Joshua Brown Reflection – Supporting Rehabilitation in Madagascar

Joshua Brown is a College of Health Professions student at MUSC. He was awarded a Center for Global Health Student & Trainee Travel Grant in the fall of 2023 to pursue a project with Growing the Nations Therapy Programmes in Antananarivo, Madagascar. View more photos of Joshua’s time in Madagascar in this Flickr photo gallery.

Arriving in Antananarivo, Madagascar, I was immediately struck by the vibrant energy and rich cultural tapestry that enveloped the city. Living with a host family provided me with an immersive experience into Malagasy life, allowing me to witness firsthand how culture shapes every aspect of daily living, including occupational activities. From the traditional music to the rituals of daily life, I found myself immersed in a world that was both familiar and entirely new.

Collaborating with Malagasy therapists and physicians to develop a culturally relevant CIMT program was a deeply rewarding experience. Together we adapted the standard CIMT protocol to fit within the context of Madagascar's healthcare system and resources. Through hours of discussion, observation, and hands-on training sessions, we crafted a program that was tailored to the unique needs of Malagasy children with hemiparesis and their families.

One of the most rewarding aspects of my experience was witnessing the change in the children who participated in the CIMT program. Seeing their progress and the joy on their faces as they achieved their goals was incredibly gratifying. It reaffirmed the importance of evidence-based interventions like CIMT and underscored the critical need for accessible rehabilitation services in resource-limited settings like Madagascar.

My time in Madagascar was not without its challenges. Navigating language barriers and cultural differences tested my adaptability and communication skills. Yet, it was in overcoming these obstacles that I truly grew as a practitioner and as a person. I learned to embrace the discomfort of the unfamiliar and to approach each interaction with humility and an open mind.

Reflecting on my journey, I am struck by the profound impact that cultural immersion has had on my understanding of occupational therapy practice. The experience has reinforced my belief in the power of collaboration and cultural humility in global health initiatives. Our project was only possible through the combined efforts of Malagasy therapists, supporting organizations, and myself. My experience has reaffirmed my belief in the power of education, collaboration, and compassionate care to make a meaningful difference in the lives of individuals and communities around the world.