpreter Leila Chantladze, a Tbilisi State Medical University physical therapy graduate.

Gail “Cookie” Freidhoff, a 1982 graduate of the Emory Division of Physical Therapy, will never forget what was supposed to be a “nice, quiet lunch” during last summer’s American Physical Therapy Association NEXT Conference in Boston. That moment changed her life. There, Zoher Kapasi, who at the time was director of Emory’s Division of Physical Therapy, spotted the recently retired Freidhoff and asked her if she would be willing to serve on an international project for three months.

“For three months, I can do anything—not a problem,” Freidhoff told Kapasi.

During the interview process, Freidhoff learned that the project was in the Republic of Georgia and was actually a four-year initiative by the U.S. Agency for International Development’s (USAID) Leahy War Victims Fund. The fund exists to increase the availability of and access to a wide variety of programs benefitting people with disabilities in war-torn countries. Freidhoff agreed to serve one year, and in January of this year, left the comforts of her Kentucky home. As for her prior knowledge of Georgia, she laughed and said, “I had to look on a map to see where it was.”

More than seven months into the job, Freidhoff admits that while she has never worked harder and rarely gets a day off, the experience has been “truly life changing.”

Her mission in Georgia, which has a government-run health care system, is simple: to improve physical and occupational therapy in a country that provides adequate rehabilitation care for children but offers nothing for adults.

“Over here, if you’re an adult with a disability, chances are, you will spend the rest of your life in your home with your family caring for you,” Freidhoff explained. “Since there are no rehabilitation hospitals per se, there is little to no follow-up care for stroke victims, people with spinal cord injuries, or amputees. This is what we’re trying to change.”

From April through July, Freidhoff and her American occupational therapist colleague, Traci Swartz, who both live in the country’s capital city of Tbilisi, first taught the English-speaking Georgian faculty and therapists how to teach, think and practice at at a clinical-reasoning level. That meant less classroom memorization and more clinical reasoning and hands-on experience.

“We’re trying to get them to use case scenarios when they’re teaching and have more lab time so that the students get to practice the skills and techniques being taught rather than just be shown the skills used in the clinic,” Freidhoff, who spent most of her career as a sports clinical specialist, says.

After the first course, three of the students were hired to teach Georgian-speaking therapists and faculty what they had learned. Translating the material into Georgian, where two words in English can equal nine words in Georgian, has proven to be a huge challenge.

“We’re relying on our instructors to translate our slides to Georgian,” she says. “We think it’s working, but we’re not sure. I guess we will find out when they take the final.”

While much of Freidhoff’s day is spent monitoring and counseling faculty at Tbilisi State Medical University, she also assists with labs and helps clinicians utilize clinical reasoning when treating patients.

“We probably won’t be able to gauge the full impact of our time here for another 10 years,” says Freidhoff. “The good thing is I can already see a change in the attitudes of the therapists and the faculty toward evaluation, treatment and educational approach. MDs, PTs and OTs are starting to talk to each other, which they never did before, and are working together on projects. They are starting to understand the importance of the team approach when treating patients.”

In the little free time that she has, Freidhoff talks to her husband back home, goes for walks around the city and cares for six stray dogs that show up at her door each day for breakfast and dinner.

While Freidhoff admits that working long days in a medically underserved country more than 6,000 miles away from home is not what she had envisioned for retirement, she wouldn’t have it any other way.

“I don’t look at it as a sacrifice,” she says. “I look at it as a great experience. I have learned so much about life here and will go home a changed person, both professionally and personally. I have learned more from the people I have met here than they have learned from me. It has been such an honor to foster the growth and development of my profession that has given me so much. I feel so blessed to be part of the Emory family and will be eternally grateful for that fateful lunch encounter with Zoher.”

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