Since May, 1998, I have been part of a team of health care professionals working in Minsk, Republic of Belarus. The purpose of our work has been to foster the development of health care service delivery in light of both the fallout from Chernobyl and the declining economic situation in that country. Our work is a partnership between The University of Western Ontario with its affiliate hospitals, and the Minsk State Medical Institute. Professor Sandra Hobson, of the School of Occupational Therapy, UWO, is also a member of this team.
Occupational therapy is unknown in Belarus so a major thrust of this work has been educating physicians and the Ministry of Health about this component of rehabilitation. Further, rehabilitation there is focused on restoration of physical function with little consideration of social or psychological aspects. Integration of people with disabilities into the society through therapy and the use of assistive technology is an important part of our work.
The initial trip was predominantly a fact-finding trip to discover the main issues of rehabilitation and establish contacts within the Belarusian medical community. Rehabilitation populations requiring urgent attention included children with neurological or orthopaedic problems, and adults with rheumatoid arthritis, head injury or cerebral vascular accident. Additionally, the development and prescription of assistive devices, including wheelchairs, aids to daily living, orthotics and prosthetics were identified as high-need areas. In addition to meetings with physicians, hospital administrators and the Rector of the Minsk State Medical Institute, a meeting was held with the Deputy Minister of Health for the Republic to provide him with our impressions of the state of health care services in that country.
During the second year, a number of presentations and demonstration were given of various aspects of occupational therapy, including a general description of occupational therapy, and demonstrations of occupational therapy techniques for clients with orthopaedic and neurological problems, including both children and adults. An exciting element of the second year was the visit to London by a physician from Minsk with a keen interest in rehabilitation. During her visit, she had the opportunity to see occupational therapy and rehabilitation practice and research. In addition, she participated in some of the classes of our professional program.
In 2000, a four day workshop on occupational therapy intervention for patients with rheumatoid arthritis was given. The workshop included both lectures and patient demonstrations. Additional work was done with children with neurological or orthopaedic problems. Each year, the information shared becomes more detailed and we generate a greater understanding of each other's culture and professional practice.
International work does not mean inserting our culture, beliefs and practice into another culture. Rather it is a process of understanding the other culture's beliefs and needs and working jointly to meet specified goals, sharing knowledge and information with each other. The ultimate measure of our success will be when our presence is no longer needed, and rehabilitation continues is a sustained manner in Belarus.
