#communityot

[survivingot]

From Lecture Halls To Beyond The Walls: Is Community Practice The Better Teacher?

Walking through a community like Kenville as an “outsider” has started to feel like a privilege. The respectful nods from those whom we pass, the cheerful greetings from familiar faces who have passed through the clinic and the joyful screams from the young ones within the crèche have stirred within me feelings of a warm welcome, appreciation, and dare I say belonging. As I spend each day in Kenville, I’ve found myself observing far more that I have ever expected, not only in the people around me but within myself. Somewhere between these interactions with clinic patients, conversations with caregivers and walking amongst the stores and homes as we navigate to our sites, I realised that I was no longer asking, "What intervention should I provide?" Instead, a different question has begun to surface: What does it actually mean to be prepared for community practice?

(A glimpse at a part of the Kenville Community through the bus window)

I entered my final year of Occupational Therapy at UKZN believing that preparation meant knowledge. If I was asked if I was prepared, I would look to my understanding of anatomy, mastering of assessment tools, memory of developmental milestones and how to select an appropriate frame of reference. Although I acknowledge that those things are undoubtedly important—they form the language of our profession- Kenville has shown me that community Occupational Therapy speaks another language as well: one of relationships, adaptability, humility and partnership.

(Snapshot of personal lecture notes on Primary Healthcare taken in my first academic block of my final year)

As I reflect over this week, I have discovered something profound: the curriculum has taught me what Occupational Therapy is. Kenville is teaching me how to be an Occupational Therapist. Community practice has challenged me in ways that no practical examination ever could. At university, learning theoretically made intervention feel structured and predictable. In Kenville, every home, every family and every conversation tells a different story. People's occupations are influenced by far more than physical ability. They are shaped by transport, employment, housing, education, safety, culture and access to resources. These realities cannot simply be acknowledged in an assessment—they must become part of our clinical reasoning.

The Alma-Ata Declaration reminds us that "health is a fundamental human right" (World Health Organization [WHO], 1978). Before this placement, I understood those words academically. In Kenville, I have begun to understand them personally. It has encouraged me to think differently about primary healthcare. Rather than viewing it as the small part of medical care, I now see it’s true importance. It is the place that provides hope, through healthcare, in the lives of each community member.

This week has also introduced me to the concept of occupational consciousness. Ramugondo (2015) encourages Occupational Therapists to become aware of how history, power and inequality shape people's everyday occupations. As I have spent more time within the community, I have started to notice these influences more consciously. Occupations in Kenville are not simply personal choices; they are shaped by opportunities that society either provides or withholds. Recognising this has challenged me to look beyond individual performance and consider the broader systems that enable or restrict participation for each of my clients.

Kenville is making me question my political beliefs and support, something which I find extremely relevant as we approach the 2026 elections. Throughout our degree we have frequently engaged in discussions about occupational justice. Whilst those conversations have been integral to our education, I believe that it is only through this opportunity on the ground that I have found myself contemplating on the political sphere in terms of our healthcare system. It has made me question whether our healthcare system truly provides equitable opportunities for participation. If occupation is central to health, why do some communities continue to face barriers that limit their ability to engage in everyday life over 30 years post Apartheid? Why should the quality of healthcare, education or occupational opportunities differ depending on where a person lives? These questions have no simple answers, but they have strengthened my belief that Occupational Therapists have a responsibility not only to provide interventions but also to work towards more just and inclusive communities.

As I continue to learn each day, I have realised that university can never be expected to prepare me for every situation I will encounter in a field as diverse and dynamic as Occupational Therapy. It has however trained me in something far more valuable: the ability to think critically, reflect honestly and continue learning from every person I meet. Kenville is teaching me that competence cannot be measured by having all the answers. It is measured by being willing to listen before speaking, to learn before leading and to work with communities rather than for them.

Perhaps that is what being prepared truly means. Perhaps, somewhere between the lecture hall and the community, I am not only learning how to practise Occupational Therapy—I am beginning to develop into the kind of Occupational Therapist my lecturers have encouraged me to become.

References

Galvaan, R. (2015). Occupation-based community development and occupational justice in South Africa. South African Journal of Occupational Therapy, 45(1), 3–6.

Ramugondo, E. L. (2015). Occupational consciousness. Journal of Occupational Science, 22(4), 488–501.

Townsend, E., & Wilcock, A. A. (2004). Occupational justice. In C. H. Christiansen & E. A. Townsend (Eds.), Enabling occupation II: Advancing an occupational therapy vision for health, well-being & justice through occupation (pp. 243–273). CAOT Publications ACE.

World Health Organization. (1978). Declaration of Alma-Ata.

World Health Organization. (2010). Community-based rehabilitation: CBR guidelines.

[occupationalfootprints2026]

The child is never the beginning of the story

Why maternal and child health matters to society: reflections from my first week in Kenville through an Occupational Therapy lens

I have a confession.

Five days into my community block in Kenville, my notebook has already betrayed me. I thought it would fill with observations about children's development, how they moved, played, communicated, and participated in the occupations that make up childhood. Instead, somewhere between the first screening and the drive home, my notes started filling with different words: mother, caregiver, poverty, support, mental health, policy, opportunity.

Somewhere along the way, my questions changed. Perhaps that is exactly what community practice is supposed to do.

Occupational Therapy has never taught me to look at people in isolation. Whether working with someone recovering from a stroke, navigating mental illness, rebuilding life after homelessness, or supporting a child with developmental challenges, the question has never simply been "What can this person do?" It has always been "What shapes what this person is able to do?"

This week, maternal and child health became the lens through which that lesson came into sharper focus.

More than clinics and milestones

When we hear "maternal and child health," it's easy to picture pregnancy, immunizations, clinic visits, and developmental milestones. The World Health Organization frames it as promoting the wellbeing of mothers while ensuring children survive, grow, and reach their developmental potential. All of that is true. But after one week in Kenville, I am beginning to think maternal and child health is about something bigger: the conditions that make health possible in the first place.

Health isn't created only in hospitals. It's woven into ordinary occupations such as  preparing a meal, resting, earning an income, attending an antenatal appointment, playing with a child, finding the emotional space to simply be present. These small, unremarkable occupations quietly shape extraordinary outcomes.

I almost wrote, "It all starts with the mother." Then I stopped. That sentence carries more weight than it should, and in South Africa, it carries a particular kind of weight. It risks placing the burden of child development onto individual women, while saying nothing about the conditions under which they are expected to mother. A mother's health does shape her child's development, but her health does not exist in a vacuum. It is shaped, often narrowed, by poverty, unemployment, food insecurity, violence, and by a healthcare system that is not always built around her. Before we ask mothers to nurture, we have to ask honestly whether they have been given the conditions to be nurtured themselves  and whether that is a fair question to leave to families alone, when it is, at root, a question of resource distribution and policy.

Maternal and child health, then, is less about individual responsibility and more about collective responsibility ; a distinction that matters clinically, not just rhetorically, because it changes where we look for the problem.

What happened upstream?

Mokwena's (2021) work on maternal depression in South Africa could easily be read through a purely psychological lens. Instead, I found myself thinking in terms of occupation. Depression changes what a mother is able to do; it can affect bonding, routine, play, rest, communication, and the countless small interactions that quietly build a child's development. Maternal mental health isn't only about how a mother feels; it shapes what becomes possible in a household's everyday life. And in a country where access to mental health support is patchy and unevenly distributed by geography and income, that is not a private struggle , it is a public health gap.

That thought stayed with me through our screenings.

Some of the children we met struggled with balance, coordination, language, or following instructions. My first instinct, trained into me, was to think intervention. That is part of the job. But another question kept interrupting the clinical reasoning: what happened upstream?

When you stand beside a river, it's easy to focus on the water passing you. Community practice asks you to walk upstream instead to ask what opportunities a child had to play, who responded when they cried, whether there was time to sing or read or explore, whether their caregivers had support, and what invisible barriers shaped this family's occupations long before I arrived with my clipboard. Developmental "delay," I am realising, is rarely a delay in the child. More often it is the visible ripple of an invisible, structural reality.

This reframes school readiness too. It's tempting to call children "ready" or "not ready," as if readiness belongs to the child alone. I'm increasingly convinced that readiness is really a record of the occupations a child has had access to, the crawling, climbing, playing, failing, trying again, being responded to, long before anyone hands them a pencil. The Nurturing Care Framework captures this well through its emphasis on health, nutrition, responsive caregiving, early learning, and safety, refusing, as I'm learning to, to isolate the child from the people and systems around them.

Ubuntu, and who gets to rest

Nyandeni and colleagues' (2024) reading of maternal and child healthcare through Ubuntu pushed this further still. Umuntu ngumuntu ngabantu  a person is a person through other people. Well-being is never manufactured alone. Occupational Therapy holds a similar, quieter belief: occupation is relational. The chances available to one person become the chances available to another. A caregiver's opportunity to rest, to access healthcare, and to be supported by a partner or a system becomes a child's opportunity to play and learn. Maternal and child health stops being a paediatric issue and becomes a community one which also means it becomes a political one: someone, somewhere, decides how support, clinics, and grants are distributed, and that decision reaches a child long before we do.

Simbeni and Mokgatle (2023) make a related point about maternal support shaping children's psychosocial outcomes , but what struck me most is that support itself is not evenly distributed. Some communities can offer families more than others; some families have more to draw on than others. The real question isn't only how we support children, but how unevenly support is currently being allocated, and to whose advantage. This is a question that sits closer to power than to pity.

What this means for practice

Occupational Therapy cannot eliminate poverty. It cannot undo structural inequality or guarantee equitable healthcare; it would be dishonest to pretend otherwise. What it can do is refuse to separate occupation from context. It can name participation as a matter of opportunity, not only ability. It can advocate for environments that enable occupation, flag barriers early, and work alongside communities rather than arriving with solutions already decided. For me, practically, that means something specific for the five weeks I have left: asking caregivers not only about the child in front of me but also about what would need to change around them, in their home, their support, and their access for that child's occupations to widen. That is a different question than the one I arrived with, and I intend to keep asking it.

Five days is not enough time to understand Kenville. It is, however, enough time for Kenville to begin questioning me. I arrived believing maternal and child health was an important public health topic. I still believe that. What has changed is why. I no longer see it as something that begins with pregnancy and ends with a developmental milestone. I see it as a reflection of how a society values care, distributes opportunity, and creates the occupations that let people flourish.

We often say children are the future. Perhaps they are. But I am beginning to suspect the future is shaped less by the children themselves than by the conditions into which they are born. Maybe the child was never the beginning of the story. Maybe they are simply the chapter where the rest of the story becomes visible. I have five weeks left in Kenville. I suspect it will keep changing my questions long before it changes my answers.

Reference list

Mokwena, K. (2021). Neglecting maternal depression compromises child development in South Africa. South African Journal of Psychology, 51(4), 567–582. https://doi.org/10.1177/00812463211033416

Nyandeni, M., Maphumulo, W. T., & Bhengu, B. R. (2024). Exploring maternal and child healthcare projects in South African communities through an Ubuntu lens: An appreciative inquiry. BMC Nursing, 23, Article 145. https://doi.org/10.1186/s12912-024-02425-z

Simbeni, S., & Mokgatle, M. M. (2023). Maternal support and psychosocial outcomes in South African children. Health SA Gesondheid, 28, Article 2123. https://hsag.co.za/index.php/hsag/rt/printerFriendly/2812/5625

World Health Organization. (2024). Maternal, newborn, child and adolescent health and ageing. https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing

World Health Organization, United Nations Children's Fund, & World Bank Group. (2018). Nurturing care for early childhood development: A framework for helping children survive and thrive to transform health and human potential. https://nurturing-care.org/

AI Declaration: Microsoft Copilot was used as a writing support tool during the development of this blog. It assisted with refining the structure, improving clarity and flow, correcting grammar, and reducing repetition. The ideas, reflections, critical analysis, interpretation of the literature, and connections to my community placement in Kenville are my own.

[sizo14]

Impacting Lives, Saving The Future!

Images from google images

All United Nations countries share a common goal which aims to ensure sustainable development that addresses economic, social, and environmental factors that impact the quality of life (United Nations Development, 2015).  There are 17 global goals, that are analyzed through open data and research, that also help achieve and measure progress on set goals(Gurin et al., 2015). In the Mariannridge community, the sustainability goals that will be working on are, no poverty, good health and well-being, quality education, zero hunger, and sustainable cities and communities.

Lacking basic human needs including shelter, food, clean water, social support, education, and also access to health are measures of poverty (Divine Word Missionaries, 2023).  Having the privilege of being placed and working in a low-income community forces one to look for strategies that can help sustain and result in access to basic needs. One can never eradicate all at the same time but seeing what the community needs the most and can be sustainable is important. In the Thornwood community under the Saint Marys’ Community Outreach Centre, we have been working with children from underprivileged homes who mostly depend on social grants and also meals provided by the After Care Centre that looks after them. We have started implementing a vegetable garden that will be used for their meals as they had mentioned that they struggle as a Centre with funds. This program will be sustainable as there are people with gardening skills within the center. This will also teach the children the skills of gardening that they can even use in the future since they will be active members in carrying out the project. This project serves as a reminder that even the little action we take, can lessen the burden and improve lives

According to GGI Insight (2024) living your life to the fullest while in a state of being healthy and fulfilled is considered good health. Being in a community setting means making an impact in people's lives, instilling hope providing and delivering health services. Chen (2023), mentioned that one can not access services such as hospitals or clinics due to reasons such as finances, being a community OT in the Marrianridge community means bringing interventions into their homes as they also have challenges with accessing health care services due to funds. Four times a week home visits are conducted to those whose health status is not in good standing. Going to their homes to provide care brings hope to them and also gives them the sense of being cared for which they always appreciate at the end of the sessions. More than 3 individuals encountered mentioned having missed their appointments not only once or twice due to lack of finances.  With these home visits from door to door, the number of people who do not get health attention decreases and some are equipped with knowledge as caregivers are also educated. Health Promotion in clinics and schools is conducted to promote health and share information that they may not need now but future.

According to World Health Organisation (2022) providing quality education to all is a global goal. It is aimed at ensuring equal access to education, encouraging lifetime opportunities and access to universal education while improving literacy rate and educational income. With the increased number of people accessing the quality of education decreases, for example, at Marrianridge Primary School there is a high number of student intake (access to education), but due to this number in each class, there's decreased individualized attention given to learners resulting in challenges in quality of education and literacy decreasing their chances of accessing higher education, increasing a number of people dropping out. Working with children who are having challenges in school such as writing, and reading has been motivating when improvement is noted due to individualized care. With a lack of access to tools that can be used to improve the quality of education, tools made out of recycled material will continue to be explored such as using cardboard boxes to improve directionality, this is to be implemented as this is something they struggle with the most. This also adds to the overall global goal of providing quality education. Seeing them having access but not benefiting makes one reflect on how they can assist in the few weeks spent with them. A Red Flag workshop will also be held with educators, sharing indicators for their learners who need attention so that their challenges may be addressed early.

Working on eradicating hunger is one of the aims we would like to achieve by the end of the block. Implementation of strategies that would be working on this is not in place as yet. Advocating for community members on the stakeholders will be considered. On observations at the Thornwood community, there's a community kitchen soup by the Councillor’s office every. Advocating for the same thing in Marianridge would assist in eradicating hunger. Improving access to quality education and access to basic needs by the programs implemented would also indirectly fight against hunger in the lives of community members. While improving one development goal mentioned before our Marianridge community would be sustained. Working hard as a community OT channeling, advocating, and implementing will surely help in achieving the goals.

Remember it takes one step

Remember it only takes one step to win the race, which we are ready to take on!

Total Number of Words: 899

References

Chen, J. (2023, July 12). What’s Poverty? Meaning, Causes, and How to Measure. Investopedia. https://www.investopedia.com/terms/p/poverty.asp#:~:text=The%20term%20poverty%20refers%20to

Divine Word Missionaries. (2023). Poverty Isn’t Just About Food — 3 Types of Poverty Around the Globe. Stories.svdmissions.org. https://stories.svdmissions.org/the-mission-post/poverty-isnt-just-about-food-3-types-of-poverty-around-the-globe

GGI Insight. (2024, May). Good Health and Well Being: What You Want to Know. Www.graygroupintl.com. https://www.graygroupintl.com/blog/good-health-and-well-being#:~:text=Good%20health%20allows%20us%20to

Gurin, J., Manley, L., & Aris, A. (2015, September). Sustainable Development Goals and Open Data. World Bank Blogs. https://blogs.worldbank.org/en/digital-development/sustainable-development-goals-and-open-data#:~:text=Open%20Data%20can%20help%20achieve

United Nations Development Programme. (2015). Sustainable development goals. Sustainable Development Goals; United Nations. https://www.undp.org/sustainable-development-goals

World Health Organization. (2022). Sustainable Development Goals. Www.who.int. https://www.who.int/europe/about-us/our-work/sustainable-development-goals

[rambling22yearold]

My Views of Working in the Community Have Changed Over Time- 4 weeks in...

Throughout my years of studying and being exposed to clinical experiences, there has been none like this community block. It has not only opened me up to my own flaws and vulnerabilities but also to the systems within our country. This block began without any expectations attached because I knew that this experience was going to be completely different and unique as compared to the rest. “we will be therapists who walk the community, they know the students in the green scrubs” is what I heard. It sounded astounding, the amount of difference we could make. 

Engaging in community block programs as students in local areas, allows us to apply theoretical knowledge practically. These programs are rooted in experiential learning theories, which involve interacting with the real world and integrating new knowledge with existing ideas.

It is difficult to approach a community without any preconceived ideas. On our first day at Cato Manor, even before jumping off the bus we all hid our phones and brought no expensive equipment and accessories because we expected to get robbed if seen with them, "From what we were told". 

According to Daniel Kahneman, potential losses have a greater impact than potential gains, leading people to regret missed opportunities more than taking risks. Reflecting on my experiences, such as the workload and feedback from other students, I encountered moments of amazement, overwhelm, and frustration. However, these experiences served as stepping stones, helping me build a strong academic and personal foundation. Developing excellent time management skills was crucial, especially when faced with deadlines before starting the block.

Transitioning from a minimalistic approach to embracing urgency, as taught in Cato Manor and Denis Hurley, required unlearning and adapting to diverse therapeutic situations. It was essential to go beyond job descriptions, putting in extra effort and occasionally performing tasks beyond my role. Working as part of a multidisciplinary team (MDT) and prioritizing top-notch patient care were paramount. Fieldwork experiences, as highlighted by Lorenzo (2006), play a vital role in shaping professional behavior and preparing students for their careers.

The initial challenge of working with various patient demographics, including physical, psychosocial, and pediatric cases, was quickly apparent. While initially challenging, being assigned to a clinic offered invaluable learning opportunities. This block transformed my approach, allowing me to appreciate the diversity of conditions and the joy of treating each one daily. Overcoming initial difficulties, particularly in working with children, was facilitated by constructive feedback and a willingness to learn, leading to a newfound enjoyment in pediatric therapy.

Working at Denis Hurley with children from the Dalton Creche significantly influenced my career direction, fostering a deep love for paediatric therapy. Engaging in diverse activities and forming meaningful connections with patients underscored the therapeutic benefits of occupational therapy. This experience highlighted the importance of continuous learning, adaptability, and problem-solving skills in delivering effective therapy.

Exploring cost-effective materials and encouraging patients' creativity and engagement in therapy sessions were rewarding experiences. Observing patients' enhanced creativity and enjoyment validated the efficacy of using such materials. Despite challenges, including the need for continuous learning and problem-solving, these experiences enhanced my skills as a future therapist.

The above quotation, attributed to Dorothy, a distinguished figure in  African American civil rights and women's rights activism, serves as a testament to the profound insights I have reaped through my engagement in community service. My involvement has yielded a deep enrichment by virtue of my interactions with community members, providing me with a heightened awareness of the privilege from which I come. The individuals within these communities have not consciously chosen the circumstances in which they find themselves. Immersing oneself in such environments promotes a greater capacity for empathy, which transcends mere sympathy from a distance. Being present and taking action in delivering healthcare services to all community members has proven to play a significant role in uplifting individuals within their community.  

The primary aim of my block was to grasp the requirements of the community and its accessibility, involving in-depth research, guidance, and practical involvement. Despite my initial lack of confidence, the journey highlighted the intricacies of rural therapy, stressing the significance of mentorship and personal development. Engaging in pediatric group therapy, health initiatives, and diverse placements provided crucial learning experiences, shaping my identity as a therapist dedicated to comprehensive care. Additionally, I value and believe that the connections I've forged with the women I worked with during this block were invaluable, making the experience more manageable

This block has been instrumental in fostering a deeper understanding of societal issues, solidifying my understanding of my profession and preparing me to provide holistic care during community service. Despite its challenges, it has been a journey of lifelong learning. Leveraging the insights gained from peers and supervisors during this block will enable me to strive for excellence, not only in transforming communities but also in personal growth. I look forward to the opportunities for greater achievements that lie ahead as this journey continues.

References

Giles, D. E., Jr, and J. Eyler. 1999. The theoretical roots of service-learning in John Dewey: Toward a theory of service-learning. Michigan Journal.

Erez, M., & Zidon, I. (1984). Effect of goal acceptance on the relationship of goal difficulty to performance. Journal of Applied Psychology, 69

Eyler, J., and D. E. Giles Jr. 2009. Where’s the learning in service-learning? San Francisco: Jossey-Bass.

King, P. 1992. How do we know? Why do we believe? Learning to make reflective judgments. Liberal Education 78 (1): 2–9.

Lorenzo, T., Duncan, M, Buchanan, H and Alsop, A (Eds.). 2006. Practice and service learning in occupational therapy 2nd edition. John Wiley and sons. New York. [ Links ]

Schwartz, D., J. Bransford, and D. Sears. 2005. Efficiency and innovation in transfer. In Transfer of learning from a modern multidisciplinary perspective, ed. J. Mestre, 1–51. Charlotte, NC: Information Age Publishing.

TOP 25 COMMUNITY SERVICE QUOTES (of 59). (n.d.). A-Z Quotes. Retrieved March 29, 2024, from https://www.azquotes.com/quotes/topics/community-service.html

[rambling22yearold]

Building Sustainable Futures: Addressing Community Needs and Development Goals.

Welcome again, changemakers and goal-getters, to the Sustainable Development Goal-diggers' hub! We’re not just dreaming of a brighter future, we're digging deep to unearth the five Sustainable Development Goals (SDGs) that will shape our community's destiny. Join us as we roll up our sleeves, grab our shovels (metaphorically, of course!), and embark on a journey of empowerment, inclusion, and positive change. It's time to dig in and make a sustainable difference!

In my view, these goals serve as an excellent framework for countries to adopt and utilize as a roadmap for devising strategies to alleviate the challenges faced by individuals living in poverty. This approach compels countries to tackle the root causes of poverty, including issues like inadequate access to healthcare services, high unemployment rates, and hunger.

Why is it imperative for us to tackle these issues? 

The article attached below offers a comprehensive explanation and insight into poverty and inequality, including their interconnectedness with political dynamics. While the article may not be specific to South Africa, its content remains pertinent to our context and can offer valuable perspectives.

Inequality, measuring it and why it matters for poverty reduction

This briefing shows that measuring and reducing inequality should be central to tackling poverty and meeting SDG10 and the 2030 Agenda to le

 I have finally linked my knowledge of social determinants of health to designing community programs aimed at tackling these factors. Now, I can leverage the SDGs to assess the objectives of my projects within the community and identify additional measures to achieve the goal to the fullest extent possible. By gathering resources and gaining a deeper understanding of the significance of SDGs in implementing impactful projects and strategies which is key in embracing a new perspective in my professional practice

In the Cato Manor Community and Denis Hurly, we can focus on working towards achieving SDGs such as:

Good health and well-being

Decent work

Economic growth

Quality education

Reduced inequalities

This goal is clearly defined in my work within the community. My role within SDG 3 is focused on health promotion, which involves advocating, educating, and modifying lifestyles or environments to prevent disease, injury, or unhealthy choices. The aim is to empower individuals to engage in meaningful activities and enhance their overall health and well-being. Introducing Occupational Therapy and explaining its scope of practice allows me to reach individuals who may not know where to seek help. We collaborate with healthcare providers, community clinics, and the NGO via the youth development officer to ensure that residents have equitable access to quality healthcare. We also bring OT services to the community…

In both venues where I am placed, my team and I conduct health promotion speeches three days a week. During these sessions, we educate clients about OT's role and address health-related risks and strategies for individuals and groups. For instance, I work with adolescents from challenging backgrounds, providing tailored interventions on safe sex practices, navigating teenage pregnancy, and improving self-esteem. I also work individually with mothers facing parenting and mental health challenges, ensuring their children receive early screenings for physical or developmental issues and educating mothers on supportive parenting practices.

Recently, I began working with men struggling with substance use challenges. Building their understanding of the risks and adverse effects of substance use has been challenging, as I fear losing progress the moment they leave that door. This goal prompts me to explore new strategies, such as creating health promotion pamphlets and delivering talks, to make a more significant impact on the community's health and well-being.

SDG 4 is aiming for quality education and there are a few targets that I contribute to when I work with the children at a crèche and adolescents at the secondary school. Some of the target aims for “equal access to quality pre-primary education” and for “universal literacy and numeracy”(The Global Goals, 2024).  I contribute to this goal because I use my knowledge of play with paediatrics and incorporate it into fun activities, songs, sessions that teach the children basic learning skills such as numbers, shapes and colours and life skills such as safety. This builds the foundation of learning that all children need in order to succeed in their academic education, especially within the disadvantaged community of the Dalton Hostel. This SDG does not only focus on kids however. Within the group of young female adolescents, we have sessions on communication skills, emotional regulation, conflict resolution, and decision-making and have collaborated with the social worker at school to create an environment within the school and amongst themselves as peers.

In my practice within the community, I work with both men and women equally. There are some aspects where women need more attention. For example, maternal and child health. I do not just put my focus on the mother taking care of the child. I also consider the mother's mental health, her employment status, and her relationship with the father of her baby or her partner.  I also provide the same learning opportunities for both men and women as all the projects that are run within the community. 

The image above illustrates the inequalities faced by women in the workplace. They make the majority of the workers in lower income jobs. 73% of people earn less than R6 000 per month, while 3.3% earn greater than R52 000 (Opperman, 2023). This statistic indicates how there is merit for ‘reduced inequalities’ which is the tenth SDG. Here we strive to provide equal opportunities for previously disadvantaged groups and minority groups and this SDG will flow well with SDG 8 that will follow. These groups include people of colour, women, and individuals with a lower socio-economic status. In the workplace women are seen as an expense particularly when they are also mothers. According to Statistics South Africa the  unemployment rate for women is 35,5% compared to 32,6% for men.

+

Within the women’s empowerment group at Denis Hurly Centre, my goal is to equip motivated women with basic sewing skills and skills such as financial literacy, life skills development, and self-esteem building to help homeless women regain independence and stability while providing holistic support services for homeless women including healthcare education and mental health support however poor attendance has been hindering the progression of this project. The same goes with the men from the substance use groups, incorporating the topic of employment, prevocational skills and job upskilling is important because what then when they return back from rehab to the very environment they are attempting so hard leave, employment could be the key to a healthy occupational balance and income generation to support themselves and their families. I believe SDG 8 and 10 work well in conjunction with each other and can be seen as a collective because they work towards providing skills and educational opportunities to enhance the capacity of these marginalized groups to address systemic inequalities and that programs and services are inclusive and accessible to all community members, regardless of their socioeconomic background, race, ethnicity, gender, or disability status.

As I reflect on our efforts to promote inclusion and positive change, I am reminded of the immense challenges that lie ahead. Achieving the SDGs in South Africa, particularly in communities facing socio-economic complexities like ours, is a formidable task.

The difficulties stem from a myriad of factors. Persistent inequalities, rooted in historical injustices and systemic barriers, continue to hinder progress. Limited access to essential services, including healthcare, education, and economic opportunities, poses significant challenges. Political and economic instability further exacerbates the situation, making sustainable development goals seem like distant aspirations.

Moreover, cultural norms, societal attitudes, and resistance to change can impede efforts to implement transformative initiatives effectively. The complexities of urban and rural dynamics add layers of complexity to our endeavours, requiring tailored strategies and holistic approaches to address diverse needs.

However, despite these challenges, our journey has also been marked by resilience, determination, and collective action. Through collaboration, advocacy, and community engagement, we have witnessed the power of unity and the potential for positive impact.

As I look towards the future, it is imperative that I continue to work tirelessly, leveraging partnerships, innovative solutions, and the unwavering spirit of our communities. The SDGs may seem daunting, but they also offer a roadmap—a blueprint for building a more inclusive, equitable, and sustainable society.

References

Goal 3: Good health and well-being. Goal 3: Good health and well-being | Joint SDG Fund. (n.d.). https://jointsdgfund.org/sustainable-development-goals/goal-3-good-health-and-well-being#:~:text=SDG%203%20aspires%20to%20ensure,medicines%20and%20vaccines%20for%20all 

Goal 4: Quality Education. The Global Goals. (2024, January 23). https://www.globalgoals.org/goals/4-quality-education/ 

Hardoon, D. (2022, February 21). Inequality, measuring it and why it matters for poverty reduction. Development Initiatives. https://devinit.org/resources/inequality-measuring-poverty-reduction/#:~:text=Economic%20inequality%20is%20closely%20linked,making%20than%20the%20wealthiest%20people.

Rensburg, R. (2021). Healthcare in South Africa: how inequity is contributing to inefficiency. Retrieved from https://www.wits.ac.za/news/latest-news/opinion/2021/2021-07/healthcare-in-south-africa-how-inequity-is-contributing-to-inefficiency.html

StatsSA (2022). Nearly half of SA women are out of the labour force in Q2:2022. Retrieved from https://www.statssa.gov.za/?p=15668

StatsSA (2023). Beyond unemployment – Time-Related Underemployment in the SA labour market. Retrieved from https://www.statssa.gov.za/?p=16312

World Health Organization. (n.d.). Sustainable development goals. World Health Organization. https://www.who.int/europe/about-us/our-work/sustainable-development-goals#:~:text=The%20Sustainable%20Development%20Goals%20(SDGs,no%20one%20is%20left%20behind 

[rambling22yearold]

Unveiling the Essence of UKZN's Occupational Therapy Curriculum

Walking through the corridors of healthcare education, we stumble upon a treasure chest of wisdom and wonder—the UKZN Occupational Therapy curriculum. Like a map to hidden treasures, it promises to guide aspiring therapists.

As the role of Occupational Therapists continues to be dynamic and continuously evolve, the need for practitioners who are well-prepared to work in community and primary healthcare (PHC) settings has become increasingly apparent. At the University of KwaZulu-Natal (UKZN), the OT curriculum plays a pivotal role in shaping the future of OT practice. In this blog, we delve deeper into the fabric of this curriculum, it becomes imperative to scrutinize its efficacy and in this,, we embark on a journey of reflection, dissecting the curriculum through the lens of community care.

Occupational Therapy is a health Profession which utilizes human occupation as the intervention media to promote health and well being

At the heart of UKZN's OT program lies a four-year undergraduate journey, crafted to shape empathetic professionals equipped with the knowledge and skills to transform lives. Guided by seasoned educators, students delve into a myriad of subjects ranging from Anatomy, Psychology and Physiology to the philosophical underpinnings of OT Theory and Practice. Theory comes to life through hands-on experiences during Fieldwork Placements. Here, students immerse themselves in clinical settings, applying classroom knowledge to real-world scenarios where these placement within the KZN province  are the crucible where theory meets reality, fostering the development of competent and compassionate practitioners. Complementing the core curriculum are electives designed for the curriculum. From assistive technology to community-based interventions, these electives empower one to carve your niche within the profession, nurturing unique talents and interests.

Delving into the heart of occupational therapy education at the University of KwaZulu-Natal (UKZN), one finds a curriculum that transcends the confines of clinical walls, embracing the principles of community-based practice and primary healthcare (PHC). Within the fabric of core courses like Occupational Therapy Theory and Practice and Professional Issues in OT, the curriculum intricately weaves discussions on community interventions and the imperative of addressing health disparities in diverse populations.

Moreover, UKZN's commitment to community-centric care is palpable through dedicated courses and clinical placements designed for this purpose. These courses delve into community assessment, program development, and advocacy strategies, equipping students with the tools to effect change beyond traditional healthcare settings. Clinical placements then provide the crucible for experiential learning, immersing students in community health centers, schools, and nonprofit organizations. Here, they apply theoretical knowledge to real-world contexts, fostering cultural competence and collaboration within multidisciplinary teams.

The community I currently serve has numerous areas requiring the intervention of Occupational Therapists. However, once students depart, the community lacks ongoing support. This reality is disheartening and requires attention, with no profession better suited to address it than ours. We consider the individual holistically. We assess their home environment, support systems, available resources, mental health, HIV status, nutrition, and sleep patterns. Despite having much to offer, our valuable work isn't fully utilized where it's most needed.

I found this amazing article that highlights our readiness to practicing within rural settings, please have a quick look.

Introduction Despite greater needs in rural areas, occupational therapists are maldistributed to urban spaces which limits service access an

There are several challenges and limitations that warrant consideration. Significant challenges being resource constraints, potentially impacting the availability of state-of-the-art equipment, technology, and facilities essential for comprehensive training. Limited clinical placements in community settings also poses a barrier, as hands-on experience in diverse environments is crucial for developing practical skills and cultural competence. In the beginning of my degree we were faced with the unfortunate introduction of the COVID-19 pandemic in which we were not able to go into the community and gain essential practical knowledge from the Community Studies module present withing the OT curriculum. Additionally, there might be gaps in the curriculum content, such as insufficient emphasis on advocacy training or addressing the social determinants of health, which are essential for effective community-based practice. Overcoming these challenges requires a concerted effort from educators, policymakers, and healthcare institutions to allocate resources effectively, expand clinical placement opportunities, and continuously review and update curriculum content to ensure that students are adequately prepared to address more complex needs of communities in PHC settings as communities are constantly evolving.

One notable aspect is the emphasis on experiential learning opportunities embedded throughout the curriculum. Through clinical placements in diverse community settings, students gain first-hand experience working with individuals and populations in need. 

Moreover, the Community module in our final year fosters a culture of community engagement by encouraging us to participate in community-based projects and service-learning initiatives. By collaborating with local organizations, such as community health centers, schools, and advocacy groups, we have the opportunity to apply their knowledge and skills to address real-world challenges and contribute to positive social change. These experiential learning opportunities not only deepen our understanding of community health issues but also cultivate their empathy, cultural competence, and advocacy skills—essential attributes for effective practice in community and PHC settings. The way that the curriculum is structured allows for being a dynamic OT who is able to work in various community settings, encourages working under pressure to meet goals and prepares us for the real word by the hours we spend within the communities.

One of the common responses found from the study below was that the participants found it challenging to practice within the realities of a rural setting because of the resource constraints and because the undergraduate programme and clinical skills development had mainly occurred in well-equipped tertiary hospitals. It's not uncommon for practitioners to find it challenging to transition to rural settings due to resource constraints and the focus on training in well-equipped tertiary hospitals during our education. This disparity in experiences and resources can create barriers to effective practice in rural areas.

In reimagining the Occupational Therapy (OT) curriculum at the University of KwaZulu-Natal (UKZN) to better equip students for community and primary healthcare (PHC) settings, several key recommendations emerge. Firstly, integrating more robust community-based learning opportunities throughout the curriculum, including extended clinical placements in diverse environments, could provide invaluable hands-on experience. Additionally, fostering interprofessional education (IPE) initiatives would enhance collaboration skills essential for interdisciplinary PHC practice. Strengthening cultural competence training and expanding community-based research projects could deepen students' understanding of the complexities of working with diverse populations. Moreover, integrating advocacy training and offering elective courses in community health would empower students to advocate for policy changes addressing health disparities. Finally, forging stronger partnerships with local organizations would facilitate expanded clinical placements and community-based projects, enriching students' engagement with PHC initiatives. By embracing these recommendations, UKZN can ensure that its OT curriculum remains dynamic, relevant, and impactful in preparing future practitioners for the multifaceted challenges of community-oriented practice.

As we draw the curtains on our exploration of the UKZN Occupational Therapy curriculum, one thing becomes abundantly clear: the journey to community care excellence is a dynamic and evolving one. Through the lens of our analysis, we've glimpsed the strengths and opportunities embedded within the curriculum, each a testament to the dedication of educators and the aspirations of future therapists.

Yet, within this journey to finding the treasure chest, there are obstacles in the road and peaks to conquer. My reflection on the curriculum's pros and cons serves as a guide towards innovation and improvement. Let us harness the insights gleaned here to nurture a curriculum that not only prepares students for the rigors of community and PHC practice but also instils within them the spirit of compassionate care and unwavering dedication to those they serve.

As the sun sets on our discussion, let us carry forward the torch of inquiry and advocacy, knowing that the seeds of change we plant today will bloom into a future where community care thrives and flourishes.

In the ever-evolving landscape of healthcare, the role of occupational therapists as champions of community care and primary healthcare has never been more crucial. Through our exploration of the UKZN Occupational Therapy curriculum, we've journeyed through the corridors of learning, uncovering both its strengths and areas ripe for growth.

So, after all, do you think our curriculum prepares us enough to work in the community?

Yes, it definitely does

No, it surely doesn't

I am not quite sure

Voting ended onMar 22, 2024

References

Hayes, K., Santos, V. D., Boyd, N., Connelly, B., & Lustig, K. (2024). Preparing occupational therapy students for practice in rural areas: a scoping review protocol. BMJ Open, 14(2), e075886. https://doi.org/10.1136/bmjopen-2023-075886

Home - Discipline of Occupational Therapy. (2018, January 11). Ot.ukzn.ac.za. https://ot.ukzn.ac.za

Naidoo, D., Van Wyk, J., & Waggie, F. (2017). Occupational therapy graduates’ reflections on their ability to cope with primary healthcare and rural practice during community service. The South African Journal of Occupational Therapy, 47(3), 39–45. https://doi.org/10.17159/2310-3833/2017/v47n3a7

[ot-is-spilled-blog]

Occupational Therapy & Conquering Community Injustices One At a Time.

Piles of rubbish and litter cannot be contained on this land. There are sewage spills and waste within the streets and people's home environments. Houses are made of tin and do not have running water. The streets are filled with drugs and violence. Not even the schools are safe from this. This is Cato Crests community, riddled with injustices and huge inequalities compared to other more affluent suburbs.

Frank Kronenberg stated that as OTS, we cannot ignore politics because this directly affects human health (Kronenberg, 2022) . Politically, all human beings are equal. However, this is far from the truth as our societies have injustices in place. It is my understanding that this all began during apartheid, perhaps even before that as racism has always existed.

The Cato Crest community is made up of predominantly black individuals who are living in poverty. Khumalo’s (2019) research stated that apartheid policies encouraged racial segregation, which sparked the growth of informal settlements in post-democratic South Africa. In Cato Crest, informal settlements are encroaching, there is a severe shortage of land, housing and supplies to the area.

Going back to Frank Kronenberg, he believes that the future of Occupational Therapy is too strong, extreme or revolutionary to be tied down by a career. I am not sure if I agree with this completely. Working within the Cato Crest community, it does feel at times that I am playing the role of everyone in the MDT. What I mean is, sometimes you find yourself giving ‘speech therapy’ or ‘dietician advice’. Although this is not within our scope of practice, we still do this within a safe limit to holistically treat a client as they may not have access to any other services besides OT. I disagree with the second half of his statement. I do not feel as if I will have to go beyond the bounds of my profession, as being client-centred, I would never hesitate to give other medical or health advice of which I have knowledge.

 However, perhaps this is why many therapists find it difficult to define OT, as sometimes it feels like we do ‘everything’, especially in community-based practice. Frank Kronenberg, continued to describe that the future of this profession needs to focus more on larger communities. I agree with this statement as someone who is working at Denis Hurley Centre and Cato Crest community. These communities are riddled with injustices. This blog will go into detail on ways a few injustices can be dismantled through the future of OT.

Poor Sanitation within the Cato Crest community cannot be ignored. At the community, I saw an open body of water which was filled with sewage, there were diapers, and sanitary pads which are not properly disposed of. Rats’ fest on the pollution too. Citizens utilise outdoor toilets and many houses do not have running water or plumbing. This increases the risk of health issues, bacterial infections and can decrease play and education participation in children (Mara, 2010). In the future, I can use health promotion talks to educate people on ways to minimise waste to create a safer environment. Pamphlets can be handed out to members of the community on the importance of this. Perhaps, we could start a group of enthusiastic community members who can assist with weekly clean-ups and motivate their neighbours to do so. They could begin calling out members who are dumping waste, with repetition of this there is a possibility to minimise or eradicate the pollution.

More than 20.4% of South Africans experience food insecurity (Mtisnsilana,2023). At Denis Hurley Centre, many of the clients are homeless or asylum seekers. There is an issue of food insecurity. DHC, does provide meals to these individuals but as OTS we could actively involve members of the community in this. Starting up a food garden initiative would allow the community members to actively engage in growing vegetables and fruits. As many are unemployed, this could be a meaningful activity as the produce can be used for many reasons. It can be used as a source of food or used by the kitchen staff to prepare nutritious meals for community members. The extra produce could be sold, to obtain an income to maintain the garden.

Another appalling statistic, the unemployment rate is a record-high 32,9% for the first four months was observed, ranking among the highest levels ever (Stats SA, 2023). Within Cato Manor, many individuals are unemployed. We can submerse ourselves within the community to motivate and upskill individuals. A long-term project idea is to begin a clothes market within the community. All clothes would be donated to the community to be sold. Half the profits would be a form of income for the sellers, and the other half would be used to continue uplifting the community. Those profits can be used to buy additional materials to maintain another project to create recyclable crafts such as coasters or jewellery. These goods can then be sold to informal traders or members of the community to generate a stable income.

Working as a student clinician on a community level can be very overwhelming because of the multiple injustices which can be seen as a crime to humanity. In my first week of community fieldwork, it felt as if I was swimming against the tide. It may seem that the positive changes we are implementing are so small in scale compared to the negatives. However, even the slightest change is therapeutic and can have a long-lasting effect on a person's life. As OTS, we have the power to bring about these changes, so let’s run with it.

South Africa is the world's most unequal country. 25 years of freedom have failed to bridge the divide | CNN

Despite 25 years of democracy, South Africa remains the most economically unequal country in the world, according to the World Bank. If anyt

References

Estrany-Munar, F., Talavera-Valverde, Á., Souto-Gómez, I., Márquez-Álvarez, J., & Moruno-Miralles, P. (2021). The Effectiveness of Community Occupational Therapy Interventions: A Scoping Review. International Journal of Environmental Research and Public Health, 18(6). Retrieved August 4, 2023https://doi.org/10.3390/ijerph18063142

Hendricks, S. (2016, August 2). Food Security in Rural South Africa - Homegrown solutions for South Africa's hungry. Retrieved August 04, 2023, from University of Pretoria: https://www.up.ac.za/research-matters/news/post_2996572-food-security-in-rural-south-africa-homegrown-solutions-for-south-africas-hungry

Khumalo, Z. (2019). The Impact of Informal Settlements on Environmentally Sensitive Areas: A Case Study of Cato Crest Informal. degree of Master of Town and Regional Planning in the School of Built Environment, 10. Retrieved August 4, 2023, from https://researchspace.ukzn.ac.za/xmlui/handle/10413/19165

Kronenberg, F. (2022, July 28). The idea of OT is too radical and powerful to be contained by a profession. (m. OTS, Interviewer): Retrived August, 02 ,2023, from https://youtu.be/yZXmsDfOI0I

Mara, D., Lane, J., Scott, B., & Trouba, D. (2010). Sanitation and Health. PLoS Medicine, 7(11). Retrieved August 4, 2023 https://doi.org/10.1371/journal.pmed.1000363

Mtinsilana, A. (2023, February 15). Hunger in South Africa: study shows one in five are at risk. Retrieved August 04, 2023, from The Conversation: https://theconversation.com/hunger-in-south-africa-study-shows-one-in-five-are-at-risk-199133

SA, S. (2023, May 16). Beyond unemployment – Time-Related Underemployment in the SA labour market. Retrieved August 04, 2023, from Statistics South Africa: https://www.statssa.gov.za/?p=16312#:~:text=South%20Africa%27s%20unemployment%20rate%20in,the%20fourth%20quarter%20of%202022.

Scott, K. (2019, May 10). South Africa is the world’s most unequal country. 25 years of freedom have failed to bridge the divide. Retrieved August 04, 2023, from CNN: https://edition.cnn.com/2019/05/07/africa/south-africa-elections-inequality-intl/index.html

[communityblock]

Why is maternal and child health important to society? The implications for Occupational Therapy, and life within the context I am working in.

“The health of a mother and child is a more telling measure of a nation’s state that economic indicators”- Harjit Gill (Chief executive officer of ASEAN and Pacfic, Royal Philips).

The above is a powerful quote that strongly reiterates the importance of maintaining the health of mothers and their children. The maintenance of maternal and child health is a significant issue in health care; that requires a global initiative for improvement to occur (Mabaso, Ndaba, Mkhize-Kwitshana, 2014). This was emphasized by it being included under the fourth and fifth Millennial developmental goals namely, to reduce child mortality (MGD 4) and to improve maternal health and gain universal access to reproductive health (MDG 5).

Being a healthcare student within the South African clinical context, has also indicated the value of maternal and childcare on a community level. Based on my own experience at Mariannridge Clinic, one can clearly identify several reasons as to why maternal and child health is so fundamental in a South African setting.

Extensive clinic queues and clinic waiting rooms, tend to primarily consist of pregnant women or young mothers with babies. Teenage pregnancy in South Africa has become the norm, with mothers being as young as 13 years old. While teenage pregnancy is attributed to various reasons such as the non-use of contraceptives, having parents who were divorced etc. (Ayanaw Habitu, Yalew, Azale Bisetegn, 2018); it cannot be disputed that these young mums or mums-to-be lack the sufficient knowledge to take care of both themselves and their baby. This relays to the need for health promotion on maternal and childcare, to ensure both the mum and baby are healthy. Failure of primary health care to provide such services is likely to result in increased maternal mortality rates. Infants with neurological or developmental delays have a greater chance of being lost in the system or identified at a substantially late stage when intervention will not be as effective.

Within the Mariannridge community, substance abuse is also a prevalent issue amongst community members. This includes the frequent consumption of alcohol, the excessive smoking of cigarettes and the use of drugs such as cannabis. The youth tends to be the most influenced by these substances. Teenagers who are pregnant may fail to acknowledge or disregard the dire consequences of engaging in substance use during their pregnancy. This can result in a greater number of infants being born with foetal alcohol syndromes. This was emphasized by statistics which revealed that South Africa has the highest reported foetal alcohol syndromes, with a prevalence of 28% in some communities ("Foetal alcohol syndrome awareness programme", 2020).

Recent research on maternal and child health, have revealed that while it has significantly improved over the years, there continues to be a gap (Goga et al., 2019). As final year occupational therapy students, it is important to recognize our role in helping to close this gap. We need to familiarize ourselves with our role of being advocates for maternal and childcare. As we approach the threshold of entering the public health sector, we as occupational therapists, need to acknowledge our part in health promotion on both maternal well-being and the importance of meeting developmental milestones. As OT’s we also play an integral role in the screening process and in the assessment of the above-mentioned areas. Problem areas that are identified earlier can result in a greater prognosis. In conclusion, I feel that maternal and child health is capable of being more successful in South Africa through early intervention.

References

Ayanaw Habitu, Y., Yalew, A., & Azale Bisetegn, T. (2018). Prevalence and Factors Associated with Teenage Pregnancy, Northeast Ethiopia, 2017: A Cross-Sectional Study. Journal of pregnancy, 2018, 1714527. https://doi.org/10.1155/2018/1714527

Foetal alcohol syndrome awareness programme. (2020). Retrieved 23 October 2020, from https://www.westerncape.gov.za/general-publication/foetal-alcohol-syndrome-awareness-programme#:~:text=South%20Africa%20has%20the%20highest,for%20this%20irreversible%20lifelong%20condition.

Goga, A., Feucht, U., Zar, H., Vanker, A., Wiysonge, C., McKerrow, N., Wright, C., Loveday, M., Odendaal, W., Ramokolo, V., Ramraj, T., Bamford, L., Green, R., Pillay, Y., & Nannan, N. (2019). Neonatal, infant and child health in South Africa: Reflecting on the past towards a better future. South African Medical Journal, 109(11b), 83-88. doi:10.7196/SAMJ.2019.v109i11b.14301

Mabaso, M. H., Ndaba, T., & Mkhize-Kwitshana, Z. L. (2014). Overview of Maternal, Neonatal and Child Deaths in South Africa: Challenges, Opportunities, Progress and Future Prospects. International journal of MCH and AIDS, 2(2), 182–189.