Part 2: How Physical Therapists Are Helping Women’s Health on the Global Stage

In January, I attended a presentation by Dr. Laura Keyser, a prominent figure in world of pelvic and global health. Keyser has been a physical therapist for 12 years and has developed public health expertise in maternal and child health. She also is the co-founder of Mama, LLC, which is a physical therapy and public health consulting firm that specializes in women’s and girl’s health. I had the wonderful opportunity to pick Dr. Keyser’s brain about global women’s health issues and how she sees physical therapy helping solve those problems.

For the past ten years, Dr. Keyser has acted as a consultant to local and international organizations such as Global Strategies, EngenderHealth, the Harvard Humanitarian Initiative, Panzi Hospital and Foundations and HEAL Africa DRC. Through this role she has developed rehabilitation programs and community outreach initiatives in many parts of Africa and south Asia. When asked about her first international experience in the Democratic Republic of Congo (DRC), she reports:

“I began treating women who had experienced gynecologic injury as a result of obstetric trauma and/or conflict-related sexualized violence. Many of these women were in need of physical rehabilitation to address concerns, such as incontinence, sexual dysfunction, pelvic pain, and other musculoskeletal conditions. I, along with my colleague Jessica McKinney, worked with local physicians, nurses and physical therapy staff to evaluate and treat these conditions and to build a sustainable rehabilitation program there.”

Dr. Keyser has helped open the door to pelvic health in clinics throughout the DRC, Rwanda, Nigeria, and Niger. In her initiatives, she communicates and educates many types or providers on the importance pelvic health physical therapy, and most importantly, the sensitivity of certain issues:

“I emphasize to providers the importance of informed consent and woman-centered care, as well as the primary role of educating women about their pelvic anatomy, their injuries, and the goals of pelvic health physical therapy. I also begin instructing on evaluation skills and treatment techniques that do not necessarily require a more invasive internal pelvic muscle exam, so that any provider can feel they have some tools to help women recover their pelvic health and function.”

Dr. Keyser has real clinical insight on the need for rehabilitation therapists in the low-resourced settings. Her efforts have had tremendous impact on local communities, however she shared that there are just not enough pelvic health physical therapists to meet the need. Dr. Keyser reports:

“While building clinical exposure and skills for the local physical therapists is always at the heart of my work, I have also found it beneficial and necessary to include the entire health care team to task share various aspects of physical therapy care. There simply are not enough physical therapists in low-income, low-resource areas to provide individualized care to each woman in need.”

She believes that physical therapists can help solve some of the global reproductive and maternal health challenges. First, she believes that as a physical therapy community, we need to acknowledge the magnitude of maternal health epidemiology statistics. If we acknowledge their importance, then entry-level physical therapy programs will begin to implement and integrate more women’s health and pelvic health training to ensure proficiency in this area. Secondly, Dr. Keyser believes that physical therapists need to forge new paths for our profession—to collaborate more with rights-focused NGOs and to dive into health policy and international health. She reports, “I think we’ll discover and demonstrate that the physical therapist’s skill set is much broader than the reputation that precedes us.”

It is obvious to see that Dr. Keyser is a profound leader not only the in the realm of pelvic health, but even greatly so in the realm of global health. I hope to someday step into a new arena and make my own way like Dr. Keyser has.

For an overview of pelvic health physical therapy please read the Part 1: An Introduction to Pelvic Health Therapy Services. Stay tuned for Part 3 of this series coming next week!


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