chiefcupcakeloveforblogs

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He that would have fruits must climb the tree.

Every story has the beginning, and the end, and in most cases what ever that happens in the middle of the story determines the end part of the story, no matter how easy or hard it was. This therefore makes me agree with Kush and Wizdom when they say,” some of life’s best lessons are learned at the worst time.”

Both professional and personal experience I had in this block has contributed to my understanding of occupational therapy rehabilitation in the community setting. My journey started while I was preparing myself for community re-entry. That the point where I learnt that sometimes to archive what you need in life, it is better to move out from your comfort zone. By comfort zone I mean depending on other people to always aid you and to work with what you only have instead of seeking more of what you do not have. Community re-entry taught me to use different sources to obtain information both personally and professionally. This includes reading articles, communicating more with my classmates, approaching few community members to specifically ask them about the community and reading through lot of handovers from the previous groups. Therefore, I can attest that another important thing that I have learnt is to prepare yourself before attempting whatever that you want to attempt/archive which I believe it is one of the things that made me to survive till this far.

The picture below demonstrates the way I view myself in community block (having a busy schedule) but managing to do all my work through stepping out of my comfort zone and prioritizing my duties as an OT in the community.

It caught me by surprise that we were expected to do health promotion in clinics with many people in the lines. This made me to quickly transition from my expectations and adapt to the reality. I am an introvert by nature, but through health promotion, I have gained the skill of communicating with large number of people without considering my weakness but prioritizing the needs of the clients through doing my duties as an occupational therapist. With health promotion, not everyone understands what is said, but opening an opportunity for questions and make it interactive does promote client’s understanding of what you mean because it allows them a chance to relate with what was said and for them to gain more clarity.

During health promotion I have also learnt that the best way to enhance occupational therapy practice is to concentrate on curriculum creation that assures values like Ubuntu, innovation, and redress emerge within the Pan-Africanist paradigms. As an occupational therapy student, I agree that the effects of colonialism and apartheid are still felt in today's OT practice with marginalized populations including children, people of color, and persons with disabilities (especially orphans and vulnerable children).

The picture below shows the pan-Africanist and its importance in our country. With the link that leads to the article titled: ON AFRICA DAY, PAN-AFRICANISM AT ALL-TIME HIGH FOR CONTINENT’S YOUTH, NEW SURVEY FINDS.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fpanafricanvisions.com%2F2020%2F05%2Fon-africa-day-pan-africanism-at-all-time-high-for-continents-youth-new-survey-finds%2F&psig=AOvVaw3B0_P4JKU7dm94TyUigWZg&ust=1665769640507000&source=images&cd=vfe&ved=0CA0QjhxqFwoTCPDt5NTh3foCFQAAAAAdAAAAABAI

As an occupational therapist, I've learned that it's my duty to facilitate people's ability to take part in and benefit from learning even if they have academic endeavors.  I learnt this while I was providing support to children with learning difficulties through giving them proper information and awareness on their rights. One interesting thing about teaching them their rights is that they will not only apply that content in a school setting only, but it will be their lifelong information that will work for them in many different contexts. This guarantee that for instance there is a possibility that my actions have contributed on the quality education SDG.

https://www.education.gov.za/Programmes/HealthPromotion.aspx (this is the link for the health promotion which was created by department of education that I used as my guide when approaching schools for intervention).

I have realized that in the communities there are lot of similar traits that people share and those are shaped by the culture, dominated religion and other societal norms. I believe that Occupational therapists occupation brings purpose to life and changes throughout a lifetime of people regardless of the societal norms, culture, and religion. In the community I believe that one's surroundings have a bearing on factors such as career decision making, work efficiency, and job satisfaction. What is essential in occupational therapy is that we view people as occupational beings and that every individual has intrinsic dignity and value. According to the Lewis, (2021), people are social and spiritual entities who both shape and are shaped by their circumstances.

The picture below shows the Social Ecological model which demonstrates the interaction between factors that affects the individual’s health.

I have witnessed that patriarchal culture is still dominating the communities in both Kenville and Mariannridge. It is imperative that policies grounded on African philosophy be put in place to broaden the scope of occupational therapy and increase participation in community rehabilitation projects because they address things that are witnessed in our communities. If this cannot be enhanced, then health promotion, illness prevention, and quality of life improvement are compromised (Braveman, 2009). The patriarchal culture puts more disadvantages to women, and I have learned that as soon as women have awareness about their maternal health, rights and responsibility, change can develop in our community regarding gender inequality. My goal then was to enhance the health and wellbeing of women in the community. What I've learned is that OT is about more than just helping people get back on their feet physically; it's also about fostering their emotional, cognitive, and social growth via structured learning experiences. I have discovered that Occupational therapy must guarantee that social involvement must be considered throughout the intervention, and that include contacts with family, peers, friend, and community members instead of treating a person in isolation from the environment which has a huge impact in his/her life.

Sonday (2016) argues that the country's social, political, and economic standing during the apartheid period provided significant obstacles to the country's post-apartheid transition. With democratisation comes a new feeling of optimism, the hope for political freedom, the desire for constructing a democratic government that embraces social equality and the promise of the establishment of a new economy. As an occupational therapist working in the post-apartheid period, I am aware of the importance of context in influencing the changes that characterize my experiences. It was alerted to me that inequality that is present in our community will take so long to be conquered because it has been felt as a normal way of living in the community and introducing something new is not easy for them to accept it, even if it intends to help them. This result to them being dependent to someone who is willing to help them, and this promotes learned helplessness in the community because they just receive things but never worry themselves about sustainability of that thing. French sociologist Pierre Bourdieu develops the idea of power from a development and social transformation viewpoint. He says that action and intellect are regulated via socialized standards (Bourdieu, 1994). Therefore, I had to ensure that I avoid spoon feeding them with something that will not last them, but rather provide them with skills and knowledge that they can use to empower their lives.

My capacity as an OT to function as an agent of change within a shifting social environment and my willingness to react transgressively to oppressive systems were both impacted by the difficulties I have encountered as part of the professional role transition process. I truly appreciate the knowledge I gained through the struggle I have been through because according to Northrup Christiane, “feeling grateful or appreciative of someone or something in your life actually attracts more of the things that you appreciate and value into your life.”

References

Bourdieu, P., 1994. Structures, habitus, power: Basis for a theory of symbolic power. Culture/power/history: A reader in contemporary social theory.

Braveman, B. and Bass-Haugen, J.D., 2009. Social justice and health disparities: An evolving discourse in occupational therapy research and intervention. The American Journal of Occupational Therapy.

Sonday, A., 2016. A case study of professional role transition for occupational therapists in specialised education in post-apartheid South Africa: a critical narrative perspective.

Lewis, K. E., Lehman, M. J., & Cockburn, L. (2021). Looking Back to Move Forward: Canadian Occupational Therapy In Public Health, 1914-2019. Canadian journal of occupational therapy. Revue canadienne d'ergotherapie, 88(1), 48–58. https://doi.org/10.1177/0008417421992617

 https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.idlehearts.com%2F1631451%2Fwhen-you-appreciate-what-you-have-then-you-will-receive-more-when&psig=AOvVaw0IK0SayDS3qAGa5GN1m1M5&ust=1665757506576000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCNDvu9C83foCFQAAAAAdAAAAABAJ

 https://www.google.com/url?sa=i&url=https%3A%2F%2Fgraciousquotes.com%2Fappreciation%2F&psig=AOvVaw0IK0SayDS3qAGa5GN1m1M5&ust=1665757506576000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCNDcyuKH4PoCFQAAAAAdAAAAABAJ

 https://www.google.com/url?sa=i&url=https%3A%2F%2Fsiphathokuhlebhebhe.wordpress.com%2F2018%2F03%2F01%2Fsocial-ecological-model-of-health-and-its-application-to-chronic-obstructive-pulmonary-diseasecopd-first-draft%2F&psig=AOvVaw0io8XzcO8UQKK7li6AxQBH&ust=1665771927954000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCLjWzZfq3foCFQAAAAAdAAAAABAE

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Implementing SDG’S in our communities as occupational therapists (health and well being, quality education, no poverty, gender equality and decent work and economic growth)

The public health community worldwide continues to be very concerned about inequalities that are observed in our communities and an important part of this is the unequal distribution of environmental risks and hazards, whether tied to where people are living, commute, study, play, seek health care, and spend their free time.  “If we are to achieve all of the Sustainable Development Goals, more needs to be done.”― Oscar Auliq-Ice.

A set of 17 interconnected global objectives known as the Sustainable Development Goals (SDGs) is intended to serve as a common roadmap for prosperity and peace for both individuals and the planet, today and into the coming century ( Barbier & Burgess, 2017). .

the picture below shows the 17 SDGs

At Kenville clinic I came across a woman who reported that she came in the clinic to collects her ARVs pills and asked the nurses to give her extra set of ARVs on behalf of his boyfriend. She started by telling lies that her boyfriend is working that is why he is unable to collect the pills for himself. The nurses started shouting at her and the truth came out that the boyfriend does not want to be seen by people that he has HIV that is why he send the lady to collect the pills on his behalf. This provoked my thoughts on why the women is protecting his boyfriend like this, because it took her more than 30 minutes to spit the truth. This then created many questions in my mind like, is he protecting him because he is a bread winner in the house, is it because he is providing a shelter, is it because the lady is uneducated, is it because the lady being threatened (GBV) or is it just a societal norm that is related to patriarchal culture? This alarmed me that at Kenville community gender inequality, poverty, poor excess to resources and poor job opportunities still exist which then reveals that the sustainable development goals that are meant to be fulfilled by 2030 still need people who will convert words to practice and make change in the Kenville community. Such cases channeled my rehabilitation process to include some of the SDGs like no poverty, good health and well-being, quality education, decent work and economic growth and gender equality.

As an occupational therapist one of my roles in the community is to ensure health and wellbeing. WHO define health as " a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Working on good health and well being SDG will require me to first understand the culture of the community and explore different factors that impact their health and wellbeing and let people to understand the true meaning of health. This SDG focuses on promoting health and wellbeing to people of all ages through reducing maternal mortality, ensuring universal health coverage and access, prevents and treat substance abuse, decrease traffic-related deaths and injuries, put an end to unnecessary infant and child deaths, end several disease outbreaks (Verdejo Espinosa, 2021). 

Looking at the fact that it is possible to find people of the Kenville and Mariannridge community in groups (in the clinic, at school, at the park and along the streets), this rises an opportunity to implement this SDG through doing health promotion that outlines different diagnoses, importance of health, etc. for individual sessions, it will be implemented through lending the client an ear and ensure that the client is part of the intervention from the start to the point where it is terminated. Giving clients relevant and realistic recommendations will promote carry over which will in turn reinforce good health and wellbeing to them. It will also be done through engaging people of all ages into different leisure activities that will promote their health and wellbeing such as craft activities and sport activities. Involving multidisciplinary team as part of rehabilitation will be very critical and it will be done through doing referrals. onre of our projects includes promoting health and well being through engaging elderly people in defferent leisure activities.

the picture below shows different components that promotes one’s health and wellbeing

Education is rated high in a way that it is classified as a key to success. In our country, more especially in communities that has low socioeconomic status, education is gradually losing it value (Ferguson, 2007). Our history has paved a fixed journey of education that has different levels and normally after reaching certain levels according to the literature you then qualify for different job opportunities. Covid-19 opened a very huge gap in learners to understand the importance of education in their lives. In our communities most people struggle to reach higher levels of education due to poor finance and lack of motivation which is brought by the fact that some of the community members mastered almost all the levels of education, but they are still unemployed, and it seems as if their hard work is not paying them.  Entering primary and high school to assist learners that has learning difficulties, working hand in hand with the teachers to address different factors that hinders some students to learn effectively (mental health issues, teen moms, bullying, substance abuse and social issues), and assisting learners to understand the benefits they can gain from education will be my options to implement quality education and health in the community (Zajacova, 2018). At Mariannridge secondary school it is part of our project to assist grade 12 learners with applications in different higher institutions and assist them with applying for bursaries to ensure inclusive and equitable quality education and promotes lifelong learning for all learners regardless of their gender or financial status. For primary school kids, a new project called a library club will be implemented to promote the development of school basic skills. At the local crèches I will work with teachers to help them understand different milestones of the kids and how they can use different toys to promote the development and assist them with identifying red flags so that kids can get help early.

the picture below shows an example of the type of education that is expirienced by poor socio-economic status communities 

Literature reveals that there are two types of poverty (absolute and relative) Poverty is defined as the inability to provide for one's basic needs (Rowntree, 1908), Contrarily, relative poverty is defined as not having access to "diets, facilities, standards, and services" that are "widely supported or approved of" in the society in which one lives (Townsend, 1979). Looking at the standard of living in the communities that I visit, promotes me to implement the no poverty SDG. The aim of the poverty SDG is that by 2030, it is necessary to halve the number of people living in poverty, put protection systems in place, guarantee equal access to economic resources and basic services, decrease the vulnerability of the poor to extreme weather events brought on by climate change, and mobilize resources in developing nations (Verdejo Espinosa, 2021).. This SDG will be implemented through promoting engagement in different agricultural activities such as gardening, that will help people to get fresh food and they can even sell the vegetables to generate some income that they can use to buy themselves other important things that they need. I have been using different social media platforms to ask for clothes donations to assist on the KITE project. The more the clothes the more people benefit from getting clothes which is an essential need with cheaper prices, and this promotes the sustainability of the project, meaning the lady that sell clothes will continue benefiting from the project.

the picture below shows the community that is experiencing poverty.

Our biggest obstacle is sustainable development (SD). Developing in a way that "meets present needs without compromising future generations" is what the Brundtland report (1987, UN) calls sustainable development. Occupational therapists have extensive knowledge of the work world and the ways in which people adapt to it. In the community there are people who suffer from certain illnesses that hinders them to accomplish their job duties. As an OT I will implement the decent work and economic growth through providing free services in the community such as free assessments (both standardized and unstandardized) and free vocational rehabilitation. The purpose of assessments and evaluation services is to determine whether an injured or ill worker can return to their previous job (Sheppard & Frost, 2016). Work-related impairments may be remedied, modified, or compensated for via intervention services (Bade & Eckert 2008). Vocational rehabilitation fascinates because it is a multi-professional, evidence-based method given in a variety of settings, via a variety of services and activities, to individuals of working age who have impairments, restrictions, or restraints with job performance due to health reasons (Ross, 2013). I will work to make sure the occupational therapy community values work as an essential adult career, an important driver of economic prosperity, an integral part of any rehabilitation program, and a desired result for those who participate in it (Bade & Eckert 2008). This will be done through finding jobs in the informal economy, starting their own businesses, or enrolling in supervised training programs which is one of the projects at Kenville.

In the following diagram, we see an example of occupational therapy used to help people return to the workforce.

Occupational therapists is important in the healthcare team because they identify the occupational component of a patient's illness and fight for its early inclusion in treatment plans (Bade & Eckert 2008). Transparent cross-sectoral collaboration among all stakeholders is essential if the SDGs are to be realized for people with disabilities and their need on social assistance reduced (Bade & Eckert 2008). Creating a consistent "language" and standardizing vocabulary is essential when discussing human occupations. Occupational Therapists' Accreditation and Standards Association (OTASA) recommends that members follow the World Health Organization's (WHO) nomenclature requirements (De Witt, 2002). Also crucial is familiarity with the steps involved in vocational rehabilitation: prevention, assessment, evaluation, therapy, placement, and follow-up. When it comes to preventing injury and sustaining mental and physical health and well-being on the job, as well as raising knowledge of suitable work practice and preventing the onset or worsening of pathology, no service is more valuable than prevention. Programs for back care, spinal hygiene instruction, ergonomics, managing stress, and energy conservation are examples of possible services (Bade & Eckert 2008).

It is evident that gender inequality still exists in our society (Belingheri, 2021). Referring from the case above, women are highly oppressed and most of them has felt comfort to where they live because most of the things that results to gender in equality are normalized in our society. Implementing the gender equality SDG will never be easy in our communities because it seems as if it is a trait that has been inherited from generation to generation. As a health care provider, I always have hope that every little action I do in the community has a potential to make a huge change. To promote the SDG of gender equality in the community it will be very crucial for me to include both genders. With women it will be empowering them so that they understand their rights and who they are in the community. As soon as they understand their rights (Baptiste, 2010). they will then have a set of expectations of how other people must treat them, but it will start with them understanding themselves. This will be covered during health promotion, in group sessions (in the clinic and in schools) and in individual sessions. I will ensure that I offer my services without being baised to a specific gender but to everyone who is in need, meaning as a therapist I need to practice what I preach which is gender equality. This will be done through assisting with opening opportunities for both gender in terms of education and skills training. For males, it will be to open their minds regarding gender equality and this will be done through hoping that the small group that I influence will have a great potential to influence other males in the community.

the picture below shows the goal that the gender equality SDG aims to archive by 2030

There is a wonderful interlink between all the SDGs (Adger WN, 2009) (No poverty, zero hunger, good health and well-being, quality education, gender equality, clean water and sanitation, affordable and clean energy, decent work and economic growth, industry, innovation and infrastructure, Reduced Inequality, Sustainable Cities and Communities, Responsible Consumption and Production, Climate Action, Life Below Water, Life on Land, Peace, Justice, and Strong Institutions, Partnerships for the Goals), and the good part of it is that the progress of one goal increases the success of another goal and the disadvantage is that the failer of one SDG impacts the success of the other SDGs. Even though there is an interlink between the SDG’s but each SDG has it unique target and the only way to make them successful is to put on action and use evidence based information throughout.

references 

https://www.google.com/imgres?imgurl=https%3A%2F%2Fbiobin.co.za%2Fwp-content%2Fuploads%2F2021%2F03%2Fenglish_SDG_17goals_poster_all_languages_with_UN_emblem_1.png&imgrefurl=https%3A%2F%2Fbiobin.co.za%2Four-commitment-to-the-sustainable-development-goals%2F&tbnid=ZUszBwpNscHswM&vet=12ahUKEwjVx7z57M76AhWBhc4BHc5hA0sQMygAegUIARDdAQ..i&docid=gVPsqSmyD_9KtM&w=728&h=451&q=sdgs&ved=2ahUKEwjVx7z57M76AhWBhc4BHc5hA0sQMygAegUIARDdAQ

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.globalcitizen.org%2Fen%2Fcontent%2Fhow-covid-19-impacts-fight-to-end-extreme-poverty%2F&psig=AOvVaw0bo_rHcejgCUKgfFa7lrQ3&ust=1665257802987000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCLCu0fXuzvoCFQAAAAAdAAAAABAE

https://www.google.com/url?sa=i&url=https%3A%2F%2Fmg.co.za%2Farticle%2F2012-09-28-00-rich-school-poor-school-the-great-divide-persists%2F&psig=AOvVaw1OZM2xpzEUP3DMWibqQW03&ust=1665257888947000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCODOw57vzvoCFQAAAAAdAAAAABAE

https://www.google.com/url?sa=i&url=https%3A%2F%2Fglobalwellnessinstitute.org%2Fwhat-is-wellness%2F&psig=AOvVaw1qPwZe7m0ZRgnYnNq7nVX4&ust=1665258056077000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCICHnO7vzvoCFQAAAAAdAAAAABAE

 Rowntree, B. (1908). Poverty: a study of town life. New York; London: Macmillan. [Google Scholar]

Ferguson, H., Bovaird, S., & Mueller, M. (2007). The impact of poverty on educational outcomes for children. Paediatrics & child health, 12(8), 701–706. https://doi.org/10.1093/pch/12.8.701

Zajacova, A., & Lawrence, E. M. (2018). The Relationship Between Education and Health: Reducing Disparities Through a Contextual Approach. Annual review of public health, 39, 273–289. https://doi.org/10.1146/annurev-publhealth-031816-044628

Belingheri, P., Chiarello, F., Fronzetti Colladon, A., & Rovelli, P. (2021). Twenty years of gender equality research: A scoping review based on a new semantic indicator. PloS one, 16(9), e0256474. https://doi.org/10.1371/journal.pone.0256474

Verdejo Espinosa, Á., Lopez Ruiz, J., Mata Mata, F., & Estevez, M. E. (2021). Application of IoT in Healthcare: Keys to Implementation of the Sustainable Development Goals. Sensors (Basel, Switzerland), 21(7), 2330. https://doi.org/10.3390/s21072330

Adger WN, Eakin H, Winkels A. Nested and teleconnected vulnerabilities to environmental change. Front Ecol Environ 2009;7:150–7.

Bade, S. and Eckert, J., (2008). Occupational therapists' expertise in work rehabilitation and ergonomics. work, 31(1), pp.1-3.

Crouch, R. and Alers, V. eds., (2014). Occupational therapy in psychiatry and mental health. John Wiley & Sons.

De Witt, P.A., (2002). The Occupation in Occupational Therapy-19th Vona du Toit memorial lecture. South African Journal of Occupational Therapy, 32(3), pp.2-7.

Ross, J., (2013). Occupational therapy and vocational rehabilitation. John Wiley & Sons.

Sheppard, D.M. and Frost, D., 2016. A new vocational rehabilitation service delivery model addressing long-term sickness absence. British Journal of Occupational Therapy, 79(11), pp.677-681.

Sturesson, M., Edlund, C., Fjellman-Wiklund, A., Falkdal, A.H. and Bernspång, B., 2013. Work ability as obscure, complex and unique: views of Swedish occupational therapists and physicians. Work, 45(1), pp.117-128.

van Biljon, H., 2013. Occupational therapists in medico-legal work-South African experiences and opinions. South African Journal of Occupational Therapy, 43(2), pp.27-33.

Barbier, E. B., & Burgess, J. C. (2017). The Sustainable Development Goals and the systems approach to sustainability. Economics, 11

van Biljon, H.M., Casteljien, D., du Toit, S.H. and Soulsby, L., 2016. Opinions of occupational therapists on the positioning of vocational rehabilitation services in Gauteng Public Healthcare. South African Journal of Occupational Therapy, 46(1), pp.45-52.

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Your home needs to tell the story of who you are and where you are going to.

All the experiences and circumstances that I have been through has shaped my positionality, as well as well as the way I take one's positionality into account when approaching clients in any type of platform. “Every child deserves a champion, an adult who will never give up on them, who understands the power of connection, and insists that they become the best that they can possibly be.” (Rita Pierson), this quote makes me describe my self as a reflection of my where I come from, “home”.

the picture below shows different factors that influence the child’s wellbeing.

Growing up at home, I had both parents and five siblings. My mother used to take use to Sunday school every Sunday morning where we were taught about different bible verses and how to obey God in every mini second of your life. The thing that they were always emphasizing was love and respect to everyone that you see, regardless of the age, gender, race, status, and sexuality because everyone is Gods creation. This was rooted in our minds, and it has created harmony at home as we always show each other love and respect. Knowing the good result of love and respect from home made me to always approach people with love and respect in the community. Greeting people in a respectful manner and using respect gestures draws their attention to me which has helped me a lot during health promotion at Mariannridge and at Kenville clinic.  Showing people that you care for them portrays love to them which promotes them to be compliant with what you prescribe for them, and it makes them to be more eager to come for the appointment dates.

the picture below shows the goodness of harmony that i grew up expiriencing at home, where each person understood the term of love and respect 

As a therapist who was born after apartheid ended in South Africa, I have firsthand knowledge of how the system was specifically designed to oppress black people. In my experience as a rural black woman from a low-income and  under-resourced society (as a legacy of apartheid in South Africa), where the effects of colonialism and apartheid are still felt, where few individuals, even middle-class professionals like teachers, nurses, and city employees, are not familiar with occupational therapy. They treat everyone as a doctor, or a nurse and they do not understand anything else besides getting injection, syrup, and pills from the hospital or from the clinic. This brings up a huge gap between me and my clients in the community because before getting to assess and treat I must always advocate for my profession and give my clients insight on what occupational therapy is about ( Christalle, 2019). Since occupational therapy is a broad profession, I always explain the portion that matches the client that I am with at that specific time, which is not fair enough because it is sometimes hard to sport mental issues by looking at a person’s appearance unlike physical problems. All in all I can say that all health care providers in a community level need to be aware of how our troubled past and newfound democracy affect the health of the community members. As a result, non-standard understandings of professional practice have become necessary (Duncan, 2004).

the image above shows a huge gap between the community and therapy, and how occupational therapist work so hard to intergrate the two.

Most of families in my community are rooted in the Zulu culture and use traditional medicine as their first option when someone is sick and consider going to the hospital or clinic as a second option when they feel like the traditional medicine is not working. This to me brings the call to consider cultural formulation as part of my assessment because cultural factors do impact the client’s life and it assist with revealing what the client consider as right or wrong (rules or norms) which will lead to the client revealing what he/she need. Culturally appropriate care has the ability to increase the level of trust and communication between the therapist and the patients, which would encourage clients to be fully compliant with therapy and I have been able to make this possible through showing love and respect to my clients.

the picture below shows a picture of traditional medicine that most people in my culture prefers to use compared to werstern medicine 

In a place that I grew up from, most people are black Africans like the Kenville population where black women have historically been excluded in most things but labelled as careers for kids or house keepers, and men being placed on a top position as a head to everything with a role to rule and judge. As a young black woman, who has experienced the patriarchal culture it enables me to reach out to people in rural areas where OT has been uninformed, more especially to females who are living according to the societal norms that deprive their opportunity to explore things and live their lives to the fullest. A feminist perspective is necessary to shed light on the gender conflicts and silenced voices that arose because of the emergence of evidence of a dominating patriarchal influence in the growth of what was formerly a female-only profession (Joubert, 2006).

the picture below shows the burden that is layed on womens which limits them to expore other opportunities in life

The apartheid and colonial policies in South Africa have had an impact on occupational therapy, which has been shaped by these policies to the exclusion of African ideas of healing and treatment in favor of a scientific basis that is skewed toward the West (Joubert, 2010). This has given me a sense of agency, since the OT programs in South Africa are based mostly on western thought, but the communities I want to aid are rooted in African tradition like the Kenville community. This is a barrier but decolonizing occupational therapy may pave the way for more efficient service delivery in local areas. However, the apartheid government did not plan for occupational therapy to help black workers who were crippled as a result of their jobs in hazardous industries including mining, construction, and agriculture. All these pushes me to find solutions that will help us bridge the gap and reverse the injustices of apartheid. My approach to OT will have more of an African context, drawing on concepts like ubuntu's emphasis on helping others regardless of their gender, color, culture, or language. This would guarantee that all members of the community, unlike under apartheid, have equal access to treatment.

the picture below shows our late former president who brought hope in our South Africans. Hope of democracy and freedom that promotes oneness in our land.

Conclusion

My positionality will serve me well in working with different rural communities like Marriannridge and Kenville, since my knowledge of epistemology has taught me that the post-apartheid revival of rural communities' desire for the African values of ubuntu, togetherness, and sharing is a crucial aspect of occupational therapy practice. To maintain healthy societies, occupational therapy programs must focus on uplifting those who have historically been excluded from society's benefits. As a young therapist, I find it challenging to be able to help bridge this division via information and reform. However, before I can bring about such a shift, I need to fully comprehend the extent to which colonial rule and apartheid's lasting effects have harmed local populations. Working in a male-dominated world as a young black woman from a patriarchal culture requires one to be self-reliant and continually resilient to the surroundings and the only way that works for me is to always portray love and respect and always bringing up the voice of ubuntu.

Finally, in my opinion as an OT student, there is a tremendous wealth difference in terms of access to OT programs. However, this chasm may be bridged by expanding access to community-based rehabilitation programs for low-income neighborhoods in the new South Africa.

References

 Christalle, E., Zill, J. M., Frerichs, W., Härter, M., Nestoriuc, Y., Dirmaier, J., & Scholl, I. (2019). Assessment of patient information needs: A systematic review of measures. PloS one, 14(1), e0209165. https://doi.org/10.1371/journal.pone.0209165

Drolet, M., Turcotte, P., (2021). Occupational therapy, colonialism, and the climate crisis: Is civil disobedience ethically acceptable?. Occupational Therapy Now. 24. 25-27.

Joubert, R.W., 2006. Indigenous fruits from exotic roots?: revisiting the South African occupational therapy curriculum (Doctoral dissertation, Doctoral dissertation, University of KwaZulu-Natal, Durban. Retrieved from http://researchspace. ukzn. ac. za/handle/10413/862).

Joubert, R.W.E., (2010). Exploring the History of Occupational Therapy’s Development in South Africa to reveal the Flaws of our Knowledge Base. South African Journal of Occupational Therapy. Volume 41(3). 21-26.

Lorenzo, T., Duncan, M., Buchanan, H. and Alsop, A. eds., 2006. Practice and service learning in occupational therapy: Enhancing potential in context. John Wiley & Sons.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.warriortrading.com%2Ftrading-large-gaps%2F&psig=AOvVaw2H8VHWx6D6FRc5bE0quCqU&ust=1664037515735000&source=images&cd=vfe&ved=0CAwQjRxqFwoTCPiV74atq_oCFQAAAAAdAAAAABAD

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Maternal  and child health is the precious Gold of the community.

“The role of women in the development of society is of utmost importance. In fact, it is the only thing that determines whether a society is strong and harmonious, or otherwise. Women are the backbone of society”, ( Sri Sri Ravi Shankar).

Occupational therapy's main goal is rehabilitation and promoting health and wellness in the patient's life’s. As an occupational therapist, in the community one of my roles is to promote optimism, motivation, empowerment, and lifestyle changes for women and children's health and all this is done because we want everyone to be successful in self-selected occupations.

In the community, advocacy is another important function for occupational therapists in helping individuals to interact and participate in their occupation of choice. For example, pressing South African governments for inclusive education for children with impairments (Van Wyk, Naidoo & Joubert, 2017). At the crèche next to the Mariannridge clinic there are kids that has signs of ASD, and the teachers does not have a full understanding of different diagnosis that children present with, and they regard the kid as the naughtiest kid in the class. To promote the child’s engagement to the occupation, which is education, it will be my duty to advocate for the child in an accepted manner to promote his engagement in education. My aims will then concentrate on roles and professions significantly impacted by cultural and contextual assumptions; hence, evaluations and treatments must be culturally relevant to comply with the profession's universal ideals of client-centered, holistic practice (Buys, 2015).

young folks deserve education because they are our future leaders.

At Kenville high school, the LO teacher reported that she has eight learners that has babies in her class, and the teacher said she feels like some of them are not coping well with their schoolwork. My role will be to have a close look on their mental health and look at the chances of occupational deprivation which might be caused by their caregiver burden. My interventions should also include fighting for legislative reforms and community efforts that address greater social disparities and obstacles to occupational participation which in this case is the teenage mothers attending school.

Many authors regard education as vital to empowering people, such as delivering caregiver education to improve understanding of the role of being a caregiver (WHO, 2017). This is important and I have been doing this with the mothers at the clinic through having talks with the mothers, doing health promotions, and providing home programmes. The process of educating the mother always starts from knowing the problems of the child and the level of caregiving that the mother is providing for the child. Community-level maternal health efforts must teach women of their reproductive rights. The right of women to govern their bodies, sexuality, and reproduction, as well as self-determination and autonomy because it has been a constant battle throughout history. Political acknowledgment and respect for women's rights at the subsequent international human rights treaties resulted from intense lobbying and alliance building by the women's movement, civil society, friendly governments, and donor agencies.

educating women will build our nation

Improving maternal and reproductive health services may improve the health system by boosting access to and usage of reproductive health services (Lule et al, 2005), hence the maternal mortality is a measure of a health-care system's effectiveness (Penn-Kekana and Blaauw, 2002).

Improving maternal and reproductive health in OT

 As humans, women have rights. They are vital even without reproducing children, families, communities, and civilizations. They are citizens of countries with rights to services the state may and should give, and they may hold those responsible accountable. Multiple international accords establish women's life, health care, and nondiscrimination rights. Governments have vowed to promote women's sexual and reproductive health and rights via international treaties, laws, and action programs (Freedman et al, 2005 and Lule et al, 2005).

Maternal mortality and pregnancy complications endanger the health of newborns and older children. Mother malnutrition causes neonatal malnutrition (Freedman et al, 2005). At Kenville most of the mothers that came in the clinic are school dropouts, unemployed and they rely on their kids grant for a living which increases chances of their young ones to suffer from malnutrition. Some of the moms that were on the line are teenagers and they are still pregnant and some of them mentioned that they are hungry and at home they have nothing to eat. Some of them have missed clinic appointments because they prioritize other things rather than coming to the clinic and this might increase chances of birth complications that might lead to the death of the mother or the death of the unborn. If moms die after giving birth, young children's mortality risk doubles.

 At least 20% of child disease is connected to poor maternal and reproductive health, nutrition, and obstetric and neonatal care (Lule et al, 2005). Orphans are less likely to attend school and may live in poorer homes (World Health Report, 2005). A woman's death threatens families' and communities' social and economic well-being. Women frequently conduct unpaid reproductive duties like cooking, cleaning, and caring for children and family members. Too frequent or early pregnancies, poor maternal and reproductive health, and pregnancy issues affect a woman's ability to perform these obligations. Illness or death will affect a woman's ability to work and her family's economic situation (Lule et al, 2005).

Teenage pregnancy

Most of the women that  came to OT for screening verbalized that they are the one who are taking care of the house holds and they are responsible for their kids’ daily meals. At Kenville Swami Maitreyi is playing a big role in the community. She conducts individual sessions with young and old people that that have different problems, she donates food and clothes for different families, she empowers young women by teaching them prayer and provide them with re-usable sanitary towels. She describes herself as a hope of the community which is her big role as a woman at Kenville.

Practice Implications

Occupational therapists play an essential role in engaging persons in meaningful activities that improve health and quality of life. At Community-based level occupational therapy should be enhance accessibility. Accessibility of services in rural areas like Kenville and Mariannridge is one of the things that is still a big problem which is due to their low socio-income status. Most of the mothers does not afford simple toys that can enhance the development of their kids and they do not spend time with them because with whatever money they get they prioritize food and clothes, and they use they time in the street selling snacks and sweets to get some income. Advising them to use recycled material to make toys like making a rattle and visual tracking cards. At Mariannridge the MCC does provide seedlings, but some families do not know that they can get free seedlings that they can use to start backyard gardens and feed their families, therefore during home visit s at Kenville I will have to introduce the concept of backyard gardens to the mothers and assist them with accessing seedlings from the MSE. Advocacy and empowerment are important for all occupational therapists, but particularly in Africa, where women may be stigmatized and ostracized. The intervention sessions should include the concept of 'ubuntu' to increase, dignity, and respect in African cultures.

Vital to improve maternal and reproductive health

As humans, women have rights. They are vital even without reproducing children, families, communities, and civilizations. They are citizens of countries with rights to services the state may and should give, and they may hold those responsible accountable. Multiple international accords establish women's life, health care, and nondiscrimination rights. Governments have vowed to promote women's sexual and reproductive health and rights via international treaties, laws, and action programs (Freedman et al, 2005 and Lule et al, 2005). To empower women that are still young like the one at Mariannridge high school, it is important to tell them their rights and their value in a way that will lighten them up from many stigmas of the community.

Improving maternal and reproductive health services may improve the health system by boosting access to and usage of reproductive health services (Lule et al, 2005). Maternal mortality is a measure of a health-care system's effectiveness (Penn-Kekana and Blaauw, 2002).

Maternal health causes

Where we live, what we do, who we engage with, and their nature all affect our health. Health is a product of our biology and our physical, financial, cultural, and political environment; and it is socially driven. Biological and social factors cause health inequities. Socioeconomic class, race/ethnicity, gender, and other social determinants affect many aspects of health, from risk and susceptibility to health seeking behavior, access to health services, and long-term health and social repercussions (Ravindran, 2001). Social determinants of health affect women's reproductive and maternal health. Influence of the mother’s companion or other family members, social norms, her education, her status in society, the distance she lives from the clinic, how sick she is, her previous experiences with the health system and how she expects to be treated by health care providers, her level of decision making power in the household, her access to credit, land, and income could all influence a woman's decision to seek health care (Lule et al, 2005).

Occupational therapy domain/process Occupational therapy promotes health and life participation via activities (AOTA, 2008). Occupational therapists help kids organize, manage, and execute daily tasks. Middle schoolers with physical limitations may struggle to write. Occupational therapists collaborate with students, parents, and teachers to assess abilities, environmental needs, and intervention possibilities. A newborn with poor feeding skills is another example. Early childhood and school-based occupational therapy clients include children, families, caregivers, and teachers (e.g., homeless children, children at risk for social–emotional difficulties).

Conclusion

It is important to consider treating the mother and the child as one, because the wellbeing of the mother promotes the wellbeing of the child, and same thing applies if one of them is not well, it affects the health of other one.”The seeds of success in every nation on Earth are best planted in women and children” (Joyce Banda)

References 

Buys, T., 2015. Professional competencies in vocational rehabilitation: Results of a Delphi study. South African Journal of Occupational Therapy, 45(3), pp.48-54.

Freedman, D.S., Khan, L.K., Serdula, M.K., Dietz, W.H., Srinivasan, S.R. and Berenson, G.S., 2005. The relation of childhood BMI to adult adiposity: the Bogalusa Heart Study. Pediatrics, 115(1), pp.22-27.

Lule, J.R., Mermin, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., Nakanjako, D., Wafula, W., Hughes, P., Bunnell, R. and Kaharuza, F., 2005. Effect of home based water chlorination and safe storage on diarrhea among persons with human immonodeficiency virus in Uganda.

Penn-Kekana, L. and Blaauw, D., 2002. A rapid appraisal of maternal health services in South Africa: A Health Systems Approach. Johannesburg: Centre for Health Policy, University of Witwatersrand.

Ravindran, J., 2008. Rising caesarean section rates in public hospitals in Malaysia 2006. Med J Malaysia, 63(5), pp.434-435.

Van Wyk, J., Naidoo, D. and Joubert, R., 2017. Community stakeholders’ perspectives on the role of occupational therapy in primary healthcare: Implications for practice. African Journal of Disability, 6(1), pp.1-12.

World Health Organization, 2005. The World health report: 2005: make every mother and child count. World Health Organization.

<a href="https://www.azquotes.com/quote/811432" title="Sri Sri Ravi Shankar quote"><img src="//www.azquotes.com/picture-quotes/quote-the-role-of-women-in-the-development-of-society-is-of-utmost-importance-in-fact-it-is-sri-sri-ravi-shankar-81-14-32.jpg" alt="The role of women in the development of society is of utmost importance. In fact, it is the only thing that determines whether a society is strong and harmonious, or otherwise. Women are the backbone of society. - Sri Sri Ravi Shankar"></a>

https://michaelcupo40.wordpress.com/2020/05/10/a-mothers-sparkle/

https://www.unicef.org/stories/nyankenas-story-fighting-malnutrition-and-hoping-peaceful-future-south-sudan

https://ilostat.ilo.org/international-day-of-rural-women-the-unfinished-quest-for-decent-work-for-all/

https://autismawarenesscentre.com/i-have-a-child-with-autism-in-my-class-this-year-how-do-i-best-support-them/

https://publications.chitkara.edu.in/empowering-women-through-higher-education-the-kerala-episode/ 

https://plan-international.org/srhr/teenage-pregnancy/

https://www.brainyquote.com/topics/women-and-children-quotes

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Never give up until you get what you want

Nelisiwe Hlonz