Guided by faith and driven by a selfless devotion to those less fortunate, Susan Athans, PT, has touched the lives of countless poor indigenous people near the northwest Mexican city of Ensenada. Focusing her efforts on children with disabilities and special needs, Athans also provides assistance to their extended families when possible. Not to mention she is a single mother of four who works full-time as a home care therapist for Sharp HealthCare in San Diego.

Starting the Journey

Growing up in Roxbury, NJ, Athans decided at age 17 that physical therapy was the career for her.

"I wanted to go into health care, but wasn't sure if I should pursue nursing or PT," she told ADVANCE. "So I volunteered at a local hospital during my senior year in high school helping the PT and nursing departments. After working in physical therapy for several months, I decided it was more along the lines of what I wanted to do-making people better and rehabbing them back to where they were before."

That path took her to the University of Delaware in Newark, which Athans said was the closest accredited PT school. She graduated with her bachelor's degree in 1983 and worked for several years in New Jersey at an acute care hospital and outpatient orthopedic clinic. Seeking new adventure, she decided to move to San Diego and started working in outpatient care for Sharp. Athans would initiate two outpatient PT programs, directing them for about eight years. Then in 2000, she experienced something that would change her life.

"I had an opportunity to join a friend who was a missionary in Romania, helping abandoned children with many disorders and disabilities. So I went there and volunteered at a children's hospital, teaching her staff normal child development and how to work with these handicapped kids. I fell in love with the work and decided I could either go to Romania once a year or Mexico once a month because it was so close."

Mexican Mission

Upon returning to the States, Athans told one of her pastors about her desire to help poor Mexican children.

"He said I should go down to Ensenada and ask a pastor named Juan Domingo what I could do. So I visited later in 2000 and was introduced to the great need of handicapped children in Mexico."

Athans estimates she has now made the trip to Ensenada, about two-and-a-half hours by car, hundreds of times. "At first I would go every other weekend, and then I actually lived there every other week for about 20 months during 2007 and 2008."

Athans works with the indigenous poor, a population that for the most part does not speak Spanish but rather a native dialect. "Because of their poverty, there's a lot of malnutrition," related Athans. "I've helped kids who were born with glaucoma, HIV, epilepsy and spina bifida." Communication with this native-speaking population can be problematic, but Athans found ways to adapt. "Some of the men speak a little Spanish and I have very choppy Spanish. We work with interpreters at times, but it's mostly done by example and demonstration. Much of the problem is they don't understand why disease happens and how hygiene comes into play. So I show them basically how to wash their hands, keep clean, give their children baths inside and keep shoes on their feet."

Athans has even drawn pictures in the dirt to help get her message across. "Wound care is important because they don't have proper protection from the elements. So we bring supplies and physically teach them how to take care of their children for everything from lice to cuts and bruises, because they'll get drastically infected."

Building Trust

Athans tries to explain very slowly, with just a few words, what's not good or is going to cause pain. "Keep it simple. You can't just go into these places and teach them something because they won't be receptive. You actually have to live with them and build a rapport, gain some trust. Before you teach, you have to learn about the culture-what motivates them and makes them do or not do things."

Slowly but surely, people will come for help when they recognize their own methods aren't working, she continued.

"When they do, we'll gently teach them. And as we make a child better, they'll come again. If you meet their needs, the trust and relationships are built over time and they learn. You want to help, but not enable or take away all their responsibility. It's about empowering them to prevent their children from becoming sick."

Although kids are the main focus, Athans and her colleagues certainly don't ignore the adults who need help. "If they are sick too, we do what we can," she explained. "Down in Mexico, you can get a lot of medicines without a doctor's prescription. So if a family is sick with worms, for instance, we're not just going to give a de-worming medicine to the baby. We'll de-worm the whole family."

Stroke is also a common occurrence among the adult population, said Athans. "Uncontrolled high blood pressure is pretty much the norm. They don't know they have it or don't bother getting medicine because it costs a certain amount of money. So I'll bring a commode to stroke victims and teach the family how to use it since they just have outhouses. Trying to get stroke patients in and out of an outhouse is very difficult, especially if they've had a severe event."

Worth the Work

Asked what she finds so rewarding about treating this poor indigent population, Athans' passion flowed through her words. "I love improving the quality of lives of children," she responded. "To help those who cannot help themselves and enable them to eventually help themselves."

She cited the example of a 12-year-old boy who had fallen off his bike and sustained paraplegia. "He was basically flat on his back in the family hut, not doing anything for eight months before we found him. We got him a wheelchair, taught him how to transfer and made a ramp for his dwelling with railings so he could pull himself up. We also taught the family how to take care of him."

Since the child had not been going to school, Athans and fellow volunteers started driving him there as well. "I would bring high-level paraplegic patients to his hut to show him that this person is the same as you and look, he can drive and play basketball."

Many of the indigenous children don't go to school because they have no birth certificates, Athans continued. "They just figure we're the poorest of the poor, we can't go to school so we're just going to work in the field for 10 bucks a day the rest of our lives because that's what we do and who we are. But we go there and say, 'No, you can learn, get a birth certificate, go to school, get a better job, make more money and help your family out of the situation they're in.' We raise the bar, which is vital to helping the children improve their lives and a simple thing we sometimes take for granted in America."

Beautiful Sight

Perhaps no case better emphasizes Athans' dedication than the 2-year-old boy who needed surgery for glaucoma.

"He was going blind," she related. "A surgery would have saved his sight so we made it happen. I found out about it, discovered he could be helped, got the doctors, the nonprofit, passport and visa and shipped him over here. He had the surgery and is seeing now, whereas before he would have been blind in an orphanage down there."

Now the boy is 4 years old, has been adopted and is living in ­Sacramento. "Even if it's just done for one child at a time, that's one child who is where he needs to be," said Athans.

A large and varying group of people assist Athans in her efforts to make such a difference. "Who is involved depends on the case," she explained. "It takes a village to raise a child, not just one person. I can't fix glaucoma, so for that child, I called up a doctor who worked for Sharp and asked what we could do. He said, 'I don't know, I need to examine him.' So I arranged for the doctor to come to Tijuana and brought the boy up there. It turned out his pressure was out of control and he needed this surgery."

So Athans called around San Diego and found a doctor who would do the procedure as well as a nonprofit to provide the surgery center. She then used her own money to acquire a passport and visa for the child with the help of friends in Mexico. "I actually talked with the Mexican government because the kid was in an orphanage. I had to ask permission to bring him across the border and save his sight. So a huge number of people were involved. I brought him across and he stayed with me for eight weeks while recovering from the surgery."

The organization that paid for the doctor and surgery center is called Fresh Start Surgical Gifts. "But every situation is different," she commented. "Sometimes I get help from Shriners Hospital or Catherine's Children's Home. I'm also on the board of an organization called Genesis, which assists the indigenous, feeds them and organizes migrant camps. So they helped me get the passport and visa and physically drive him."

To overcome the frequent challenges, Athans finds strength in her faith. "I say, 'Lord, this is the situation, I don't know how to get this kid across the border or what your plan is for him. So you lead and guide me.' And it's amazing because He does it all. I say to Him, 'If you want this kid to see, then open the door.' And He did."

Athans considers some of the outcomes she has helped produce to be truly miraculous. "There's no human explanation for how and why these things happened," she said. "Nobody has ever brought a kid from a Mexican orphanage across the border by herself. But in this particular case, they gave him to me and for whatever reason said, 'OK, go fix him and bring him back to us.' All of a sudden I had this kid with me for eight weeks and he was able to get cured."

Brian W. Ferrie is managing editor of ADVANCE and can be reached at bferrie@advanceweb.com