November 2018
by: Marina MacDougall

When the phrase "global health physiotherapy" comes up in coversation, it typically stirs images of working far away from home in some exotic locale. Rarely does one think of tundra, mountains, and more moose than people! But Canada is a vast country and physiotherapy practice in the North draws some interesting parallels to traditional "global health" work. Remote locations can mean limited access to services, and the cultural differences found among Canada's Indigenous communities can mimic the conditions for physiotherapy practice found in other parts of the world. I remember being in high school the first time I heard the phrase, "think global, act local" and it's something that has always stuck with me. After several years of involvement with the Global Health Division, that phrase was always in the back of my mind, and when the opportunity came up to take a locum position in the Yukon Territory I jumped at the chance.

Tombstone Territorial Park, YT

I spent six weeks working in a private practice clinic in Whitehorse during September/October. The clinic often takes locums so they were able to help me navigate the licensing process for practice in the Yukon and had housing available for my stay, which is one of the big challenges of a temporary move to Whitehorse. They were also able to arrange my flights to and from Vancouver with Air North - the best flight experience I've had with a Canadian airline! Up until the locum, I had never been further up north than Jasper, Alberta, and I was excited to experience the "magic of the Yukon".

Whitehorse is the major hub of the Yukon; of the 36,000 people who live in the Yukon, over 27,000 live in Whitehorse. This gives Whitehorse an interesting feeling of being the "big city" in the Territory, while still maintaining a small town feeling of a close-knit friendly community. The owner of the clinic I locumed at told me that it's one of the few places you can be truly deep into the backcountry one day, and on a plane to Europe the next.

Whitehorse, YT

From a global health perspective, I was interested to see how working in private practice would affect the feeling of a "global health" experience, which more traditionally rely on government funded or volunteer programs. I discovered that a lot of the traditional global health considerations were still valid and affected my daily practice. With Whitehorse as the major rehab centre for the Territory, the hospital outpatient clinic is busy and local clinics help distribute overflow. Many of the smaller towns throughout the Yukon don't have any available physiotherapy services and inhabitants have to make trips into town to access them. These drives often take several hours so it is not feasible to have patients return on a weekly basis. This required flexible treatment plans on focusing on patient education and home exercise programs to aid recovery. During my time there, I treated patients from the communities of Carcross, Dawson, Watson Lake, Haines, Atlin, BC, and Dease Lake, BC.

Carcross, YT from Nares Mountain

Whitehorse is home to the Kwanlin Dün and Ta'an Kwach'an First Nations communities. First Nations culture is an important part of Whitehorse's history and a present day lifestyle. The Kwanlin Dün are the largest First Nations community in the area and provide multiple community services, including the only health centre "north of 60" that is operated by First Nations people. This was a great resource for my First Nations patients as the centre works to provide culturally appropriate health interventions that were complimentary to their physiotherapy treatment.

Kwanlin Dün Cultural Centre

If you've ever wanted to have a global health experience but felt overwhelmed about how to start or where to look for opportunities, I highly recommend "acting local" and starting with the North. It is an experience that will stay with you a lifetime and give you a chance to discover some of the more remote places our beautiful country has to offer.

Marina currently works in a private practice in Vancouver, BC. She has been part of the Global Health Division since 2013 when she joined the Executive Committee as a student representative. Her insterest in global health stems from a childhood of travel, growing up in a multi-cultural household, and listening to stories her father told of working in developing nations. Inbetween her Kinesiology and Physiotherapy degrees, she spent a month in Madurai, India, volunteering as a physiotherapy assistant. Her time with the Global Health Division has helped shape her awareness of the challenges in the field of global health and she is passionate about educating physiotherapists about how they can make a meaningful impact while participating in global health work.