University of Manchester 2023

Nursing, The Philippines Iloilo

My university offers an elective placement in the second year of study. I chose to spend this elective period abroad as I wanted to experience first-hand the differences in the healthcare services in another country. I organised to spend 6 weeks in Iloilo, Philippines.

I travelled alone despite never having done so before and was extremely nervous about the prospect of being on the other side of the world with a house full of strangers. I needn’t have worried - I was warmly greeted by the Work the World team as soon as I set foot off the plane in Iloilo and quickly met the other students who had arrived to start the programme the same week as me. 

During my time with Work the World, I was able to work in several departments: paediatrics, NICU, obstetrics and gynaecology, oncology outpatients, orthopaedic outpatients, A&E, and a mixed adult ward.

The Work the World team planned the whole of our hospital placement and have a good rapport with the hospital staff so they can assist you at any point should you need it. The hospital staff know who you are before you start due to them liaising with the team.

On our first day in the hospital, we had a flag ceremony introduction and a PPE and hand hygiene session, after which we had a jeepney tour of the city. The Work the World team were so friendly and caring and really made the experience special. We had a couple of Hiligaynon lessons which was useful in the hospital to be able to interact with patients as well as outside of the hospital setting. I feel as though it helped me to settle into the new environment and feel confident within the hospital.

Each time we were in a new department we were accompanied by a WtW team member who introduced us to our supervisors. They would also check up on us to make sure we were comfortable and getting everything we wanted from the placement as the weeks went on. They really went above and beyond for us which I am incredibly grateful for.

I went into this experience with an open mind, not sure what to expect from the hospital itself, as I had organised this placement on such short notice. I knew that things would be different in the hospital, but I wasn’t quite sure to what extent. I spent my first week in a paediatric unit where I saw how well all of the families interacted and cared for each other. Most of the children’s care was attended to by their mothers or grandmothers who stayed at their bedside all hours of the day to change and feed them.

My second week was spent split between NICU and the OBG unit. In NICU, I was faced with tiny babies who were in broken incubators used as cots either under rickety heat lamps or sheets of cling film over the head of their cots to keep them warm. Mothers were not allowed to visit babies due to tight Covid restrictions still in place, and the unit was at full capacity with babies waiting in a side room in the delivery suite, some with 2/3 to a cot. 

Whilst in delivery, myself and a newly qualified paramedic observed a natural vaginal birth. There were many cultural differences. We saw a lack of privacy in this unit, examinations were carried out in busy corridors and in full view of other patients and staff. The labouring mother wasn’t given any pain medication even during an episiotomy and was expected to stay quiet throughout the birth. They also weren’t allowed to have anyone with them during the whole birthing process. I also witnessed a c-section in which the lady was given no anaesthetic before a spinal block was inserted. It was an emergency caesarean as the midwives couldn’t find a heartbeat when using the doppler, but it took around 40 minutes from starting to insert the spinal block to the baby being birthed.

A huge difference in the care we saw was the way in which the sterile field of the operating room was maintained. Also, the c-section was done vertically not horizontally like we do in the UK. 

I spent the rest of my time across several other departments: orthopaedic outpatients, a mixed general medical and surgical ward, and an adult medical unit comprised of many critically ill patients receiving ICU-level care. 

Each week I learned so much and was met with enthusiastic staff teeming with information. But the final weeks I spent on MM1 and oncology outpatients were by far my most cherished. The brilliant staff encouraged me and allowed me to be involved in administering medications and inserting cannulas. The amazing staff in these two departments had incredible patience with me and guided me carefully through the processes. I had been anxious about the prospect of inserting IV cannulas but on the oncology unit, we had plenty of patients receiving chemotherapy treatments who were more than happy for us to insert their IVs. By the end of my time there I felt so much more confident now I had learnt these new skills. The staff perfectly demonstrated the nature of Filipinos - exceptionally friendly, smiley, and willing to go out of their way to help you, as well as being partial to spontaneous Taylor Swift singalongs!

Being able to live and work alongside healthcare professionals from all over the world was invaluable. We had so much fun, worked well together, and learnt so much from one another. 

After placement, we would take a jeepney or trike back to the Work the World house where we would relax and have dinner. The food was delicious, and the chefs always catered to everyone’s dietary needs. We would explore the beaches, malls, swimming pools and surrounding area in our free time. I quickly found my feet and made friends in the house - so don’t worry if you’re going alone, everyone is in the same boat and are so friendly and welcoming you won’t be bored for a second.

Every Thursday we would have a BBQ night, and each week had a different food theme. One week was Mexican, another was American and my favourite: Filipino night. It was amazing, and we would all be stuffed and then attempt to sing karaoke. We would finish the night off with some games and maybe go to one of the local bars with the rest of the house.

Our first weekend away was in the idyllic Boracay. The team helped us to organise the transport and students from the previous weeks were able to give us recommendations for accommodation, food, and any paperwork we needed for the travel. Going away at weekends was great, as there are so many gorgeous islands easily accessible from Iloilo to visit.

We spent a weekend in Antique snorkelling and tubing down the river, another we spent in Cebu canyoneering and swimming the sardine run in Moalboal, we had a weekend eating fresh scallops and island hopping in Gigantes and our final weekend was in Bacolod where we visited Lakawon island and some beautiful ruins.

I am so glad that I had the opportunity to spend my elective abroad, as not only did I get to learn from some amazing nursing and healthcare staff in the hospital, but I also was afforded unmissable experiences to travel and immerse myself in the culture with newfound friends.

It was a truly once-in-a-lifetime experience and I can’t thank everyone enough who made it what it was. If you get the chance to have your elective placement abroad- do it! You won’t regret it for a moment and will create lifelong memories which you will cherish.

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