Alum Kristen Tsai writes children's book inspired by placement in Madagascar

Kristen Tsai holds a lemur in her book, Nosy Be, Madagascar.

After Kristen Tsai (MScOT 2024) completed her fieldwork placement at the Sunrise Centre in Nosy Be, Madagascar, she found the experience stayed with her long after she left. She couldn’t stop thinking about the children she had worked with and the inspiring people she had met along the way. 

The Sunrise Centre is a first-of-its-kind school for children with physical and intellectual disabilities in Nosy Be, a small island off Madagascar. In a place where formal education is often inaccessible for students with disabilities due to limited resources, the school offers an opportunity for inclusive learning. 

Every morning during her placement, Kristen would arrive at the Sunrise Centre by tuk-tuk where she was greeted by the children smiling, waving and calling out “good morning” in Malagasy. At the school, Kristen collaborated with teachers to better understand the challenges they faced and to explore how occupational therapy students could support learning. One focus was helping students develop handwriting skills. 

“Watching a child write the letter ‘A’ on their own for the first time and seeing their face light up with pride – it’s hard to describe how impactful that is unless you’ve experienced it. A big part of occupational therapy is breaking tasks down into smaller, achievable steps, and in that environment, you can really see how these small successes build confidence and motivation,” she says. 

A deep connection

After returning home, Kristen felt a strong connection to the Sunrise Centre. “It didn’t feel like the experience was over,” she explains. “I stayed in touch with Nathan, the founder, and continued following the school’s journey. I found myself thinking about the kids often – wondering how they were doing and whether there was a way I could continue contributing, even from far away.” 

That reflection led her to write a children’s book. Let’s Be Nosy in Nosy Be! follows a young lemur, Kely, on a visit to the Sunrise Centre where he sees children learning, playing and connecting in all kinds of unique ways. The story reflects on Kristen’s time at the Sunrise Centre – the warmth of the community, the inclusivity of the school and the idea that every child, regardless of their abilities, deserves the opportunity to play, learn and connect. “More than anything, I wanted to capture the spirit of the kids themselves and share their stories.” 

The student occupational therapy placements at the Sunrise Centre were made possible through the efforts of another alum, Stephanie Ellis (BScOT ’97), who has been volunteering with the school since its founding about four years ago. Recognizing the need for specialized support, she worked to connect the school with occupational therapists who could assist teachers in supporting students with disabilities. Stephanie reached out to Professor Andrea Duncan, who coordinates international fieldwork placements, to help bring students to Nosy Be.

Gaining deeper understanding

The partnership has proven valuable for everyone involved. “Students who have gone to Nosy Be have had the opportunity to fully live and work in a unique environment,” says Stephanie. “They gain a deeper understanding of the social and physical impacts of the environment, including both the barriers and the strengths present.” The school, in turn, benefits from their expertise. “For example, the school received donated equipment to support students with cerebral palsy but didn’t know how to use it. The occupational therapy students worked with teachers to begin using the equipment effectively.” 

Kristen published Let’s Be Nosy in Nosy Be! last year with 100% of the proceeds going back to support the Sunrise Centre. “Since the school relies entirely on donations, I started thinking about ways to support it in a sustainable and creative way," she says. "In many ways, that placement continues to shape how I see my role as an occupational therapist, not just as a clinician, but as someone who can advocate, create, and find different ways to support communities, even beyond direct care.” 

Originally published by Temerty Faculty of Medicine