Case study - Charles Sturt University (CSU) International WPL in nursing

My name is Cathy Maginnis and I am a lecturer at Charles Sturt University (CSU) Dubbo campus. I have just returned from facilitating an international WPL in Thailand with 8 Bachelor of Nursing. This is our third WPL trip to Thailand and it provides enormous benefits to the students to be immersed in clinical practice in a different country. The two-week trip to Thailand is supported by CSU Global, a University initiative to provide students the opportunity to experience the world through a broad range of international study experiences.

During the trip students travelled to villages in the Wat Jan region in northern Thailand as well as visiting the McCormack Nursing Faculty at Chiang Mai University. This is a great experience for the students as the Dean of the Nursing School and her staff present an overview of the Nursing course offered at this University providing a tour of their facilities including the simulation area, living areas and finishes with lunch in their cafeteria. We were based at a small rural 10 bed hospital and accompany a team of local health staff to remote villages each day. During these clinics they engage with the school children and deliver health education and engage in an exchange of songs, stories and games with a lot of fun had by everyone whilst learning from each other. This year we also undertook top to toe assessments on all the school children, up to 200 per day and referred any issues to the nurse practitioner or nurse for treatment.

The students delivered primary health care and assessment of patients as well as participated in health promotion and education activities. It’s a chance to see the ground-level realities of living in a remote rural village and learn about the health issues and the ways these challenges are met by the local health professionals and community members. The students learnt to communicate in different ways and to build upon their critical thinking and reflective skills as well as delivering culturally appropriate care. These skills will enhance their confidence and they will be able to incorporate them in their future practice with delivering culturally appropriate care in our Australian multicultural communities. It also contributes to better health outcomes for the people living in these villages.

There are obvious challenges with an International WPL as all experience some degree of culture shock and there are many challenges not the least being language barriers and communication. Fortunately our partnering organisation provides a guide and interpreters who are very experienced and have accompanied several universities whilst undertaking international WPL. Culture, food, dress, transport, weather conditions and using squat toilets are other factors that provide challenges. Whilst they are different they are not wrong and enhance the experience. We are very privileged to be able to immerse ourselves even for a short period in another culture and observe the differences. The health care system and what is provided in Thailand is very good but where we visit access is the biggest problem, requiring transport, someone to take the person to the health facility and accessible roads as monsoonal weather causes roads to wash away. Travel from our base can take up to 3 hours in 4 wheel drive vehicles through the most picturesque countryside. This is part of the adventure of an international WPL as we greet villagers in their paddocks as we go by, watch the water buffalo and livestock being moved on the roads and watch the villagers go about their everyday lives.

Many of the presenting health conditions mirror those in Australia but with different risk factors. Respiratory issues are linked to cooking inside the houses and the smoky environment as well as smoking. Osteoarthritis and RSI from farming in the fields for long periods every day and then bending sewing intricate garments at night in poor lighting. Colds and flu are common due to seasonal changes and poor hygiene practices as well as gastroenteritis from contaminated water and a lack of sewerage in some villages. Not accessing health care to identify and prevent health issues due to difficulties accessing the care exacerbates the conditions. Hygiene and epidemic control is a priority with health education and vaccinations are given. Malaria, TB and other infectious diseases are present but non-communicable diseases and injuries have also increased. A mixture of traditional and western medicine is practiced and many engage in meditation and stretching to assist with aches and pains. We were lucky to be able to view a traditional clinic offering acupuncture and speak to the doctor that runs it as well as health clinic staff who offer massage as part of their health care practice.

On the first visit to Thailand the team identified eye care as one of the immediate and far-reaching aspects of healthcare that they could contribute to in a meaningful way. As a result, the nursing students and their lecturer have teamed up with OPSM Dubbo store to collect donations for the villagers, there was a great response last year and this has been matched again this year with hundreds of glasses being donated, cleaned, checked and graded by OPSM. These glasses can make such a big difference to the lives of people in the poorest area of northern Thailand. All villagers work in the fields in the harsh glare of the sunlight for long hours every day. Many of the women sew intricate detail on clothing and items to sell and often this is done in the poor evening light. Donating reading and sunglasses can provide an immense and immediate benefit and is an example of how Charles Sturt University strives to enhance the lives of people in our own backyard and further afield. The donated reading and sunglasses provide an immense and immediate benefit.

I feel very humbled and honoured to be able to accompany the students and to further the relationships I have built with the local health staff and the villagers. The experience is very unique and undertaken in a beautiful setting with friendly and caring people. The villagers we provide the health care for are not the only ones to benefit from this WPL, the health staff and the nursing students also benefit from exchanging information and building relationships as well as learning a bit of the language form each other.

Cathy Maginnis

Head of Campus- Dubbo
Student Engagement Academic, Bachelor of Nursing- Dubbo campus

SNMIH Marketing Manager

Lecturer SNMIH

Tel: +61 2 6885 7324

Email: cmaginnis@csu.edu.au