“When someone shares something of value with you and you benefit from it, you have a moral obligation to share it with others.”—a Chinese proverb
Why did I decide to volunteer two years of my time in what was once a strange land thousands of miles away from home? Probably to gain international experience and professional advancement, for the adventure of living in a new and exotic location and immerse myself in a totally different culture, to gain a fresh perspective of my own career, for the sheer satisfaction of being able to say “I did it!” I volunteer simply because I am a global citizen, and in this small world, we can all lend each other a helping hand, no matter where we come from.
Despite the warm hospitality that was accorded to me by my Ethiopian colleagues and some of the locals, there were some challenges that I needed to cope with if I wanted to make my placement successful.
First, there was the constant bombardment of the eternal question: “How can you volunteer in another developing country when you come from a developing country yourself?” And my answer has always been the same. Why shouldn’t I? I have the skills. I passed through the rigorous selection process like my Western counterparts. I have lived in a developing country all my life and I know first-hand how to survive with limited means. I breathe, I feel, I touch poverty every single day, so how can I not know the developing world better?
Then there was the language and cultural barrier. It was difficult at first to effect even the minutest of changes because of some resistance brought about by ingrained cultural practices. In addition, the language was hard to learn in the beginning. Although my colleagues speak very good English, the main struggle was communicating with the patients who mostly come from rural areas. Slowly, I learned to speak basic Amharic. I have also learned to respect the culture and the fact that culture is dynamic and positive changes can be effected without destroying the cultural identity of the people.
The next challenge was the low status of the profession in the hospital. In the beginning, I was struck by how “low” senior health professionals, especially doctors, looked at physiotherapists. My young colleagues often found it difficult to communicate with the medical team; hence they were left out of the treatment and discharge planning of their own patients. Quite often, they went to the wards and found out that their patients were already discharged without their knowledge and permission. Because physiotherapy is still in its infancy in Ethiopia, awareness of the profession is still very poor. Its importance in the prevention of disability is still not generally acknowledged even by policy-making bodies. This issue, I believe, fuels the low morale of local staff who feel underappreciated despite their efforts to be acknowledged as a profession at the same level with nurses, doctors, and other health professionals.
Tackling these challenges, however, was not as painful as I anticipated because of the genuine support shown to me by my local colleagues. Even though most of them were just recently qualified, my young and dynamic colleagues were always willing to learn from me and at the same time share their local expertise. I was able to share my knowledge and skills to them easily because they were always open to new learning. It was very important to me to work alongside local counterparts as it was the most effective way I knew to ensure sustainability of my work as a VSO volunteer, and I knew that building the capacity of the physiotherapy department would take far longer than my two-year placement.
My time at Gondar University was quite an interesting and productive journey. After working closely together with my local colleagues and another VSO volunteer, Joanna Griffin, positive changes in the department began to unfold slowly before our eyes. We have managed to develop service development objectives, which served as an action plan for the year. Under the service development program, standardized assessment and treatment forms were developed, which made it easier for the physiotherapists to keep patient records. The in-service trainings and journal clubs likewise honed the physiotherapists’ clinical knowledge and skills and most importantly their clinical decision-making, which resulted in more thorough assessments and proper treatment planning. This, in turn, lead to more patients being discharged when they should be, hence patient outcomes and satisfaction were improved. This also decreased daily patient traffic in the department, which then made the local physiotherapists less stressful and hence were able to spare some time getting involved in continuous professional development opportunities such as browsing journal articles in the research library and attending in-service trainings and journal club discussion.
In addition, we as a department were able incorporate evidence in our practice, improve our patient management skills, enhance our teaching and coaching skills, implement HIV and AIDS mainstreaming activities, conduct the first-ever Physiotherapy Awareness Week, publish and disseminate a monthly e-newsletter, Ethio Physio. The list goes on. The changes in the department also boosted the confidence of the local physiotherapists as it showed that by working together as a team towards common goals, they have the capacity to improve their skills and services even with limited resources.
These achievements would not have been possible without a supportive environment and willingness of my colleagues to allow my work to develop. And I have been very fortunate to have a placement that gave me the opportunity to maximize the use of my knowledge and skills. There was so much to be done, so many gaps to fill, and so many opportunities for positive input. Despite initial resistance to change, which was expected, my colleagues gave me the support that I needed to do my work effectively and showed enthusiasm and appreciation for all my achievements.
Volunteering in Ethiopia has given me a fresh perspective not only about my career, but also about being a responsible global citizen. The ups-and-downs were just brushes that polished my personality. I would like to believe that I have become a different, if not better, person.
My dealings with the Ethiopian people has somehow humbled and inspired me, for despite the difficult circumstances that they have to face on a daily basis, they are striving not only to survive but more so, to improve their lives. My young colleagues’ enthusiasm and genuine willingness to learn from me has given me the motivation to go on. Unknowingly, in the process, I was also learning from them, and learning a lot about myself.
I have learned that life still goes on even if we experience resistance in our work. I have learned that it’s not yet the end of the world when a project fails because there is always another alternative lurking around the corner if we just give ourselves time to reflect about our priorities against the priorities of others, accept that we can’t always do things our way and that common sense is sometimes more effective than knowledge gained from books, and lastly be humble enough to accept our weaknesses and rely on the strengths of our local colleagues.
Working in Ethiopia has been very enriching, both professionally and personally. Overall, I feel that this is an experience that can’t be traded for anything else.