Occupational therapy fieldwork in Ayikudy, India

Kirsten Christensen Anderson, an occupational therapy student at UBC, spent one month completing an elective in India.

"Having the opportunity to complete an international fieldwork placement to further my academic and professional career as an occupational therapist was immensely impactful. This experience fundamentally altered the way that I will carry myself both personally and professionally, moving forward with a deeper understanding of how cultural backgrounds shape an individual’s occupations and how they interact with the world around them. Gaining this perspective has equipped me with a more refined lens to approach culturally safer care and has made me more aware of my personal biases and how my experiences have shaped my identity.

Applying my academic knowledge in a complex, real-world setting offered insights into how community dynamics, systemic challenges, and early life experiences impact the role of occupation and a person’s chosen occupations, especially in the context of child and adolescent development. I was fortunate to have a wide range of clinical experiences during my fieldwork, working with adults recovering from strokes and spinal cord injuries, as well as with children and adolescents with various developmental and physical conditions. In this essay, I will focus on my work with children and adolescents through sharing stories about the projects I was honoured to be part of.

My fieldwork took place at Amar Seva Sangam (ASSA), a rehabilitation center located just outside the rural village of Ayikudy in South India. The center supports many children with both cognitive and physical disabilities and hosts a “special school” where children begin their day with yoga and engage in play-based learning and practical life skills, such as practicing math skills through purchasing snacks. The center features a “sensory garden”, which is a therapeutic space with textured rock pathways, grass hills, flowing water, swings, and other sensory play elements.

While I was at ASSA I had the opportunity to facilitate a “drawing class” for the children living at the center. This class had been piloted by an occupational therapist from Victoria prior to my arrival. It promoted a sense of community, play, and skill development among the children. The camaraderie and mutual support that I observed over the weeks were incredible and challenged my Western views of what a calm and safe learning environment could look like. I quickly learned that loud, upbeat Tamil music lent itself to creating a welcoming space that the children enjoyed working in – contrary to my previous assumption that it would be overstimulating and make group learning challenging. Through activities like drawing, and making bracelets and hair accessories, the children worked on fine motor skills while building meaningful social connections. I witnessed remarkable peer support and adaptability, as children taught each other how to modify markers for easier grip, or how to string beads despite physical limitations like limb differences. I am incredibly grateful to have had the opportunity to work with these children and witness their resiliency, strength, and desire to learn and grow with each other.

Additionally, I was invited to help develop a vocational training program in collaboration with community day programs and a local physiotherapist. These programs supported children and teenagers with cognitive disabilities by promoting occupational engagement and building skills necessary for employment or safe social and community interaction. Given the wide age range (5 to 18 years), staff expressed difficulty finding a way to involve all students in the activities they organized. During our weekly visits, we observed that some students were diligently working on basket weaving, while others completed math problems, some stacked blocks, and many were seemingly disengaged from all activities. The day center teacher expressed frustration that many of her students didn’t want to participate, especially in physical activity.

Working with two fellow OT students, and a local physiotherapist, we co-developed fun and engaging ways to incorporate movement breaks into the students’ day that were accessible and enjoyable for all age groups at the center. We were grateful to build close working relationships with the staff and watched them put their own twists on the games we demonstrated over the weeks. We also suggested structuring the day with 2-3 rotating activity stations, enabling students to take turns leading stations based on their interests and abilities and allowing staff to better support students with specific needs. Over the six weeks, we witnessed an increase in student engagement – both in vocational tasks and social interactions. Seeing the students laugh and jump around as they played with each other and the staff made me reflect on the positive effects of collaborative program development.

This opportunity to learn and grow in a lower-resourced setting has been an invaluable experience and I am extremely grateful for the support of the Global Health Trainee Grant provided by the Institute for Global Health, which made this possible. I will carry the knowledge that I gained on this placement with me throughout my career – not only in clinical practice but also in how I approach empathy, cultural humility, and community-driven care. It was such a privilege to be welcomed into a community so deeply committed to compassion and mutual support. This placement has left a lasting impression on me, and I remain inspired by how much strength and joy thrive within an inclusive community that prioritizes connection and interdependence."