Occupational Therapy Practice Placement in Ethiopia

Who?

Occupational therapy students in their last semester travel to Ethiopia to complete their final practice placement. Requirements include demonstration of exceptional maturity and dedication to the profession of occupational therapy. Currently the program partners with two European universities and is open for expansion. Please contact us if you are interested in participation.

What?

The practice placement is a unique experience which focuses on transformational learning, community based rehabilitation, service learning, role emerging practice, and culturally responsive care. Students are given action oriented and reflective assignments throughout their 10-12 week stay and required to complete a service-learning project with a partner organization. Some students also complete a thesis and/or field study research as per the requirements of their universities and time is allotted for these projects throughout the curriculum.

When?

Typically the program runs for 10-12 weeks from mid to late February or beginning of March through May, depending on the schedule of the participating universities.

Where?

Currently we operate in Addis Ababa, the capital of Ethiopia, and partner with pediatric organizations but have possibilities for expansion to other regions and populations according to interest.

Why?

This program is intended for students who have an interest in self-reflection, deepening their professional skills in relevant areas, and experiencing a deep transformation during the learning process. The development of skills in role emerging practice settings, cultural responsiveness, and community-based rehabilitation are important trends for the future of occupational therapy practitioners around the world and the occupational therapy capacity on the African continent is still very low. Participation in this program aids the future practitioner as well as the local community and the profession of occupational therapy as a whole through demonstration of the utility of occupational therapy to local populations.

Dr. Toporek received her advanced clinical doctorate in occupational therapy specializing in pediatrics in 2012 from Rocky Mountain University of Health Professions and developed this program as her capstone. She received her undergraduate degree in occupational therapy from Medical College of Georgia (now Augusta University) in 1999 and has practiced in the United States, Israel, and Ethiopia. Her areas of interest are pediatrics, role emerging practice, developing nations, culturally responsive care, and transformational learning. She currently owns and operates a pediatric outpatient and home care clinic in the United States and is developing Ethiopia’s first occupational therapy educational program in cooperation with an Ethiopian university, in addition to staffing this program annually.

Service Learning

After careful observation and discussion with the staff and administration of the center, this year’s group of occupational therapy practice placement students presented ergonomics education and training. All parties felt this would be a valuable and sustainable service-learning project for the staff and administration of the center.

Students researched principles of ergonomics and developed an excellent PowerPoint presentation and practical training course to protect their backs during daily activities such as washing dishes, cleaning, working in the garden, positioning for sleep, desk work, and core strengthening exercises.

During the course they took photographs to create a poster for the facility to remind staff and administration of techniques for back safety during daily activities.

Participants compared their traditional lifting and weeding techniques with techniques taught in the course.

Discussions were lively and staff members generalized the knowledge to other activities of daily living such as bathing and laundry.

Feedback from staff and administration was excellent and we saw many more opportunities for occupational therapists to contribute to ergonomic education throughout the nation.

Children's play

As an occupational therapist, I know that culture affects occupation, but what are specific ways and specific occupations relevant to the Ethiopian context?

One song I am fascinated with illustrates the impact of how changing cultural norms affects child’s play.

Watch a video of this song, sung by a 6 year old boy in Ethiopia. (if the embedded video doesn't work, click here)

A 2 year old girl singing

What was your initial response to this song? When I heard it in Amharic, I heard only the lovely tune and sweet voices. I saw only the beautiful physical and emotional connection to one another as they simultaneously sang and gestured.  

The English meaning of the words are as follows:

My sister, my mother, you taste like lemons

Tonight, what did that man say?

He said only one thing, that he wants to marry me and get divorced

He will never divorce, but he will marry you by force

(There are several versions of this part)

A raven nested on top of my roof

Flew away thinking that I wasn’t home

Oh, poor raven! I feel bad it flew away

May I will be cursed to drink Elephant’s bile

Elephant’s bile is bitter!

A brave man’s heart is as big as a mountain

When I came back after a mountain trekking

I saw a hyena crying for a dead donkey

I saw a flea standing there and praying

I saw too a snake getting tattooed its neck

50 chickens were slaughtered

One chicken survived

And ran away to the backyard!

When I heard the translation, I was reflexively horrified to realize that young children were casually singing about child brides. I realized I needed to learn more about the origin, history, and context of this song.

I could not find any published research so I asked many adults from the community as many questions as I could think of. What people said is they hope the themes of this song (connection to female friends, family members, and role models, enjoying childhood, eschewing marriage while still a child) can shape a child’s thinking about childhood and marriage and hopefully contribute to the decrease in the rate of child marriage.

This song is sung by many children nowadays, but in the beginning it was intended in particular for girls. While some in the West shun the idea that activities should be assigned a particular gender category, the history of this song was an answer generated by the community to address a particular need in the community. The fact that it is now sung by all children, regardless of gender, can be seen as a cultural evolution in several ways. It may empower girls who will grow to be young women and later women possibly raising children of their own, to make safer choices on their own behalf. It may prepare boys who will grow to be men to see the world in a way they may not have previously which may impact their decisions regarding marriage and their own daughters when they become men. Parents who teach this song to their children or hear their children sing it will hopefully also be impacted by it's message.

Although the Ethiopian government has committed to eliminating child marriage by 2025 and child marriage rates have declined by around 20%, in the period from 2000-2011, 41% of girls in Ethiopia under age 18 were married or in a union.

For more information regarding child marriage and efforts to end this practice in Ethiopia, visit these places:

United Nations in Ethiopia

Population Council

Unicef

United Nations Foundation

Assumptions

A conversation I had with a gentleman (waiter at a restaurant) accented an important assumption regarding children experiencing disability and their families in this cultural context. The conversation went like this:

Waiter: What do you do for a living?

Me: I am a therapist.

Waiter: Oh! That is wonderful. So you help people.

Me: I try to. I work with children with conditions such as Autism and Down Syndrome.

Waiter: Oh, yes, orphans.

Me: What?

Waiter: Orphans.

Me: Oh, in Ethiopia, yes, many of the children live in orphanages but in other countries they live with their families.

Waiter: Really? So they can take care of them?

Me: Yes.

Waiter: Families here must learn to take care of these children.