OT.com

Just me (an OT student), my thoughts and OT

[fathimapatel]

Life in a sine graph- Community Edition

Sourced by A. Stewert, (2017)

I was on LinkedIn the other day and came across the graph above. It symbolized “life is a sine curve,” with the analogy linked to the weather all year round. I thought to myself, “What better way to describe this block, than using a mathematical correlation that we are all familiar with?” Hence the title of my blog is “Life is a sine curve- Community edition.”

We started this block on quite a high, feeling refreshed after the relaxing holiday we deserved. Feeling very nervous but excited, the first week was orientating myself to the community, the many projects that I had to continue, and just trying to blend in. As the days went by, I slowly started to feel the physical and mental exhaustion kick in. Just like the highs and lows in the sine graph that many of us drew in school, this block felt just the same. Some days were good, and I felt like I was conquering the world, while other days felt like I was failing at everything. When faced with failure, we are often given two choices, either stay down or get up, just like how the following video describes, https://www.youtube.com/shorts/NYXOo8y6MFg . I chose to get up!

Full disclosure, it was difficult to adjust to the informal conditions that we were working in, especially when you are so used to a structured system in a hospital setting, with specific patients in certain wards, and the variety of resources you have access to. Here we had to “rough it out,” and use what we had.

Physically, it was draining. Walking about 6 kilometres daily from the old clinic to the new clinic, being on your feet while screening patients, running after children in the primary school, and not forgetting to carry all the heavy tools, gazebos, and tables. Let me just say that community is not for the weak. Apart from what felt like physical torture, emotionally and mentally it was exhausting as well. I found it challenging to advocate for a profession, that not many individuals know of. More so, it was also very cognitively demanding, especially when we working long hours, and still had other submissions like essays and blogs to do. However, I am thankful that I got to experience this block the way I did because it was an eye-opening experience for me.  

I watched the following TedTalk ,https://www.youtube.com/watch?v=uzDsT-25w14 , which talks about Personal Empowerment through reflection and learning something that Dr. Craig Mertler mentions that learning can come from asking experts for advice, and it is through their experiences that we hope we learn something. Within this block, even though I asked for advice from my supervisor and peers, a lot of the learning came from myself, and reflecting on what happened on a daily basis. I realised that learning does not rely on what others experience, but rather on how I approached the situation, what I took from it, and how I went back to look at the things I didn’t know.

Something that I learnt very quickly into this block, is how important it is to have cultural humility. It is vitally important to understand one's culture, how one sees oneself when ill, and how important it is to respect individuals for whatever culture they belong to (Yeager et al, 2013). Although I was already practicing this, it was amazing to see how much of an impact culture has on the types of occupations individuals engage in and why. For example, I saw many women in Kenville, who reported that they are not working, because they are mothers, but the baby's father, who does not necessarily stay with them is financially supporting them. This is not an ideal situation that I was brought up in, but I realized that in the cultures and traditions practiced around Kenville, this is acceptable. Just like the image below, if we practice humility, we build trust and we demonstrate respect around our clients and their needs, we create positive change, and are able to sustain that change throughout their lives. This makes our therapy as OTs more effective as well.

Sourced by First Nations Heath (2016)

I learned a lot about an ongoing pandemic we face- Gender-based Violence, as illustrated in the image below. Especially when working in a community like Kenville.  I screened individuals daily and nearly every third woman I interviewed was a victim of GBV. Initially, I thought it was impossible to have such high numbers, but after researching, I realised that it is true that 1 in 3 women experience some sort of violence every day (WHO, 2023). I was astonished at how strong these women are, and how some of them just have to get up and carry one living every day, as if nothing happened. I connected the dots as to how it not only socially impacts a woman, but also the children of the home and how these children grow up either thinking that violent behaviour is okay, or completely wrong. What really made me feel all kinds of emotions was also how these children protected their mothers and sisters against violence.

Captured by J. Gerber, (2021)

Another important thing I learned was having good communication, not only with the people of the community but with the MDT team as well. I learned that every member of the MDT team plays an important role in the well-being of every individual. Just like the image below, when we put pieces of a puzzle together, we complete a picture. Similarly, when we join minds with other professionals within the MDT team, we ensure that each client is getting complete care for their well-being. Furthermore, working with the MDT team also promotes clarity and continuity of patient care (O’Daniel et al, 2008).

Sourced from Impact Learning, (2023)

Professionally speaking, this block has made me understand the reality of working in communities, and how even though these communities lack resources, it does not mean that health care services must be deprived. People in these low-income communities need just as much care as those in private hospitals. I saw how health promotion speeches every morning made a huge difference in getting individuals to speak up about what is bothering them, and for them to ask for help. I also learned to ask questions that I used to think seemed irrelevant, for example, “What is your HIV status?” I finally understand the role OT plays with HIV patients, and how HIV impacts a person's health and well-being. I have also changed the way I think, whereas now I am thinking more deeply, researching more about topics that I am unaware of, and reading good literature to support my thinking.

On a more personal level, this block has made me more confident, especially when talking to strangers, as every morning we did health promotion talks where we advocated for our profession to the community. It has made me physically strong, after carrying the gazebo and tables every day, and all the equipment from one clinic to the next, and emotionally strong, especially when someone shared their grievances with you, and you had to hold back the tears.

I am eternally grateful for the highs on this block, especially when the children in the community are always so excited to see you, when the old Gogo finally gets out of bed, or when the old Mkhulo says ‘Thank you, you helped me a lot.’ It is because of these highs that I kept pushing myself. As much as I am grateful for the highs, there were equally, if not more, lows. Some lows made me cry, for example when your projects are just not working out, or when you client choses not to come for therapy and you have to start from the bottom all over again, but it is these lows that made me stronger. I will definitely be taking what I have learned in this block with me into Community Service and look forward to learning more in the years to come.

When I think back to the graphs I drew in school, the sine curve- community edition has by far been the best one I drew yet!

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References

August 16, 2023, from World Health Organisation: https://www.who.int/news/item/09-03-2021-devastatingly-pervasive-1-in-3-women-globally-experience-violence

O'Daniel, M., & Rosentein, A. H. (2008). Chapter 33- Professional Communication and Team Collaboration. In Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Retrieved August 17, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK2637/

Yeager, K. A., & Bauer-Wu, S. (2013, August 12). Cultural humility: Essential foundation for clinical researchers. Retrieved August 15, 2023, from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834043/

Zyl, M. v. (2023, May 30). Quarterly crime stats: schools are crime scenes. Retrieved August 18, 2023, from DA: https://www.da.org.za/2023/05/quarterly-crime-stats-schools-are-crime-scenes#:~:text=30%20May%202023%20in%20News&text=Given%20the%20high%20rate%20of,and%20staff%2C%20not%20crime%20scenes.

[fathimapatel]

“An abstract idea- sustainable development…”- Kofi Annan

From the poor infrastructure, poverty, and poor sanitation to the sewage smell around the community, I have wondered these past three weeks how the people in the Kenville Community continue to live in such profound conditions. It got me thinking about what we as OTs can do, to improve the living conditions in the community, and uplift the people residing in it as well.

Out of the 17 sustainable developmental goals that exist, as seen in the image below,  I observed five prevalent ones in the Kenville Community. These include, but are not limited to, good health and well-being, gender inequality, poverty, unemployment, and clean water and sanitization.

Image by United Nations, 2015 (link attached on image)

When it comes to health and well-being, there is no question that everyone should have access to primary health care. Although the world has made progress when it comes to health and well-being, the Kenville Community in particular, offers free and affordable health care from Monday to Friday at the local clinic to people in the community. Many people have to take time off from work, and other responsibilities, to visit the clinic just to collect their medication for the month, receive vaccinations, ARVs or see the doctor if he/she are around. In relation to this, I intend to try and collaborate with the staff at the clinic to introduce a shift system, where medical professionals rotate their schedule and work on a Saturday or Sunday, to allow people to work during the week, and collect their medication or visit the clinic for emergencies, on the days that they do not have to report to work. This can include public holidays as well. Imagine the care people will receive on a weekend, instead of having to wait for the next working day to take time off to wait in long queues only to be referred to a public hospital, to see a specialist. Something that is being implemented already is free health promotion, screening and intervention from the occupational therapy students, every day in the clinic and around the community. This offers people from the community an opportunity to access a service that is not accessible in the community easily, and stops them from having to travel far to the nearest hospital to wait in more long queues to see a specialist.

Gender Inequality is a huge problem faced in the Kenville Community. According to statistics, more than half of South Africa’s population is female, and more than two-fifths of this population are female-headed households (Stats SA, 2022). This is prevalent in the Kenville Community, as most females who are screened or receive intervention on a daily basis are single mothers, who receive a grant for their child/ children, while the father is not supportive in the household. As a result, there is a financial burden on the female. These women are unable to find jobs, as they need to look after their family, and household, and do not have emotional support for themselves. Something that would really help uplifting the women of Kenville is to introduce a work skills programme, where they can use their talents and inherited or learnt skills such as crafts, beadwork, knitting, sewing and woodwork, to generate an income for themselves. This will empower the women in the community and make them financially independent. There are existing projects that are run by the OT Students in Kenville, particularly the KITE project and the Work Skills Project that facilitate in uplifting the women in the community. These projects can be carried over by new students, and even by people from the community that can take on the leadership role and uplift the community. The image below shows a bar graph between the difference in male-headed households to female-headed households.

Image by T. Zwana, News24, 2020 (Link attached to image)

As of April 2020, roughly 55.5% of South Africans are living in poverty (World Bank Group, 2020). This is prevalent in the Kenville Community, as the majority of the people residing in the community are unemployed, have little to no food, and live in informal housing. Something that can be introduced to alleviate poverty is to educate the people within the Kenville Community, and promote self-employment, and start up businesses that will allow them to generate income for themselves and their families.

Relating to poverty is the alarming unemployment rate in South Africa. As seen in the image below, within the first quarter of 2023, 32.9% of individuals were unemployed, and this is currently increasing by 0.2% (Stats SA, 2022). As previously mentioned, many individuals in the Kenville Community are unemployed and thus do not generate a steady income. If individuals are unable to find jobs, they are unable to buy food, are more prone to diseases, and fall into the category of 55.5% of individuals living in poverty. As some individuals may not have skills or be trained in a professional degree, it becomes more difficult for them to find employment. A goal I would implement is introducing skills such as fixing appliances, that individuals can benefit from, for them to get employment in businesses. Through this, they can learn new skills, expand their knowledge that they can use to start a business and further develop the skills they already have.

Image by Stats SA, 2023 (link attached to image)

Dating back to July 2022, 19% of South African citizens did not have access to clean water, whilst 33% lacked basic sanitation (Igamba, 2022). The majority of the individuals living in the Kenville Community, reside in informal housing with little to no access to clean water. Thus, they have to walk kilometres daily to fetch water, and store water in buckets to use. This becomes a problem when they have to drink water, as the water can become contaminated, and individuals are prone to contracting diseases and infections as a result. There are sewage leaks all around the community, which makes it unhygienic for people in the community to live. Very few houses have toilets connected to them, while most individuals make use of the toilet stalls supplied by the municipality, similar to that in the picture below. Yes, the municipality is doing a good job by providing these toilet stalls, but who is cleaning them? Very rarely do the people in the community clean these stalls, which makes them unhygienic for individuals to use. In order to improve the clean water and sanitation problems experienced in Kenville, individuals need to be educated through health promotion talks on basic hygiene and perhaps get volunteers to clean the toilet stalls once a week. When it comes to clean water, it is important that the people in the community are educated on the correct ways to store water, and that water is boiled before drinking it. A long-term goal is to also try and get sponsors for building boreholes for the community, to access clean water. Below is an image by the World Health Organisation (2023) that shows statistics on clean drinking water, and the projections expected to illuminate inequalities.

Image by WHO, 2023 (link attached to image)

Kofi Annan, a former Ghanaian diplomat who was the seventh secretary general for the United Nations (1997-2006) said that the biggest challenge that we face in this century is to take an idea that seems abstract, such as sustainable development, and turn it into a reality for the world. I simply agree to this, because despite having these goals and working towards them, there are always obstacles to overcome. The important thing is to overcome these obstacles, by looking for alternative ways to improve the community and strive for development, for a brighter future for the people in these communities.

Just because people live in poverty does not mean they should be deprived of basic health care, or good hygiene and sanitation. Everyone deserves to live a comfortable life, in terms of health, care and well-being. As training occupational therapists, it is our duty to advocate for our clients, and that means going beyond and merging our scope with other professionals, in order for our clients to gain optimal independency and quality of life!

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References

Babe, A. (2016). Retrieved 08 10, 2023, from https://nextcity.org/features/khayelitsha-cape-town-toilets-plumbing-poverty-data-collection

Group, W. B. (2020). Poverty and Equity Brief. Retrieved 08 09, 2023, from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://databankfiles.worldbank.org/public/ddpext_download/poverty/33EF03BB-9722-4AE2-ABC7-AA2972D68AFE/Global_POVEQ_ZAF.pdf

Igamba, J. (2022, 07 5). Water Crisis in South Africa. Retrieved 08 10, 2023, from Greenpeace: https://www.greenpeace.org/africa/en/blogs/51757/water-crisis-in-south-africa/

Nations, U. (2015). Retrieved 08 10, 2023, from https://education.nationalgeographic.org/resource/sustainable-development-goals/

SA, S. (2022, 10 19). Economic, social and political empowerment are critical for achieving gender equality in SA. Retrieved 08 09, 2023, from Department of Statistics of South Africa: https://www.statssa.gov.za/?p=15833#:~:text=equality%20in%20SA-,Economic%2C%20social%20and%20political%20empowerment%20are%20critical%20for%20achieving%20gender,households%20are%20headed%20by%20females.

SA, S. (2023, 05 16). Beyond Unemployment- TIme-related undermeployment in the SA Labour Market. Retrieved 08 10, 2023, from Department of Statistics of South Africa: https://www.statssa.gov.za/?p=16312

What are the sustainable developmental goals? (2023). Retrieved 08 10, 2023, from United Nations Development Programme: https://www.undp.org/sustainable-development-goals/no-poverty?gclid=Cj0KCQjwz8emBhDrARIsANNJjS5ydiVGlH9beR8dzoTO9CWBamumjT7pm4C-bxbs9AfB6N6S8bpvBToaAn_tEALw_wcB

[fathimapatel]

The Future of OT

The Kenville community, situated in the northern part of Durban, is one of the many communities in South Africa, that is known for environmental, social, and political injustices, which deprive individuals within the community of many resources, occupations, and opportunities. However, despite the lack of resources, occupations, and opportunities, working in a community like this can be very eye-opening and makes me ponder on the future of the occupational therapy profession.

Many individuals face various types of injustices that deprive them of engaging in meaningful and necessary occupations they need in order to have occupational balance in their lives.

One of the major injustices experienced in communities is poor healthcare services. We see this between the private and public health systems, where private healthcare offers a diverse opportunity to access the best healthcare, in the best form at an absorbent fee that more than half the population in South Africa cannot afford (Rensburg, 2021). The public sector, however, is not funded enough and thus does not provide basic specialised services to those who cannot afford it. In the Kenville community, for example, there are few to no employed Occupational Therapists that work there, thus individuals living here, do not know about the profession, or how individuals can benefit from the profession. As Occupational Therapists in training, it is our duty to advocate for our profession, go out into the community and screen for clients, and tell the community members what it is that we do and how we can offer our services. We have to make ourselves part of the community to understand the members of the community.

Looking at the map showing the statistics of poverty in South Africa in the year 2016, we can see that poverty is not a new injustice experienced among individuals, and is alarmingly increasing as the years go by. Poverty can be defined as the “lack of financial resources and essentials, to meet a minimum standard of living (Chen, 2023).” Essentials refer to things such as basic healthcare, education, clean drinking water and sanitization, and infrastructure. In most informal communities, individuals reside in poverty, and one of the implications of this is not having access to essential healthcare services that can benefit individuals. Many individuals live in informal homes, made out of corrugated steel or scarp pieces of wood, with no running water and no electricity. If electricity is available, it is usually through illegal connections. How can OTs irradicate this injustice within communities? Sadly, we are not miracle workers to provide food and essentials, but we can provide free healthcare, by opening up more government posts in smaller, less resourced communities. It may seem impossible with the current corrupt government that we have, but I do believe that the change in the healthcare system begins with us individual healthcare professionals.

Linking to poverty, another injustice experienced is unemployment. Many individuals are unable to find jobs because they lack the education to qualify for a certain job, or do not have the skill for that particular job. The graph below supports this statement, which illustrates the unemployment rate in South Africa, in 2023. In the Kenville Community, for example, many individuals who are screened, report that they are unemployed, and are seeking employment, but do not have the skills for the required jobs. Most individuals also do not have the education needed for certain jobs, as they did not complete school, or did not further their education due to not having the financial means. As OTs, our scope assists individuals with skills development, where they can use the skills they have, such as sewing, to start businesses to eliminate the unemployment experienced in communities.

There are many other injustices that are experienced in communities around South Africa, which include poor infrastructure, poor sanitization, and more serious, traumatic injustices such as Gender-based violence, oppression, and social injustices like drugs and teenage pregnancies. However, as advocates for our profession, it is our responsibility to work with these injustices, to change the way healthcare services are distributed in South Africa.

Wilcock and Townsend (2004) proposed a perspective that states that in order to create good opportunities to live, work, and play safely in communities, it is important to not only think of reducing illness and disability but also promoting healthcare, and providing support to individuals. I agree with this, as our profession trains individuals to continue living an independent life, despite their illnesses and disabilities.

Kronenberg and Pollard (2005) describe our profession as an “apolitical profession.” To an extent, this is true, because we chose to accept working in hospitals and well-resourced environments but neglect the communities that need us the most. Going forward, our profession has to become more community-based, and with increasing amounts of advocacy from OTs themselves working and volunteering in communities, such as the Kenville community, more posts for government workers will emerge, creating more sustainable healthcare services for the public.

Frank Kronenberg states that “the Idea of Occupational Therapy is too radical and powerful to be contained within a profession,” and I agree with these words. In order for occupational therapy to grow, we need to put ourselves as OTs out there and advocate for the services we have to offer. Only then will we see a bright future in our profession!

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Chen, J. (2023, July 12). What's Poverty? Meaning, causes, and how to measure. Retrieved 08 02, 2023, from Investopedia: https://www.investopedia.com/terms/p/poverty.asp#:~:text=Poverty%20is%20defined%20as%20the,clean%20drinking%20water%2C%20and%20infrastructure.

Hess-April, L. (2013). Conceptualisations of occupational justice in Community service practice in South Africa: A UWC Case Study. Retrieved 08 02, 2023, from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://core.ac.uk/download/pdf/58914394.pdf

Hocking, C. (2017). Occupational Justice as social justice: The moral claim for inclusion. Journal of Occupational Science. Retrieved 08 02, 2023, from https://www.tandfonline.com/doi/full/10.1080/14427591.2017.1294016

Kronenberg, F., & Pollard, N. (2005, January). Overcoming occupational apartheid: a preliminary exploration of the political nature of Occupational Therapy. Retrieved 08 01, 2023, from ResearchGate: https://www.researchgate.net/publication/271908873_Overcoming_occupational_apartheid_a_preliminary_exploration_of_the_political_nature_of_Occupational_Therapy#:~:text=Kronenberg%20%26%20Pollard%20(2005)%20claim,%2C%20among%20others.%20...

OTs, m. (Director). (2022). The Idea of Occupational Therapy is too radical and powerful to be contained by a Profession [Motion Picture]. Retrieved 07 28, 2023, from https://www.youtube.com/watch?v=yZXmsDfOI0I

Phalatse, N., Casteleijn, D., Plooy, E. d., Msimango, H., & Ramodike, V. (2022). Occupational therapists' perspective on the impact of COVID-19 lockdowns on their clients in Gauteng, South Africa- a qualitative study. (P. Govender, Ed.) South African Journal of Occupational Therapy. Retrieved 08 01, 2023

Rensburg, R. (2021, July 07). Healthcare in South Africa: how inequality is contributing to inefficiency. Retrieved 08 01, 2023, from University of Witwatersrand, Johannesburg: https://www.wits.ac.za/covid19/covid19-news/latest/healthcare-in-south-africa-how-inequity-is-contributing-to-inefficiency.html

Townsend, E. A., & Wilcock, A. A. (2004, May). Occupational Justice and Client-centred Practice: A Dialogue in Progress. Retrieved 07 31, 2023, from ResearchGate: https://www.researchgate.net/publication/8553036_Occupationaljustice_and_Client-Centred_Practice_A_Dialogue_in_Progress

[fathimapatel]

Maternal and Child health care in the community

I used to believe that life was like a fairytale, that when a woman fell pregnant, it was because she wanted to have a child, she chose to start a family and was overjoyed that she was bringing into the world a human being. When I read that in 2020, every 2 minutes a mother died, I was mortified and soon realized that pregnancy is no walk in the park (WHO, 2023). Instead, it has a lasting impact on a woman, on her body, her mental state, her physical state, and there are a lot of financial implications that are to be considered as well, and once a child is born, there is much more impact on a woman, as a mother.

Working in the health sciences, I come across many women and children, some healthy, others not so much and it made me realise that maternal health is vitally important. If a mother is healthy, it has a ripple effect on the child, making child health care just as important.

What is maternal health care, and why is it so important? The World Health Organisation defines maternal health as “the health of women during pregnancy, childbirth, and during the postnatal period(WHO, 2023)."

Maternal health is vitally important as it aims to educate women and mothers, on risk factors during pregnancy and childbirth, for them to know what to expect and how to prepare themselves, mentally and physically. It provides them with information on typical child development, what to look out for if they are worried their child is not meeting certain developmental milestones, and who to consult if they are concerned about their child’s development.

Maternal health also includes the basic skills needed for taking care of a child, for example, how to feed a child, how to bathe a child, and how to swaddle a child. It also prepares a mother for what she possibly needs to care for her child. For example, a child will need diapers, clothes, food or formula, warmth, and stable home. It prepares women on how to support their children financially and emotionally.

During childbirth, the hospital ensures that both mom and baby are well, however, once mom and baby are discharged, that is when the real test begins. Post-natal maternal health is just as important as a woman’s health during pregnancy and childbirth. It takes 6 weeks from the day of discharge, until the next check-up for both baby and mom, which is a long time. It is a time when mom will find her sea legs and baby will adapt to the outside world. These 6 weeks and after are important for a child’s development and a mother’s mental health.

Mothers often feel overwhelmed by their new role and often go into post-natal depression as a result. This has a ripple effect on babies as they are not being cared for by their mothers. Sometimes, a mother is unable to produce milk for her child and falls into post-natal depression as a result. This is where maternal health is important as it provides a mother with the necessary knowledge on what to do if she is in this particular situation and whom to seek help from if faced with such challenges (Loesche, 2018).

Although there has been progress in children's survival rates over the past 2 decades, at least 5.3 million children under the age of five died in the year 2018, with nearly half of these deaths originating from sub-Saharan Africa (WHO, 2023). This tells us that it is extremely important for a child to receive adequate health care at all times.

Child health care can be defined by physical, mental, intellectual, social, and emotional well-being and not just the absence of disease or disability (Health Workgroup, 2007). Child health care is vitally important for the development of children, for them to be able to function in the real world, be able to attend school, and be aware of their surroundings. Child health care is important for their physical health, disease prevention, and their safety against infection. Child health care is also important to ensure that they live in a secure environment and that they have the necessary skills to attend school, that they are socially and emotionally secure and healthy (M. Choudhury, 2023).

Within the community practice of Occupational Therapy, there are many barriers to ensuring that mothers and children receive excellent health care. Most mothers are working mothers, single mothers, have 2 or more other children, and most mothers receive a basic grant for their children, making it impossible to provide the necessities for their children once they are born. The expectations of their role as a mother in the society they reside in can cause mothers to feel overwhelmed and depressed most of the time. Some mothers often neglect their children and are often not aware that they are doing so. The sad reality is that older children become parents to their younger siblings, which creates a vicious cycle of neglect. Some children are also a result of unwanted pregnancies, which result in neglect from childbirth, which has a ripple effect on a child’s development.

Within the context of the Kenville Community, most mothers and children are from low-income households, with little to no access to necessities. This makes it difficult for children to receive adequate nutrients for optimal growth and most mothers are burned out from working long hours, earning a minimum wage, and not having enough money to take care of their child. Most mothers also receive a basic grant for their children, which is not enough to cover the costs of childcare. Many mothers wait in long queues at the local clinic to be seen by a nurse if their child is sick or to collect medication. Children have to take time out of school to receive their vaccinations and often come with other family members or friends to the clinic as their mothers are either working or neglecting the child’s health. Due to a lack of finances, most mothers choose to ignore certain red flags in their children, as they are afraid of the costs that will come with their children receiving optimal health care.

This is where health promotion and screening play a huge role. Through health promotion and screening, therapists and other medical professionals can provide both mothers and children with the health care that they require. Often these services are at no additional cost, which makes it affordable for mothers and children to receive the intervention and treatment that they require.

Let us not forget what Ralph Waldo Emerson said about health, “ The first wealth is health!” As health care professionals, it is our responsibility to ensure that both maternal and child health care is done correctly and as appropriately and accurately as possible, to give wealth to communities that lack the most basic foundation of life, health!

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References

Education, M. S. (2023). Division of Early Childhood. Retrieved 07 25, 2023, from Supporting Childcare and early learning: https://earlychildhood.marylandpublicschools.org/why-child-care-and-early-education-so-important#:~:text=High%2Dquality%20child%20care%20keeps,Social%2C%20emotional%20and%20communication%20skills

Loesche, S. (2018, 06 26). Maternal Health and Occupational Therary: Exploring our role with new mothers. Retrieved 07 26, 2023, from OccupationalTherapy.come: https://www.occupationaltherapy.com/articles/maternal-health-and-occupational-therapy-4385

Organisation, W. H. (2023). Retrieved 07 25, 2023, from Maternal Health: https://www.who.int/health-topics/maternal-health#tab=tab_1

Organisation, W. H. (2023, 02 22). Retrieved 07 25, 2023, from Maternal Mortality: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality

Organisation, W. H. (2023). Retrieved 07 26, 2023, from Child- Mortality/ causes of death: https://platform.who.int/data/maternal-newborn-child-adolescent-ageing/child-data/child---mortality-causes-of-death

Workgroup, H. (2007). Retrieved 07 25, 2023, from Child Health- Definition: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.azftf.gov/WhoWeAre/Board/Documents/Program%20Committee/Health/January%2013,%202011%20Meeting%20-%20Health/07%20Child%20Health%20Definition%20Recommendation.pdf

[fathimapatel]

Advise to my future self as a person and as an OT

It is a very strange feeling to be near the end of my 3rd year as an OT student, a 22-year-old young lady, with a whole life ahead of me. It is overwhelming to think that in just a year’s time, I will be graduating, hopefully, and soon entering a whole new world with more responsibilities, bills, and even more challenging obstacles.

According to healthline.com, anticipatory anxiety describes fear and worry about bad things that can happen. It also focuses on things that cannot be controlled. (Legg &Raypole, 2020). As someone who likes to take control and be in control, anxiety is something that really dampens my thoughts, and I have to constantly remind myself that certain things are beyond my control, just like the future of myself as a person, and as an OT.

The best advice I can give to my future self, and as an OT is a poem written by William Henry Channing (1810-1884), titled “My Symphony.” This poem has made me see life from a different perspective and I cannot thank my matric form teacher enough for introducing it to me!

This poem advises me to be grateful for every little and big thing that happens in my life. This means being thankful for what I have and for what I do not. As a blooming OT, I am still learning, and I have come to realise that it is okay to not know everything. I should be grateful when my client with depression gets out of bed in the morning and be encouraged to celebrate their small (and big) achievements. It further advises me to stay true to myself and have faith in myself. According to research, it has been proven that self-belief helps one embrace the journey of life, with all it’s challenges and makes one realize that each challenge gives us new skills, and new strengths. (Robbins, T. 2022)

“To be worthy, not respectable, and wealthy, not rich;” are the words that I admire the most. I have learned in the past, throughout life so far, that not everyone respects you. There will always be people that are envious of you and your achievements, sometimes it is those closest to you. However, the most important thing that I should remember is that my actions speak volumes, my kindness will touch the most hearts and being humble is what I will be worthy of. Speaking of money, we all love it, I do too, but when you do what you love and are passionate about, money finds you. According to a recent study by Business News Daily, it was reported that many individuals work in jobs that make them happy rather than for money, and it has shown that it leads to higher levels of success. (Morrison, 2022)

The poem also reminds me to study hard, follow my dreams and work hard to fulfil them. My role model is my future self, so I shouldn’t give up even when it gets too much and strive to be the best version of myself. I must learn to express optimism, and positivity, and opening my heart to the greatest of blessings that life has to offer. I also believe these words remind me to open my heart to new opportunities, and to take risks, by stepping out of my comfort zone.

Furthermore, the poem tells me to “await occasions, hurry never.” This speaks volumes because it reminds me that patience is key. Good things come to those who wait. I should not feel discouraged if a colleague gets a job before me, my turn will come. We each live a unique life, and we each have a unique timeline…

Amongst all the advice, the most important one is “to let the spiritual, unbidden, and unconscious grow up through the common.” In all the craziness that life throws my way, I should always make sure that I am true to my religion, and never let go of my spirituality, and even though we live in a world that is very trendy, I should live a life that is suitable for me, myself and I because I am me and nobody else can ever be me.

Just like the KAWA model that we learn about in OT, the rocks represent all the different challenges in life, such as anxiety of the future, trauma, loss, the unknown, balancing work life to personal life, there will be personal attributes (driftwood) that will help me overcome these challenges, such as being optimistic, working hard, being kind to everyone and being enthusiastic and brave, all of which will help me to become the better version of myself. The water represents the flow of life, the constant things that will always be there to provide support, such as my religion, my family and friends, and hopefully one day a family of my own.

There is still a long road ahead, with many challenges, many worries, and anxieties and I like to believe that there are many happy moments in between… That being said, I should always keep in mind that “the past is my lesson, the present is my gift and the future is my motivation!”

[fathimapatel]

Occupational Barriers experienced in mental health in South Africa

In my second year of studying, we learned about occupational science, which is the “rigorous study of occupational beings.”(Asaba& Wicks, 2010)  Here, we were introduced to Occupational Injustice and came to know the sad reality of how certain circumstances do not allow individuals to receive or engage in occupations. This can be through individual, community, or environmental stress, social conditions, limited access to resources and opportunities, and lack of occupation. These are referred to as Occupational Barriers.

The word ‘occupational’ (derived from occupation) is familiar to OTs, as we know it is the everyday activities individuals engage in to occupy their time and bring meaning to their life. The Oxford Dictionary describes a barrier as “a circumstance or obstacle that keeps people or things apart or prevents communication or progress.” Hence, an “occupational barrier” is an obstacle that keeps individuals from engaging in meaningful occupations every day.

When I reflect on what I have learned and experienced in many facilities in South Africa, it is evident that occupational barriers do exist, either in the form of deprivation, alienation, or apartheid, which impact mental health in various ways.

Occupational Deprivation refers to the “state of political, displacement, or socio-political restrictions an individual or group of individuals experience, that does not enable them to engage in occupations meaningfully.”( Whiteford G, 2000) This also includes social, environmental, geographic, cultural, and interpersonal factors. I have learned so far in the facility that I am in, that low self-esteem (which is an interpersonal factor) is a huge factor as to why individuals may not participate in occupations, as they fear they might fail or not be good enough. The National Library of Medicine states that there are various reasons as to why individuals do not seek professional help for common mental disorders and can include “negative attitudes towards seeking help, as well as costs, transportation or inconvenience, confidentiality, the feeling of being able to handle their problems on their own, and the belief that treatment will not help.”(National Library of Medicine) This is true because sometimes, it is factors out of an individual’s control that restrict them from getting the care that they need. I have seen clients not attend treatment sessions, as traveling to the clinic is expensive and a distance to travel. This can also mean that there are a limited number of clinics that offer OT services to clients in communities. Not attending intervention sessions, an individual may experience low mood, and further decrease in self-esteem, as they are not receiving the intervention and their condition may deteriorate as a result.

Occupational alienation is described as a “prolonged experience of disconnectedness, isolation, emptiness, lack of identity, a limited or confined expression of spirit or a sense of meaninglessness” (Townsend & Wilcock, 2004, p. 80) This also relates to “limited or forced participation in occupations viewed as meaningless or purposeless” (Stadnyket al., 2010; Wilcock, 2006). In my experience thus far, I have noticed how individuals experience low mood and isolation, especially when living away from family and friends. Many times, in situations when individuals are placed in a facility that caters to their needs, family and friends stop contacting individuals, which results in individuals experiencing isolation, grief, loneliness, and disconnectedness. They are forced to be disconnected from their family and past life and this can cause them to resent therapy or engage in occupations, resulting in depression. This also included institutionalization, where clients are forced to follow the routines and rules of an institution they reside in, which also affects their overall engagement in occupations as it can restrict their opportunities to try and be independent.

Occupational Apartheid, I think plays the biggest role in individuals engaging in occupations. This occurs in “situations where opportunities for occupations are afforded to some individuals and restricted to others based on personal characteristics such as race, disability, gender, age, nationality, religion, social status, and sexuality.” (Kronenberg & Pollard, 2005) I have personally witnessed this, when a client was diagnosed with right CVA, left hemiplegia. This affected his cognitive and physical abilities, and he was asked to leave his job as the company did not want to employ him because he would not be able to perform his roles in the workplace like before. Yet, what about the company adapting the workspace to allow the client to keep his job despite having a disability, as a return to work after he has received therapy? Is it necessary to exclude an individual from earning an income just because he may not look ‘normal?’ I can only imagine the effect it would have had on his mental health, the added stress it gave him, the anxiety and fear of whether he is going to ever be able to work again and not forgetting how his family would now have the burden of performing his daily occupations for him, which can cause the client to be vulnerable.

As a blooming OT, I have come to understand how important taking care of one’s physical and mental health is. It requires a lot of commitment, hard work, and acceptance. To allow individuals with mental health impairments to engage in meaningful occupations, change needs to happen, and that change begins with me, as a therapist. It is my responsibility to advocate and mediate for my clients, aim to equalize opportunities for participation, adapt the environment to suit my client’s needs, and to educate people that everyone has the right to experience meaningful occupations.

 Bill Clinton said, “ Mental illness is nothing to be ashamed of, but stigma and bias shame us all,”(Holmes & Williams, 2015) so going forward, let us try to eliminate the stigma of mental illness and provide equal opportunities for all!

[fathimapatel]

The loss, the gained and the future

The pandemic was and still is, a baffling 2 years and counting, of our lives. Society had to make many changes to their daily routines, such as working or studying from home, sanitizing their hands and groceries all the time, wearing a mask when leaving the house, and catching up with family and friends through a screen. It was almost like the world needed a detox from the hustle and bustle of life.

Apart from the physical changes that the pandemic did to us, it has equally affected our mental health. The World Health Organization defines mental health as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.” Mental health is an important part of our lives that needs to be treated with care, love, and lots of support. The CDC (Centre for Disease Control and Prevention) further states that mental health “affects how we think, feel, and act” as well as “helps us determine how we handle stress, relate to others, and make healthy choices.”

Many people have faced many challenges during the pandemic, such as losing loved ones, being retrenched from their jobs thus losing their income and livelihood, and not being able to physically meet their friends and family. All this would have naturally created stress and worry for an individual before a pandemic but add an unknown virus in the mix and a person’s worry and stress are beyond their control.

The Lancet reported in a published paper that “almost one in five Covid-19 patients develop a mental condition such as depression, anxiety or dementia within three months of diagnosis.” Many people, regardless of whether they had covid or not, have become anxious. There is without a doubt, lots of uncertainty about what the future holds. Children worry if they are going to see their parents again, and parents worry if their children are going to have a future. Many families have lost loved ones and have become depressed because of grief. They experience extreme sadness and loss and struggle to wake up and move on with their lives. Funerals became so rushed that families and friends did not get the chance to have closure.  

Although the pandemic was a difficult time for everyone, many communities came together in support of one another. Many people had lost their jobs and livelihood and loved ones. This could have caused them to struggle with coping, feeling fearful and scared, angry, sad, worried, and overwhelmed. Yet neighbours, friends, and family came together to support one another, by lending an ear, sharing a meal, and consoling one another.

I think that the habits people developed during the pandemic such as being careful with what they eat are good things to come out of the pandemic because this will improve their overall health in the future. It will help boost their immune systems and they will feel healthier. When you are physically healthy, you become mentally healthy. Your self-esteem is boosted, you learn to handle stress better and you learn to think forward more. It is important to remind yourself that time heals. With time, you will learn that life is too short to worry about the things you cannot control. We are not going to be living like pre-pandemic times, but we will learn to adjust our lives to the time we are in.

We are already on our way to a new normal. Wearing masks have become a choice, we are able to see and hug our family more often and we are able to travel again (even though we need much more paperwork done). The pandemic has taught us a lot and made us stronger and more resilient, and it is not over yet…

Yes, the future will always seem blurred and unexpected things will happen, but always try to look for something positive in each day, even if you must look a little harder some days!

[fathimapatel]

Standing at the edge of becoming an OT- reflections of my journey thus far

Winnie the Pooh said, “Life is a journey to be experienced, not a problem to be solved.”

We are well beyond the halfway mark in this current chapter of our life called university. Boy has it been a rocky road, each turn taking us through a series of emotions and having us second guess our life decision every single day.

From anatomy spotters, and community studies, to the many theory lectures and fieldwork days, and fun, innovative therapeutic media sessions, OT has shown me a side of myself that never fails to amaze me. I have seen such personal and academic growth thus far, that the young me is extremely proud of.

Without a doubt, when embarking on a new chapter, there are always feelings of anxiety, fear, and nervousness but at the same time, there’s excitement, adventure, and motivation. I like to think of these past few years as a gravel road, at a steep incline, with many loose rocks that one wrong step is enough to set you back a whole year. This is exactly what happened to me. I always knew I wanted to study in the health field and when I was accepted for OT, I was over the moon! It is different but very intense. After failing 2 anatomy modules in the first year, it was hard to see my friends go forward into the second year, and I had to stay behind, repeat 2 modules and the thought of making new friends was daunting.

Giving second thought to whether I made the right decision to study OT, I continued into second year with mixed feelings of worry, excitement and fear of failing another module again. Soon after, the world shut down… A chapter within this chapter that is incredibly strange. A single virus closed all doors to the world and every single person on earth, rich or poor, of all races, gender, and religion, was confined to their homes for 3 weeks. 3 weeks turned into 6 weeks, which turned into the longest lockdown. Understanding it was for our own safety, we moved on with each day experiencing a new challenge with technology, losing connections, mourning loved ones and learning new skills for survival. I completed my second year in 6 months, online. It was different, I have no other words to describe this experience.

Tests were online, and lectures were on zoom, but the best part was attending lectures in my pyjamas. I had to grow up overnight, study content on my own, and learn new skills through videos. It was challenging to say the least, but if “it doesn’t challenge you, it won’t change you!”

It was frustrating when you lost connection on zoom, or load shedding happened in the middle of a test. It got arduous, at most. It was frantic to meet deadlines, study for tests, and find time to still take care of myself. The only thing that kept me going was my faith, the support from my family, and excellent organization, of course.

Third year has been a bit better, having more exposure to practical learning, really put into perspective my goals for myself, for my career, and why I chose to study OT. It confirmed that I was where I belonged. I have learned and still learning new things every day, loving the challenge OT brings to me and learning from my mistakes. I have become more compassionate, more confident, and more considerate than before. There’s a certain pride in me when I say, “I am studying to be an OT,” it is something I cannot explain.

It may seem selfish, but it is good to put yourself first sometimes, know when you have reached your limits, if you break, cry it out. Sometimes that is all you need to do. There have been tears, laughter, and many wonderful memories, of trying to make a difference in the lives of others and being a part of positive change in the world. And there is going to be more, I know that.

After you cry it out, do not stay there. Refocus on where you are headed. Remember, “it’s always hard at first, messy in the middle, and gorgeous in the end!”- Robin Sharma