From idealistic helper to enterprising learner: Critical reflections on personal development through experiences from Afghanistan

Abstract

There is little written about the cultural, social, and ethical challenges encountered by physiotherapists engaging in development work. This article takes a critical perspective on what it means to engage in development work as an expatriate physiotherapist, through a self-critical reflection on experiences from Afghanistan. The field notes from an ethnographic study of a development project conducted in Afghanistan were analysed to explore the transformative process of personal and professional development of the development worker. The critical reflective process entailed a change in meaning perspective, described as a shift from the position of an Idealistic Helper to an Enterprising Learner. Of importance in this process were “disorienting dilemmas” that challenged personal perceptions. Critical reflection over such dilemmas led to deeper understanding facilitating the process of change. The essential lesson learned is that the baseline for understanding others is an understanding of one's own meaning perspectives and manner of participation in relation to others and their context. The insights gained have implications for physiotherapists working in development contexts, for other development workers, and for physiotherapists working with patients in clinical practice in a nondevelopment context. Exploring how to collaborate in development contexts could be done using reflective groups with expatriate and local physiotherapists and/or patients. This could lead to greater understanding of oneself, each other, and the local context.

Acknowledgements

I thank my many Afghan physiotherapy colleagues, with gratitude and respect.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the writing and content of the article.

Notes

Development worker is often synonymous to volunteer and refers to an expatriate who participates in and gains experience of development work. Their primary role is to advise, but often they also provide some measure of technical expertise (Eriksson-Baaz, 2005).

There are three main senses of the term “development”: 1) “a vision or measure of a desirable society; 2) an historical process of social change; and 3) deliberate efforts at improvement by development agencies” (Thomas, 2000). The last is the one of relevance for the work we did. This must be distinguished from professional development.

The physiotherapists and physiotherapy assistants worked independently in practice, and for simplicity they are referred to collectively as therapists.