Caira Lavelle - Occupational Therapy in Thailand
It is a common occurrence for people to ask what you do, then smile politely when you say 'occupational therapy'. This is usually because they don't know what occupational therapy is, and in all honesty, there is no easy one way for one to quickly summarize what occupational therapists do. Some might say that occupational therapists provide people with 'skills for the job of living', others might say that they promote independence and empowerment in others.
Because of the breadth of essential skills required, occupational therapy students are required to complete a number of placements in a range of different settings throughout the course of their degree. For my final placement, I wanted to challenge myself, to throw myself into the deep end and see if I could swim. Was I was ready to make informed decisions based on clinical reasoning, problem-solving and be creative about the therapy I provide for my patients?
While I was pondering these thoughts and trawling the internet, I stumbled upon Projects Abroad, who I read had internships in occupational therapy. Some application forms and negotiations later, I was accepted on to the projects in Thailand, a new project where I would be the first volunteer. No pressure there then!
Thailand became a member of the World Federation of Occupational Therapists in 2002. The number of working therapists is still low, with approximately five hundred in the whole of Thailand. I was to be located in Surat Thani Hospital, a tertiary care hospital for the southern provinces of Thailand, where there are four qualified occupational therapists. Unlike a final placement at home, which I would be organising myself, I had Nou, my co-coordinator from the projects who did all the initial organising for me.
Nou joined me on my first day at the hospital. I was naturally nervous but more excited and keen to get started. The team was so friendly and welcoming and made me feel instantly at ease. They showed me my desk space and around the department. The department was not too different from departments found in the west; rooms for therapy, activities of daily living and a sensory integration room. The most notable difference for me was the language barrier. Nou acted as my translator and I wondered how I would manage when she was not around...
I have now been at the hospital for five weeks and certainly think of myself as a team member. Language differences have been the main barrier, but my skills in problem-solving and creative thinking have overcome difficulties when working with my patients. I use diagrams, gesticulations and ask others to help with interpreting. The hospital staff and the friendly locals are keen to try out their English, and I have been made to feel very welcome in Surat Thani. This is especially helpful as I have been the only farang (foreigner) in the local vicinity.
In terms of occupational therapy practice, I have experienced plenty of hands-on experience in paediatrics, orthopaedics and hand therapy. I have also learnt a great deal about the differences between eastern and western approaches to occupational therapy and how, despite the profession originating from the west, the theoretical philosophies underpinning western practice are not always appropriate for Thai culture.
Outpatients mostly attend in the mornings and in-patients are visited on the ward in the afternoon. Unlike the west, where there is rigid structure to days, client appointment times, from assessments through to reviews are much more relaxed. I remember noticing early on that the client and their family are treated like extended family members.
I have certainly fulfilled my quest in seeking a challenge, and the challenge may not have been as conscious as my initial reasons for coming. I have learned a lot about myself as a person, on a practical and emotional level, and most importantly about the kind of therapist I will become once qualified. I would highly recommend volunteering abroad to people who wish to seek out a challenge in life unconsciously or consciously!