Experiences from the Field

ADAPT: North held our second evening lecture on Wednesday 24th January. We have now grown in size, and boost a committee numbering 12 members (on a good day!) Establishing a committee to help with the organisation and running of evening lectures has been a huge help, and I found this lecture to be much easier to plan than our first one in August were there were just 3 of us trying to plan everything! We had two speakers at our event who have previously worked overseas, and kindly offered to come along and speak about how they first became involved in their work and what their work entails.

The ADAPT:North committee

Gill Brook: Working in Ethiopia
Gill is a women’s health physiotherapist who works in Bradford, but frequently travels to Ethiopia. (She’ll be heading out again soon for her ninth visit!)

Gill explained that her work involves working with patients who have suffered Obstetric fistula following childbirth. Obstetric fistula is common in Ethiopia, and can lead to problems such as urinary +- faecal incontinence, foot drop, contractures, and general weakness.

layoutPhysiotherapy treatment for obstetric fistula involves:

  • Pre-operative pelvic floor muscle assessment
  • Pre-operative rehabilitation
  • Post-operative rehabilitation
  • Post-operative pelvic floor muscle exercises and other related interventions

Gill explained that her role at the hospital is varied and can take on many forms:

  • Educator-  This can be face to face, via email, or helping point towards online resources
  • Mentor-  This is mainly via email, helping to mentor and develop the knowledge and skills of the physiotherapists based in Ethiopia
  • Clinician- This is not a primary role of the visiting physiotherapist, however, Gill can help assess and treat patients if needed
  • Strategic Planning- This involves stock control and planning in line with the hospital’s plans
  • Research & Publication-  Study published:  Brook, G. and Tessema, A.B. (2013). Obstetric fistula: the use of urethral plugs for the management of persistent urinary incontinence following successful repair.
  • Overseas supplier- Helping in the provision of continence pants, patient transfer boards, shoes, electrodes, ferrules, foot-up splints etc.

Gill’s top tips if planning to work overseas included:

  • Understand that it is not your department, therefore always be respectful as you are a guest to this new area.
  • Set an agenda with your host before arriving, this way you will have mutually agreed goals which will benefit both parties.
  • Prepare for the cultural and national differences. Gill gave an example of time-keeping being different when working in Ethiopia compared to the UK. This may take some time to adjust to, but just because you may be used to working one way, it does not mean it is the “right or only way!”
  • Always remain professional, especially with regards to consent, and privacy. If working via interpreters, ensure that the patient understands what you are asking/they are consenting to.
  • If you do set up a new service, plan for how it will continue to run in your absence, is it sustainable? Will you offer ongoing support? This may involve repeat visits and succession planning, are you prepared to do this or will someone else continue this?

Jane Schofield: Working in Nepal

Jane Schofield is a children’s therapist, who also works at Bradford, but has previously worked in India and Nepal.

Jane spoke about her work in Nepal and how she initially became involved in this work. She completed her Junior, or Band 5 rotations at Sheffield, before volunteering and travelling in India for a month. She then decided to travel to Nepal, where she volunteered for six months, before gaining a work visa to work there for a further two years. Jane worked as a locum physiotherapist in the UK between posts working in Nepal.


The Western Regional Hospital in Pokhara is the main hospital were Jane was based in Nepal. She described the wide range of specialties the hospital covered including: orthopedics, medical, surgical, head injuries, spinal injuries, burns/plastics/cleft palate, paediatrics, outpatients, A&E, Obstetrics and gynaecology, and mental health.

Jane explained that often, when returning from working abroad, you must be prepared for how you will change, and that returning to the UK will be an adjustment. She described ways to remain involved in working overseas, even when based in the UK, such as:

  • Becoming involved with ADAPT, the organisation who support physiotherapists in international health and development
  • Becoming involved with agencies who work overseas, such as VSO
  • Volunteering with local charities
  • Supporting charities who are already based overseas. Jane worked with the NGO-community based rehab service (CBRS) at first, before going on to help set up the registered charity Western Nepal Disability Trust in 2008.

Both our speakers have worked overseas, but showed the variation this involves and different routes available to begin working overseas. Gill has worked in the NHS, and takes short but frequent trips to Ethiopia to act as an adviser and educator to assist in the development of Women’s health services in Ethiopia. Whilst Jane has spent longer periods based overseas for years at a time, and continues to develop the charity she helped set up in Nepal whilst based in the UK.


The evening lecture was considered a great success, with many of those who attended explaining that the advice and guidance given has only helped fuel their passion to work overseas in future! Thank you to our amazing speakers!

ADAPT:North are planning further evening lectures, with the next one planned for April on the topic of “Burns”. We will be advertising this event closer to the time, however, if you have any questions on either event please email me at cloverseasclaire@gmail.com or check out our facebook page: ADAPT-North.


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