We were very grateful to have had the opportunity to have a placement at REACH and ILLC. Coming from Toronto, we were really excited to learn about how Occupational Therapy (OT) is practiced in the Philippines and we feel that we were able to learn a lot. All of the staff at both centers were very welcoming and worked to ensure our learning goals were met. Not only were we able to learn about OT, however, we were also able to learn a lot about Filipino culture and experience Christmas in the Philippines! We really loved traveling around the Philippines- It is such a beautiful country!
In terms of our time at REACH, it was amazing to be able to connect with the children and families that we worked with. Working in a community based rehabilitation center was new for all of us and so we were grateful to gain new insight into this realm of practice. We were impressed by the resilience of the Philippino families that we worked with and the knowledge of all of the other staff.
At ILLC, we were really grateful for the independence that we were given working one-on-one with students and leading our own sessions in the classroom. We appreciate the support we were given by the classroom teachers to make this possible.
We could not have completed this placement without the support of Sir Archie and Jeffrey from U of T. They continuously supported us throughout our time in the Philippines, while working to ensure we were challenged intellectually so we could grow as OTs.
Working in the Philippines at ILLC and REACH was a learning experience that we will remember forever!
Michelle, Hannah, Rose, Maddie and Nadine
Essay for ICDR
A once-in-a-lifetime opportunity.
A lifetime of memories.
Clinical placement in the Philippines:
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– If you are interested of doing an internship in a community-based setting in the Philippines.
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First PT placement in the Philippines
It is with great excitement and fond memories that I reflect on my physiotherapy internship in the Philippines. I have had a strong interest in global health for several years, particularly in the paediatric population, and my time in metro Manila allowed me to appreciate the similarities and differences in the provision of healthcare and physiotherapy services across the globe. As such, I feel that this internship not only provided me with a once-in-a-lifetime learning opportunity, but also facilitated professional self-reflection and heightened my understanding of cultural sensitivities, all of which has ultimately made me a better clinician.
To say that the five weeks that I spent in the Philippines was eventful would be a huge understatement. I experienced two very different sides of physiotherapy through internships in both a private clinic and community-based rehab setting. Quality Life Discoveries (QLD), which was the private clinic I was situated at, catered to paediatric populations suffering from neurological deficits. Global Developmental Delay (GDD), Mental Retardation (MR), Autism, Cerebral Palsy, and Spina Bifida were just some of the conditions that I was exposed to in this setting. The clinic boasts some of the best technology available in the Philippines, which I was not at all expecting. These included: a multisensory environment room (laden with different textures and toys to encourage children to explore their environment), hyperbaric oxygen chamber, and heated pool for aquatherapy. Much of the way this clinic ran its operations was comparable to physiotherapy delivery in Canada, and I was fortunate enough to participate in and lead aquatherapy sessions, which remains one of my favourite experiences of the internship.
In contrast, community-based rehab was an entirely new experience for me. Consequently, Project R.E.A.C.H. (Rehabilitation, Empowerment, & Assimilation for Children with Handicap), put simply, was both extremely challenging and rewarding. Similar to the framework in the U.S., healthcare in the country varies from very high class, to non-existent, with most of the national burden being taken up by private health providers. As hospitals can be either government-funded or privately funded, the access to physical therapy varies among Filipino peoples, and favours those with affluent incomes. This poses complications to those who can’t afford such services. Project R.E.A.C.H is just one of the initiatives to provide care to the indigent populations of the Philippines by offering free health services in exchange for volunteerism. In other words, family members or friends of children with disabilities are expected to volunteer their time in exchange for that child’s rehabilitation. The volunteer roles available include assisting with clinic maintenance, carrying out exercises designed by the PT or intern, or leading lesson plans in the special education classes.
Each PT intern was designated one of these ‘CREW’ (Community Rehab & Education Worker) members for each patient on their caseload. For me, having what was essentially a personal PTA for the duration of my placement was both helpful and intimidating. Because of language barriers, it was hard to determine how much of my instructions the CREW were understanding, or what they were expecting of me. Though I found it challenging to remain more ‘hands-off’ during therapy sessions and instead take on a supervisory role, this responsibility was helpful in the end in terms of gaining leadership skills and confidence in my program planning. I also admired Project R.E.A.C.H’s dedication to multidisciplinary care. One of the assignments that I had to do for this site included a full assessment of a new patient that was conducted alongside an OT intern and SLP intern. From that assessment, we had to devise interdisciplinary goals and schedule how we could best combine our skills to deliver effective patient-centered care. It’s not often that PT students get to interact with their OT or SLP colleagues, so I highly valued this experience.
Although internship days were long and tiring, I was still able to immerse myself into Filipino culture. From riding the Jeepney/tricycle on my own, to wandering the streets of Mandaluyong during a monsoon, to eating Halo-Halo at Kawayan Cove in Batangas, I was fortunate to experience some of Manila’s travel highlights. I was blessed to remain healthy for the duration of my travels, and while I never did end up testing my luck with Filipino street food, I discovered a new all-time favourite dish in Laing. Most importantly, I was able to witness the friendliness and warm-hearted nature that Filipino people are most famous for. The acceptance that I felt when I was there further sparked my interest in physiotherapy in a global context, and inspired me to become involved as a laboratory assistant with the University of Toronto’s OIEPB program, which helps ease the transition for internationally educated physiotherapists to practice in Canada.
As the first Canadian physiotherapy student to have an internship in the Philippines, there were several moments of uncertainty and frustration during the planning process as well as the actual internship itself. In truth, not every day that I spent there was positive, which I think is realistic and comparable to any other internship that I would have experienced in Canada. Differences in techniques like transfers, exercises, or the use of assistive devices created situations of conflict that required understanding from both parties to turn into positive teachable moments.
I can honestly say that my placement to the Philippines was one of the most challenging and rewarding experiences of my life, and while it may not be for everyone, I would highly recommend this experience for anyone with an interest and the financial means to go.
BSc (Hons) SSP KINE
International Fieldwork Experience
SYPNOSIS PLACEMENT PHILIPPINES
In Canada, financial and material resources for occupational therapists are readily available. However, my experience at Kaakbay has taught me that while all these things are helpful, the most important aspect in occupational therapy interventions are the people and the relations that are created.
As part of my placement, I planned scheduled activity programs that were designed to meet the child’s specific sensory needs. When the sensory needs are met, the nervous system feels properly organized and the child is able to attend, learn, play and interact. As occupational therapists, we also modify the daily routine, provide environmental adaptations with the available resources, suggest leisure activities, interaction strategies as well as educate the family. Through community visits, I came to observe the disparities that exist between different communities as well as the significant impact that available resources for clients can have.
I also had the opportunity to discuss several matters with the Dean, teachers and students enrolled in the new occupational therapy program at the Davao Doctor’s College. It is a very intensive and thorough program. The students are very motivated, disciplined and very well educated.
During Kaakbay’s Annual Recognition Day, we took the opportunity to highlight everyone’s accomplishments over the past year. Each child received an award, indicating their strengths, some demonstrated their talents by dancing or singing and everyone participated in various games and activities. It was memorable day for the children, the staff and the parents.
Asides from the work, I truly enjoyed and took advantage of my time there during the weekends. My new friends assured my stay would be a memorable one and organized trips to various locations. Every weekend was a new getaway. Davao and its surroundings is an amazing place I truly fell in love with. Although the scenery, the beaches, the food and the history are unforgettable, Davao would not be half as amazing without its people. The people make Davao the terrific place it is. They are hard working, dedicated and devoted people. Joking and laughing at every occasion, they truly are positive people. From the very first day, my foster parents took me in like their own child. Filipinos are incredibly hospitable people and love entertaining foreign visitors. I will forever remember Filipinos for their generosity, their hospitality and their exceptional friendliness. The old proverb “It takes a village to raise a child“may be African but I found it to be very appropriate to describe the communal spirit I saw during my time at Kaakbay in Davao.
– Mary-Eve Vermette
Mon expérience de stage aux Philippines
Ce fut un stage tout à fait unique, une expérience enrichissante qui m'a permis de découvrir une très belle ville, une culture captivante et des gens très sympathiques. Dès la première journée , j'ai été chaleureusement accueilli et les employés de Kaakbay m'ont amené dégusté le fruit typique de la ville : le durian, un délice, un fruit si crémeux.
J'ai vraiment apprécié travailler avec les enfants atteints d'autisme. Il s'agissait de ma première expérience avec cette clientèle spécifique et je pouvais voir concrètement que les interventions en ergothérapie avaient un effet bénéfique pour ces enfants au niveau fonctionnel et des interactions avec les autres dans le futur. Les enfants et leur famille étaient très attachants et j'ai adoré pouvoir assisté à leur Recognition Day. J'ai pu voir que les employés de Kaakbay sont des gens passionnés et qui prennent la cause des enfants atteints d'autisme à cœur.
J'ai aussi apprécié le fait que dans ce stage , le superviseur m'a donné on propre (caseload) de clients dont j'étais responsable durant toute la durée du stage. J'aime avoir un plus haut niveau de responsabilités qui me permet ainsi de développer toutes les habiletés requises pour devenir une future ergothérapeute. J'ai pu faire mes propres plans d'interventions, prendre en charge les clients, être créative pour trouver des modalités d'interventions appropriées et selon les ressources disponibles, écrire les rapports de progression, mais aussi visiter l'environnement de vie de certains de mes clients. Je suis entrée dans leur maison, rencontrée les familles et donnée des recommandations aux familles. Je ne peux nier le fait qu'on s'attache aux enfants avec qui j'ai eu à interagir.
J'ai aimé la relation que j'avais avec le superviseur : (Donnant-donnant). Il nous partageait beaucoup d'informations sur sa pratique aux Philippines, son approche privilégiée, sa clientèle mais il voulait aussi apprendre de moi , connaître l'étendue de ma connaissance , apprendre comment nous travaillons au Canada. Je lui ai présenté avec ma collègue de nombreuses présentations Power Point sur des sujets reliés au stage afin de maximiser nos connaissances , chacun a pu apporter à l'autre.
J'ai adoré faire une visite en communauté, j'ai visité des gens qui avaient été victimes d'un ACV, qui vivaient dans des conditions de vie assez difficiles mais qui malgré tout demeurent positifs et gardent le moral, un exemple à suivre. J'ai aussi pu visité des clients à bord de jeepneys décorées selon les goûts et l’imagination de leurs conducteurs.
Je ne pourrai oublier la journée où nous avons visité deux universités de la ville où avait lieu notre stage. Nous avons pu rencontrer les doyens de la faculté ainsi que des étudiants en ergothérapie et en physiothérapie. Nous avons eu la chance d'échanger sur comment se déroule la formation afin de devenir ergothérapeute aux Philippines et au Canada. Nous avons aussi pu visiter les locaux réservés aux étudiants en ergothérapie
Je dirais que le fait qu'il s'agissait de mon premier stage exclusivement en anglais m'a demandé un peu + de travail. Je comprends très bien la langue mais je devais parfois chercher les bons termes pour bien m'exprimer et écrire mes notes mais je dirais que j'ai ainsi réellement pu perfectionner mon anglais parlé et écrit .
Je retournerais certainement faire un stage dans les Philippines accompagnée de ma famille pour leur faire eux aussi découvrir ce coin du monde tout à fait unique.
– Marie-Eve Livernois