ÉäÒùʪ

Henry Mitchell Scholarship Report

May 20, 2014 marked the start of my six---week journey abroad to participate in fieldwork through University of the Western Cape (UWC) in Cape Town, South Africa. I had just finished my first semester of my graduate studies in occupational therapy and was excited to be putting my knowledge to work.

I applied for the Henry Mitchell Scholarship in October of 2013 and was one of two students chosen to represent the University of ÉäÒùʪ Department of Occupational Therapy at UWC. I had several reasons for applying to the exchange program, a few of which were: experience occupational therapy in a different social context, getting to travel to a different country, and be exposed to a different culture.

Due to conflicts in university semester schedules, I was not able to participate in coursework at UWC; however, the department placed me into two fieldwork sites to work under occupational therapists. For the first three weeks, I was at St. Joseph’s School and the second three weeks I was in Tygerberg Hospital’s outpatient pediatric clinic.

I was somewhat anxious arriving in South Africa because I felt unprepared and was not given any guidelines or expectations prior to my arrival. The communication leading up to the trip had been between me, the other occupational therapy student going on the trip, an administrator here at Mizzou, and the department chairs at UWC. There was no communication from our department of occupational therapy and there was not to be any credit awarded from Mizzou. Therefore, this trip was completely voluntary on our part and any expectations were to be set up by UWC. This was communicated to the administrators at UWC, but I felt it was not understood, which led to some misconstructions as far as expectations given for the trip. I was, however, given a supervisor from UWC who visited me weekly at my sites and kept up with my work, progress, answered any questions, observed a group that I led, and provided feedback.

St. Joseph’s School is a special needs school connected to St. Joseph’s Home for Children. The children in the home receive long---term care for a variety of chronic illnesses and are being treated there because they don’t have access to the level of care they need in their normal environment. If the children are school---aged, they attend the school while staying in the home. The school was originally built for the children of the home, but as time went on the institution noticed there were children in the community who were not receiving the level of education they needed, so they now accept children from the community in their school. There are three occupational therapists in the school and I worked closely with all of them. I was given two children to primarily work with during my time there, but if there was ever a need for an extra child to be seen in a day, I would

work with them as well. The language barrier was a difficulty I experienced in the school, as the children were typically fluent in either Afrikaans or English, but not both, and I do not speak any Afrikaans.

St. Joseph’s Home

I spent a lot of time in a classroom with 6 and 7 year---olds because there were not enough children to be seen in therapy during the time period I was at the school. Also, the school day ended at 1 PM for the children, so I had an extended amount of time to do things with the children in the home until I was picked up at 3 PM. I asked if I could work with the OTs in the home, but they had two students and felt like their plates were full and they could not provide a good experience. So after school, I would typically play with some of the school children that were not picked up until around 2 PM and once their rides arrived, I would go to the home and play with the children there. I had a great time with the children at St. Joseph’s, but my supervisor and I felt I was not getting a complete occupational therapy and contextual experience at St. Joseph’s; consequently I was switched to Tygerberg Hospital for my last three weeks in South Africa.

One of my clients in school

The children I would play with after school

Tygerberg Hospital is a large government hospital that has several occupational therapy departments and I was placed in the outpatient pediatric clinic. I felt very welcomed by the entire department and was not intimidated by anyone. In the outpatient clinic, I did developmental assessments, check---ups on home programs, and interventions on children that had developmental delays. The OT there was very good in letting me observe her sessions and letting me lead some of my own sessions with her observing and providing concurrent feedback.

I did not spend all of my time in the outpatient clinic; part of this was due to the fact that almost none of my clients showed up to their appointments, which gave me lots of free time, and part of it was due to the fact that I was given the opportunities to spend time in the other parts of the hospital. There was one other OT student there doing a short fieldwork and we were able to spend lots of time together on the inpatient wards. Since my clients had the tendency to not come to their appointments, I was given some inpatient pediatric patients of my own. This really opened my eyes to the socioeconomic aspects of the individuals living in the surrounding area. I worked with several children that had tuberculosis meningitis, HIV, and other unknown conditions. These are not common diagnoses that I will come across in practice in the United States which I felt was good to experience because it helped broaden my interest and knowledge of occupational therapy in another culture. I also got the chance to talk about the similarities and differences in OT with the student that was there. It was nice to get a native’s perspective on everything we saw.

Tygerberg Hospital

The outpatient pediatric treatment room

I only spent my weekdays at my fieldwork placements, which gave me ample time to sightsee with my classmate and the other OT students at UWC and the other universities. I felt very comfortable and safe the entire time I was in South Africa and I

can contribute a lot of that to the welcoming nature of the faculty and students in Cape Town. I had the chance to visit Table Mountain twice, go to the V&A Waterfront, see the penguins at Boulders Beach, visit some of the museums in Cape Town, and see numerous other places. My social calendar was filled and I was very grateful for that, because I did not want to miss out on all the wonderful things Cape Town had to offer.

Looking over Cape Town from the top of Table Mountain

Enjoying lunch with some OT students at the V&A Waterfront

I truly enjoyed myself in South Africa; however, I felt that the program was not organized very well and that there may have been some misunderstandings. I feel that there should be more coordination between the departments of occupational therapy at UWC and Mizzou in order to receive a more well rounded experience. If there had been more coordination, I believe it could have prevented any apprehension I had about starting at my first fieldwork site.

Overall, I was very pleased with my South African endeavor. I had the chance to experience everything I wanted to and so much more. My horizons have been broadened and I can say that I have changed the way I approach occupational therapy in my studies because I encountered so many different things in South Africa. I believe that everyone should come in contact with different cultures, contexts, and environments because it can make one appreciate all they have in their lives.