Experiences of working overseas as an OT

1. Experiences of working overseas as an OT Alice Shipman Wed 5th Nov 2014

2. Content • Introduction • Danger of a single story • Share personal experiences • Share Challenges when working out of your context • Identify benefits of working overseas • What is OT Frontiers? ADAPT? • Resources available • Question time

3. Thoughts? Feelings? Emotions?

4. Provoke the same emotions?

5. The danger of a single story…? Chimamanda Adichie https://www.youtube.com/watch?v=D9Ihs241zeg

6. Chimanda goes on to share how she too has been guilty of believing a single story and how it is all to easy to buy into the media and stories… When we show people as one thing, over and over and over again that leads to single stories – stereotypes – often incomplete and can rob people of dignity by emphasising our differences not similarities. She concludes… when we reject the single story we regain a kind of paradise

7. Snippets from a colleagues blog… “There is just no single story of what Occupational Therapy is. Like all the best professions, it can’t be explained in a one-liner. And there is ALWAYS DANGER IN THE SINGLE STORY. If I condense OT down to a single story, you’ll miss the beauty of its diversity”  ”We all want to present the exciting, together, beautiful story of our lives. We all buy into each others’ mythical cyber lives everyday. I know I do.” “I hope you’re getting the right picture. My life IS as good, beautiful, picturesque, fun and full as the pictures tell…..  It is also hard, lonely, sad, challenging and very ordinary.” Hesitant to convey any single story to you, at the risk that I will contribute to the culture and practice of the single story – so please remember – this is just one story of which I am the narrator… I encourage you to make your own

8. My story so far… Don’t let it be your single story! Studies / Overseas placement Work /Conference Malawi - Lilongwe Move to Blantyre Current situation – work/study

9. The personal and professional benefits to experiencing OT from a global perspective Cultural awareness Personal and professional development Increase professional confidence and belief in its value Enhances skill set: problem solving, communication, observation Project management skills Creativity and innovation Collaborative working Working in an ethical and sustainable way International work offers healthcare professionals the opportunity to ‘develop a range of hard and soft skills such as clinical, managerial, leadership, cultural and educational skills, which are beneficial to and transferable to the NHS’ (DH, 2010).

12. Thinking about it? A few practical pointers… Personal matters for example, will your personal relationships be put under excessive strain? Safety Do you think you personally could fit in with the local culture and environment? Also check the foreign office travel advice if you are unsure of the current situation in the country you intend to visit Clinical experience are your clinical skills sufficiently well developed at home for you to manage the additional challenges of working in a low-income context? Relevant skills to support local priorities Can you offer something that is genuinely wanted and needed in the country you intend to visit? Are you sure this cannot be provided by someone more local than you? Remember, we should aim to enhance local care. We do not want to undermine it, overburden it, distract it from more urgent priorities, or make it dependent on us. How well has the project been set up? For example, have clear and realistic goals been agreed with the host organisation?

13. Humanitarian Workers - some additional risks and stresses in an emergency situation: • Exposure to the environment that precipitated or sustains a crisis or event, such as a natural disaster or conflict • Working long hours under adverse or extreme conditions, often in close contact with the affected population • Damaged or absent infrastructure, including availability of food, water, lodging, transportation, and health services • Reduced levels of security and protection particularly where affected populations become desperate. • Stress, ethical, and moral challenges related to the event and the resource

14. Cultural competence This model highlights that cultural competency comes, evolves and changes over time – it is an ongoing process. More on Papadopoulos’s model: http://www.ieneproject.eu/learning_intro.php_

15. What is ? A network of occupational therapists based in the UK who support the development of occupational therapy in low and middle income countries. We collaborate with our overseas colleagues in projects they undertake. We strive to understand how as UK occupational therapists we can most appropriately apply our practice in the context of these countries.

16. Resources available Occupational Therapists: World Federation of Occupational Therapy: http://www.wfot.org/ OT Frontiers: http://www.otfrontiers.co.uk/ Occupational Therapy African Regional Group: www.otarg.org.za/ British Association of Occupational Therapy: www.cot.co.uk Physiotherapists: ADAPT www.adapt.csp.org.uk/ Speech and Language Therapists: CTI - http://comtherapint.wordpress.com/ https://www.facebook.com/communicationtherapyinternational Nurses & Midwives: http://www.nmc-uk.org/Registration/Planning-to-work-outside-the-UK/ http://www.rcn.org.uk/__data/assets/pdf_file/0007/347920/Working_with_humanitarian_organisations.2010.pdf

17. Websites: VSO - http://www.vso.org.uk/volunteer/opportunities/health Handicap international: http://www.handicap-international.org.uk/ Skillshare International: www.skillshare.org People Potential: www.peoplepotential.org.uk MAITS (Multi Agency International Training and Support): www.maits.org.uk The TALC website  www.talcuk.org The Hesperian Foundation Website: http://hesperian.org/ THET: www.thet.org/ Great OT resources: WFOT (2013) Working as an Occupational Therapist in Another Country (WFOT website) Alers, V., Crouch, R.(eds.) 2010. Occupational therapy.  An African perspective, Johannesburg: Sarah Shorten Publishers. Kronenberg, F, Algado, S & Pollard, N (2001) Occupational Therapy without borders Learning from the spirit of survivors: Elsivier, Churchill Livingstone Kinebanian, A. Stomph, M.,2009. Guiding principles on diversity and culture. World Federation of Occupational Therapists. WFOT website.

18. Practice, policy, guidelines & curriculum development bits: Building a caring future.  Hospital, community, home. Toolkit for gathering evidence from  international development work for CPD portfolio. Intended for NHS staff going overseas then returning to the NHS to be able to make a record of their professional development in terms meaningful to NHS managers.http://www.thet.org/hps/resources/publications/building-a-caring-future Improving health at home and abroad. Report.  How overseas volunteering from the NHS benefits the UK and the world. http://www.rcpsych.ac.uk/pdf/Improving%20Health%20at%20Home%20and%20Abroad%20-%20Final%20Report.pdf Longstaff, B., 2012. How international health links can help the NHS workforce develop. Health Service Journal. Available:http://www.hsj.co.uk/resource-centre/leadership/how-international-health-links-can-help-the-nhs-workforce-develop/5044915.article World Report on Disability. http://www.who.int/disabilities/world_report/2011/en/ CBR Guidelines . http://www.who.int/disabilities/cbr/guidelines/en/ The UN convention on the rights of persons with disabilities (CRPD).http://www.un.org/disabilities/convention/conventionfull.shtml Guidelines on the provision of manual wheelchairs in less resourced setting.  http://www.who.int/disabilities/publications/technology/wheelchairguidelines/en/index.html Getting to know cerebral palsy. Working with parent groups – a training resource for facilitators, parents, caregivers, and persons with cerebral palsy.  Pretty much the official guidelines now. http://disabilitycentre.lshtm.ac.uk/publication-of-getting-to-know-cerebral-palsy-manual/

19. A few bits by OT Frontiers members, some with CTI and ADAPT colleagues: Ekwan, F., Lassman, R., 2012.  The vision for Occupational Therapy in Mental Health in Uganda Celebrating the Unique Contribution of Occupational Therapy.  A Research Project and Position Paper. http://www.wfot.org/Newsletter/201208/OTinMentalHealthinUgandaResearchProject.aspx Bringing hope to the developing world. Atkinson, C., 2005.  Bringing hope to the developing world.  OTnews, August, 39. Adams, M., Barker, C. Brundle, C., Everett, T., Waddell, M.A., Wilson, A.,2012. Collaboration, coordination, communication: Common challenges to effective international working. OT Frontiers, communication Therapy International, ADAPT.  Available from enquiries@otfrontiers.com. The cultural competency debate.  Professional role and identity in Uganda.  Atkinson, C. 2008. OTnews, June, 44. What is cultural competency? Ugandan OTs’ perspectives. Brundle, C. 2007. OTnews, July, 28. A training week in Uganda.  Describes a CPD event with British OTs and Ugandan OTs in Uganda.  Atkinson, C., Wilson, A.  2009. OTnews, July, 46-47. Atkinson, C., Landrock, A., 2011. Using action learning sets to facilitate CPD in Uganda. OTnews, February, 38-40. The manual on preparing to work overseas from the joint 2014 study day “Working Abroad: Guidance for Allied Health Professionals” is available on http://comtherapint.wordpress.com/downloadable-resources/ There is a pack on the OT Frontiers website about volunteering agencies “Working As A Volunteer Abroad”http://otfrontiers.co.uk/media/docs/Working%20as%20a%20volunteer%20abroad.pdf A few bits by OT Frontiers members, some with CTI and ADAPT colleagues: Ekwan, F., Lassman, R., 2012.  The vision for Occupational Therapy in Mental Health in Uganda Celebrating the Unique Contribution of Occupational Therapy.  A Research Project and Position Paper. http://www.wfot.org/Newsletter/201208/OTinMentalHealthinUgandaResearchProject.aspx Bringing hope to the developing world. Atkinson, C., 2005.  Bringing hope to the developing world.  OTnews, August, 39. Adams, M., Barker, C. Brundle, C., Everett, T., Waddell, M.A., Wilson, A.,2012. Collaboration, coordination, communication: Common challenges to effective international working. OT Frontiers, communication Therapy International, ADAPT.  Available from enquiries@otfrontiers.com. The cultural competency debate.  Professional role and identity in Uganda.  Atkinson, C. 2008. OTnews, June, 44. What is cultural competency? Ugandan OTs’ perspectives. Brundle, C. 2007. OTnews, July, 28. A training week in Uganda.  Describes a CPD event with British OTs and Ugandan OTs in Uganda.  Atkinson, C., Wilson, A.  2009. OTnews, July, 46-47. Atkinson, C., Landrock, A., 2011. Using action learning sets to facilitate CPD in Uganda. OTnews, February, 38-40. The manual on preparing to work overseas from the joint 2014 study day “Working Abroad: Guidance for Allied Health Professionals” is available on http://comtherapint.wordpress.com/downloadable-resources/ There is a pack on the OT Frontiers website about volunteering agencies “Working As A Volunteer Abroad”http://otfrontiers.co.uk/media/docs/Working%20as%20a%20volunteer%20abroad.pdf Interesting blogs: This blog is an interesting and insightful report from a humanitarian worker: http://trauma.blog.yorku.ca/2012/02/trauma-and-the-humanitarian-aid-worker/ Alice’s colleague in Malawi: http://kateswonderingsandwanderings.com/2014/08/

20. Any Questions? Thanks for listening aliceshipman@googlemail.com