Student perspectives on occupational therapy overseas

University of Alberta occupational therapy students Janelle Daku, Camille Dube, Jarett Stastny, Claire McEwan, and Brookes Charlong completed an international placement in Solo, Indonesia in the summer of 2011. Through Surakarta Health Polytechnic, the students were paired with three different sites over their six-week placement.

Holly Gray - 16 November 2011

University of Alberta occupational therapy students Janelle Daku, Camille Dube, Jarett Stastny, Claire McEwan, and Brookes Charlong completed an international placement in Solo, Indonesia in the summer of 2011. Through Surakarta Health Polytechnic, the students were paired with three different sites over their six-week placement. In a recent interview, they shared their experience of completing a clinical placement abroad.

Why were you initially interested in completing a clinical placement abroad?

Janelle: I have an undergrad in sociology and I've always been interested in the differences between cultures. Basically, I wanted to be absorbed in a different culture and see how they do OT abroad.

What kind of preparation did you do beforehand?

Janelle: I had to do the International Placement application, which involved stating where I would be staying and an estimate of how much the whole trip would cost (accommodations, food, etc.). I also had to search for and book a flight, get in touch with the contacts abroad, buy gear to go (i.e. backpackers backpack for leisure travel after my placement), ensure I had all necessary immunizations, etc.

Why did you go to Indonesia?

Jarett: I'd never been to Asia and was interested in exploring! Also, there is a longstanding relationship between Surakarta Health Polytechnic and the U of A that began when several of the current Indonesian OT professors attended and graduated from the University of Alberta as international students. Surakarta Health Polytechnic has taken students from the U of A before, so the familiarity with the process made things very convenient and easy for us to get involved.

Describe OT in Indonesia:

Jarett: Indonesia is still considered a developing country and their health care system and hospitals reflect this. Indonesian OTs don't have many of the luxuries we take for granted in Canada. The resources available to OTs for practice are quite limited. This makes therapy very challenging because you have to constantly prioritize and modify treatments so that you can offer the client the best therapy possible within those limitations. It can be very frustrating when you know of a very basic treatment that would work wonders for a client, but you're incapable of providing that treatment to them because of the associated cost. On the other hand, you learn to get very creative with the supplies that are available - we created homemade playdough, built a custom commode from a lawn chair, designed a mirror-box, and made all sorts of things (from rudimentary hand splints to exercise weights) with discarded water bottles.

Janelle: I think that Indonesia still has a very negative image of mental illness and this was portrayed in the psychiatric hospital. The patients are treated more like prisoners than patients - they have a very structured day and are locked up in their wards when they do not have activities, such as rehab services. It was hard to see.

What were the Indonesian clients like?

Jarett: We spent two weeks at three different sites which gave us the opportunity to work with a wide range of clients. My sites included a public hospital where I worked with clients who have suffered a stroke, a private school working with children who were developmentally delayed, and a mental health hospital. Indonesian people in general were tremendously friendly and generous. The professionals we worked with were very receptive and eager to exchange knowledge with us.

Any heartwarming client stories?

Camille: I met one woman who had never received care and she was post-stroke after her second stroke. She was the mother of ten children between the ages of eight and 35, yet she didn't know her own age and guessed she was in her 50s or 60s. I visited this woman three times, and our conversations were translated through an Indonesia occupational therapy student. On my last visit I asked for a picture and explained I wouldn't be back, and she started crying. I was touched by the fact that even though we didn't speak a word to eachother in the same language, we had developed a therapeutic rapport that clearly meant so much to her.

What was the Indonesian culture like?

Jarett: The vast majority of people on the island of Java are Muslim so their religious practices were very much a part of everyday life. On top of that, it's quite unusual to see Caucasians in Surakarta so we got a lot of attention - it seemed like everyone wanted to say hello to us, or take a photo with us, or sometimes even just to practice English with us!

Did you experience any culture shock?

Janelle: I think I did the second day, but just for the day. I was just like, "Wow, what am I doing here!" But this feeling faded quickly as I realized I was there to immerse myself in a different culture.

What was your living situation like?

Jarett: There were five of us students living together in a small house about two blocks from campus. Each street was its own small community and we became immersed in ours. It was common for us to buy fruit or hire laundry service from our neighbours!

Janelle: It was definitely very different from what I am used to in Canada. It took some getting used to - I just kept telling myself to think of it like camping! The washroom was probably the one thing that took the longest to get used to - the toilet was right with the shower.

Did you do any sightseeing?

Jarett: We had a chance to explore a good chunk of Java on the weekends, including the UNESCO world heritage sites of Borobudur Temple and Prambanan Temple. Plus we had the Bali beaches to look forward to at the end of it all!

Camille: We had free time in evenings and weekends. We went everywhere. We hiked Mount Merapi volcano, visited many temples including Prambanan, went to a beach that had white sand and black sand combined, and I went to Bali with Brookes and Claire. Indonesia was almost like a clash of two worlds because there'd be a huge mall on one side of the streets and then on the other side there'd be all the market vendors lined up selling their fried chicken and such.

Did you stay longer after your clinical placement to travel?

Jarett: Our clinical placement was six weeks long and my vacation afterwards was even longer! I was lucky to have this placement as my last so I didn't have any classes to rush home for. Being able to vacation, especially in Southeast Asia where it is relatively inexpensive to do so, was definitely a big draw for me.

Janelle: I travelled to Bali for two weeks afterwards and then to Australia for two more weeks.

Any advice to pass on to others considering an international placement?

Camille: I would recommend that students fundraise beforehand in order to purchase equipment and supplies to help clients. We often spent money out of our own pockets, and fundraising beforehand would have helped.

Describe your placement abroad in three sentences:

Janelle: It was an experience of a lifetime. Nothing can compare to the challenges I went through in Indonesia but in the end it was all worth it! I feel blessed to have had such an amazing opportunity to grow as an individual.

About the University of Alberta Faculty of Rehabilitation Medicine

As the only free standing faculty of rehabilitation in Canada, the University of Alberta Faculty of Rehabilitation Medicine balances its activities among learning, discovery and citizenship (including clinical practice). A research leader in musculoskeletal health, spinal cord injuries and common spinal disorders (back pain), the Faculty of Rehabilitation Medicine aims to improve the quality of life of citizens in our community. The three departments, Occupational Therapy (OT), Physical Therapy (PT) and Speech Pathology and Audiology (SPA) offer professional entry programs. The Faculty offers thesis-based MSc and PhD programs in Rehabilitation Science, attracting students from a variety of disciplines including OT, PT, SLP, psychology, physical education, medicine and engineering.