Reflecting on Madagascar: Lessons Learned

Now that I have finished my 3 months of voluntary work in Madagascar I thought I would write a blog post on the lessons learned during my time there. I hope this will help others who hope to work overseas, and pass on the words of advice I was given before Madagascar!

Before Arriving/Planning your trip
I began planning my work in Madagascar about a year before I travelled there, however the desire to work overseas started about 6 years before this when I volunteered for a month in a school for disabled children in Tanzania as a student. My advice to anyone planning to work overseas is:

• Think long and hard about why you want to work overseas. Is it to experience a different culture? Learn new skills? Experience your profession in a developing setting? Or simply to see more of the world and travel? What is it you want to gain from this and ideally what would you like to bring to this setting?
• One of the most important follow up points from my first point is to understand that you will likely gain a lot more than you will be able to give to any country or place you visit! This is to be expected, but often many people may have an idea that they are going to ‘make a difference’. Set realistic expectations for yourself and what you can achieve or bring to this setting.
• If you are working in a professional context such as Physiotherapy, gain as much experience in your home country as possible before working overseas. I worked for 3.5 years gaining experience in Respiratory Medicine, Stroke Rehab, General Medicine, Rheumatology/MSK outpatients, Major Trauma, Paediatrics, and Neurology before working in Madagascar. I found this really helpful as most countries do not have speciality areas of Physiotherapy, therefore a wide range of skills and experience levels is really useful when working in a developing setting!
• Network and speak to as many people who have worked overseas previously to learn from their experiences. I found this invaluable in helping me understand the context in which I would be working.
• Make contact with the team you will be working with before arrival. Try to gain an understanding of specific training topics or equipment which might be needed so you can have a basic idea of what is needed before arrival.
• Attempt to learn even basic phrases of the language used in the country you will be working in. I was so busy preparing for my work overseas and fundraising that learning French fell lower on my priorities list. Looking back, I wish I had focused on this more as understanding even the basics of the language is a great help when working overseas!

In country
Now that you’ve finally arrived in the country you will be working you will likely be feeling nervous and excited to get started. My top tips are:

• Keep an open mind! Don’t rush into anything. Give yourself time to settle into this new context as it will likely be very different from anything you’ve experienced in your home country!
• Try to take the time to observe the practices and ways of working of your new colleagues. Most importantly, don’t rush in to offer suggestions or criticise. Just because their ways of working may be different to what you are used to doesn’t mean they’re wrong. Imagine how you would feel if someone walked into your workplace and began offering new suggestions or criticising your methods of working with little understanding of your work!
• Try not to plan too much in advance. I arrived in Madagascar without any plans for what my work would involve, and instead sat down with the Physios frequently to ask what they would like me to help with or develop whilst here. I feel that this worked really well as it made my work much more targeted and specific to the local setting.
• The above rule applies even if you will be working in the country for a short time on a specific training programme. Have a basic plan of what your training will involve, but then ask the team you are working with what THEY want to gain. I’ve heard time and time again of foreign agencies arriving into a country and delivering training sessions which are not appropriate or targeted enough to the attendees receiving the training. Try to avoid this!
• Keep logs and reflections of your experiences. You will likely be completely overwhelmed and exhausted at first. By keeping a log of your work you can remember all that you’ve learned and keep a record of this.
• Understand that you will likely become sick or run down during your work. Give yourself time to rest and recover. You will be much more useful when fully recovered rather than pushing yourself to exhaustion!
• Remember that it’s OK to switch off and enjoy some much needed relaxation time. A lot of the time I struggled with feeling guilty about taking time off. I would also continuously ask myself if I am doing as much as I can, or getting the most out of my experience. Looking back on this, I shouldn’t have been so hard on myself! The fact that you are there in the first place is a great achievement, so try not to underestimate this!
• During my time in Madagascar, I chose to travel to lots of different centres and understand Physio in lots of different places. I feel that this helped me gain a greater understanding of Physiotherapy in Madagascar, however by moving around often I potentially lost the opportunity to fully embed myself in one place and tried to take on too much. Have a think about what you would like to do and if staying in one place or moving around will help you gain more from your experience.

Reflecting on your work
Now that you’ve finished your work you may feel confused and lost about what to do next. This is completely normal and to be expected! My advice is:

• Take time to appreciate your work and feel proud of all you have achieved!
• Reflect on your experience and try to learn from it for your future work whether overseas or back home.
• Speak to others who have completed similar work. Maybe you’re struggling to think of what you would like to do next. This is normal and exciting, as you’ll likely have gained a lot from your experience and now have the opportunity to put this learning into practice!

As for me, over the next few months I will be travelling and reflecting on my time in Madagascar and the many lessons I have learned during my time there. I will also be writing up my report of my time in Madagascar and giving recommendations for how I feel the profession can be developed in future. I have been planning and working towards Madagascar for a long time, and honestly feel a bit confused and lost about what I would like to do next! However I understand that this is normal and to be expected and is a really exciting time!

I hope you find this post useful, and if you have any words of advice for me or lessons you’ve learned from working overseas, please comment below or email cloverseasclaire@gmail.com.