When Noemi was fifteen and pregnant, her spine was fractured in a devastating vehicle accident. (We shared some of Noemi’s story a few months ago.)

After delivering a healthy, full-term boy, she lived at home with her parents. Depressed by her extensive paralysis, she rarely left the house. Several months after the accident, a compassionate teacher’s visits to her home lifted Noemi’s spirits, motivated her to return to school in spite of constant barriers, and inspired her to pursue a technical career. Noemi enrolled in a computer science program at the Eterazama technical school, an institute with which Mano a Mano has a long-standing internship relationship.

Noemi combines an IT internship with intensive rehabilitation in Mano a Mano’s physical therapy program in Cochabamba

Noemi’s Internship

About to finish her Eterazama degree in computer science in a few months, Noemi must meet one final requirement – complete an internship where she could practice and demonstrate her knowledge and computer skills. Mano a Mano provides the perfect opportunity.    

Mano a Mano staff, volunteers, and interns gathered for a distribution of school supplies at the Mano a Mano office/warehouse site – February 2024

Noemi’s internship with our physical therapy program started 4 months ago. Noemi and Mano a Mano staff organize her schedule so she can receive physical therapy every day and also complete her internship assignments.

Noemi’s computer technician internship involves improving the physical therapy program’s spreadsheets and digitizing them. She helps maintain the computer systems and installs programs on computers that will be distributed to schools. And if she still has time, she wheels herself to the medical supply warehouse and helps volunteers who are working there.

Volunteers at our Cochabamba warehouse sorting supplies sent from Minnesota into more specific categories in preparation for distribution throughout Bolivia.

Noemi’s Physical Therapy

All new patients in Mano a Mano’s physical therapy program undergo three evaluations: medical, physical therapy, and psychological. First – the medical evaluation. Volunteer physician Dr. Paola Guarayo’s examination of Noemi resulted in an unexpected finding: three serious ulcers on the backs of Noemi’s legs that required deep cleaning and several stitches. Medical supplies shipped from Minnesota were immediately available for this purpose.


With ulcer treatment in process, Noelia, our lead physical therapist, could initiate her assessment of Noemi’s therapy needs. Because Noemi’s mobility depends on sufficient arm strength to propel her wheelchair, the therapist chose a set of weights for her to use while a specialized stander supports her.

The current focus of Noemi’s daily 45-minute therapy sessions: balance, core/trunk strengthening, and improving motor skills – all intended to increase her mobility, flexibility, and general health.


Co-located with Mano a Mano’s Center for Ecological Agriculture (CEA) and our medical supply sorting and distribution facilities in El Abra, Cochabamba, Bolivia, physical therapy program patients, including Noemi, have access to a handicapped accessible dry bathroom and to a shower.

The Physical Therapy Program is housed in the office building in the bottom left corner of Mano a Mano’s office/warehouse site in El Abra, Cochabamba.

The physical therapy program’s third patient evaluation involves a psychological assessment.  Noemi says that she has found refuge at Mano a Mano, that she has learned to make friends and feel accepted, that the psychologists have helped her look at her problems from a different perspective and see that she has much to contribute. “Every day I work with about 30 people who make me feel like family,” she says. “I have support and encouragement from everyone. Thanks to those who have made this program possible for me.”

“Every day I work with about 30 people who make me feel like family,” Noemi says. “I have support and encouragement from everyone. Thanks to those who have made this program possible for me.”

Learn More

Jhostin is one participant in Mano a Mano’s physical therapy program