My experience in occupational therapy in Namibia

How it all started:

After my occupational therapy training, I was seized by the desire for adventure and so I decided together with a classmate: "Off to Africa!". We agreed that we wanted to gain professional experience in occupational therapy there in order to stay on the ball. At our request, the RGV team management in Namibia looked for a suitable facility and found it. She mediated us to the Central Hospital in the capital, Windhoek. So we were the first interns for this project and we were very excited about what awaited us there until the actual start.

My location:

The Central Hospital is one of the two largest state hospitals in Namibia. The other hospital is also located in Windhoek. Together, these two houses cover all medical disciplines and officially have around 1.500 beds. "Officially", since it is quite common to increase the number of beds with mattresses in the corridors at peak times.

The approximately 25 occupational therapists at the two facilities are spread across the specialist areas of paediatrics, spinal cord unit (paraplegic patients), stroke unit/neurology, hand therapy/orthopaedics/surgery, cardiology, oncology, forensic psychiatry and general psychiatry. Both inpatients and outpatients are treated.

My internship in occupational therapy:

Since the occupational therapist training completed in Germany is not recognized in Namibia, we were deployed to support the team as interns and assigned to forensics and general psychiatry. On a few days, however, we also had the opportunity to gain an insight into other departments.

The tasks in general psychiatry were:

• Support and independent organization of groups (eg sports group, cooking group, drum group, ...)
• Participation in the interdisciplinary morning meeting
• Participation in visits
• Participation in the Ergo team

Since these tasks and the African working pace - which is a lot more relaxed than the German one - were not enough for me, I offered to carry out additional individual treatments and work projects. These were accepted with great enthusiasm by the patients, since their day included only very few program items, if any at all (so very different from German psychiatric hospitals) and they were bored for most of the day without any meaningful activity.

In general, there was a friendly, happy, and relaxed atmosphere among the patients that I would not have expected in a psychiatric ward. It seemed as if the African joie de vivre could withstand illnesses such as depression, schizophrenia or addiction. The patients were also very open, interested and friendly towards us.

In forensics, the daily program was a bit fuller and consisted of:

• Support and independent implementation of occupational therapy groups (including sewing group, kiosk operation, carwash operation)
• Realization of everyday practical training in the Predischarged-Group (eg PC Basics, cooking)
• Implementation of sports groups
• Supported the recurring Coffee Shop project, where patients spend a day transforming the Ergo department into a café and gaining experience in the kitchen, service, event planning and bookkeeping.
• Participation in so-called observations, in which offenders are observed, interviewed and tested, in order to subsequently assess their culpability (→ Forensics or prison)

To be honest, I initially had respect for working with the forensic patients, all of whom had committed really serious crimes such as murder or rape, but was then surprised at how pleasant and “normal” these patients turned out to be to deal with. I got to know most of the patients as friendly, very polite and grateful people, which was probably also due to the fact that I knew very little about the exact crime.

My experience in ergotherapy internship in Namibia

Although I am actually more interested in the motor-functional area, I was glad to have been "pushed" into the psychiatry by the Namibia internship, because otherwise I would never have collected the interesting experiences in this field. But of course I was very happy that I was also able to help in the following areas:

• Wheelchair-Clinic (Wheelchair supply, adjustment and repair fall in Namibia in the scope of occupational therapists, orthopedic technicians in the sense there is not.)
• Hand Therapy and Rail Construction (Since there is a high rate of violence in the township, we saw above all cuts due to street fighting.)
• Spinal-Cord-Unit (very structured department with exact schedule of rehabilitation from the acute treatment to the outpatient follow-up after discharge)
• Paediatrics at Katutura Hospital and Pediatric Oncology at Central Hospital
• Clubfoot consultation (gypsum treatment after Ponseti)

Findings that I was able to gather while working in this beautiful country:

1. Man, are we Germans accurate! Whether in terms of hygiene, work structure, planning, bureaucracy or data protection: the "Namibian way" is no comparison to our regulated conditions. BUT: It also works like this!
2. time = money? Maybe... BUT: African serenity = joie de vivre and contentment
3. Occupational therapy can be even more versatile! Making wheelchair seat shells, putting club feet in plaster, assessing culpability... Respect for the responsibility our Namibian colleagues bear!

An experience report by Carina S., who completed an occupational therapy internship in Namibia from October 2016 to January 2017.