ot3blog

[ot3blog]

REFLECTIONS/ƧИOITƆƎ⅃ꟻƎЯ

The Community Fieldwork Block 1

When you think about your most important life experiences, there are a few memories or events that stick out and immediately draw your attention to them and of course as we grow so too do these memories – they change and progress. After 4 weeks in the community block I can with utmost surety confirm that this experience will form part of my ‘core’ memories. During this block I experienced extreme highs as well as devastating lows, both experiences serving as learning opportunities for me as an OT as well as for me as a person. The community block has been far from a walk in the park, it’s been challenging, it’s been nerve wracking, and it’s been very stressful…a few weeks ago I would have ended the sentence at that point but at this time in the block I am able to say that even though it’s been difficult, I was able to build up the determination and resilience to get through the ‘hard’ parts and am at a place where I can say that I thoroughly enjoy and appreciate the experience I am having on this block.

“Isn’t it funny how day by day nothing changes but when you look back everything is different.” – O. S Lewis

As per my previous blogs I have explained the changes and effects which this block has had on my OT practice, my positionality and the goals which I intended to work towards in the community. I would now like to further elaborate on some of the most important personal and professional lessons which this block has taught me. Going into this block was a whole new experience for me as a person – I had only had experience with hospital patients who were ‘handed’ to me, and I also always had a supervisor who sort of held my hand throughout the whole block and was always there to check on what I was doing and monitor my progress. In this block, I had neither of these privileges, I had to rely on daily health promotional talks in order to get individual clients and go to schools, creches and the old age home to advocate for OT and run groups involving participants from these areas. I was also given immense responsibility by not having a supervisor looking over my shoulder every day, I found this to be most challenging at first as I was used to having someone instruct me on the finer details of my practice as well as provide me with daily feedback. I was pushed to learn a ton of responsibility and to take accountability for my own learning experiences and my own actions.

“The price of greatness is responsibility.” – Winston Churchill

Taking accountability and responsibility is a lesson thought best by the community block, it is also a lesson which will equip you to take on and manage so much better with the rest of the fieldwork blocks. This lesson and experience do not only apply to the fieldwork blocks, but it is also a life lesson which will become extremely important and relevant when you are in the working world, and you are solely liable for yourself. It ties into ethics and professionality and overall being a good person who is reliable and initiates OT practice to the best of their ability.

The image below shows that to achieve success the stage which we are on (practice) is extremely important in order to reach the top.

Another lesson specific to the community block which I have learn is that everyone may come from the same community or may have the same background, but each person is so different. In Inanda the people are part of the high substance abuse statistics, the high sexual assault statistics, the high unemployment rate statistics and the low-income rate statistics. Now, this may be true, but the people of the community are so much more than these statistics – once you are in the community you are able to see the beauty of it, the diversity, the ubuntu and the way the people are there for each other and there for you when you are in their community. This also ties in with being mindful of your positionality and not viewing the community in the light reflected by only things you have heard about it.

The community of Inanda is a very welcoming group of people – they respect and appreciate that you are there to assist them and they try to do all in their power to assist you and make experiences easier for you. It is then your part as an outsider to the community to learn the traditions, ways and language of the community. I have witnessed first-hand how happy and seen a person can feel when you as an English speaker greet them or talk to them in their home language of Isizulu.

Below is an image taken of the view in Inanda - the beauty of the image also represents the beauty of the community and the individuals of the community

A professional and personal lesson which I have learnt is to keep your emotions in check. A personal fact is that I have been brought to tears multiple times during the past 4 weeks, these incidents were due to interactions with clients who had experiences that were so traumatic and which I had never dealt with as well as experiences with my superiors. I quickly realised that dwelling on the past and letting your emotions get to you or taking things too personally was just a waste of time and energy which you could spend growing and learning. It is okay to have these emotions but what matters is that you deal with them in a healthy way and to keep them under control especially when expressing yourself to a superior.

It is also important to acknowledge the fact that the world is an unequal and unjust place, and however hard we try we aren’t going to change that in just a few weeks. The community block is about addressing worldly issues which we would not have the chance to do in a hospital setting – we are exposed to equalities, discrimination and abuse in a patriarchal area which abides to old traditional ways (Perspectives on Kwa-Zulu Natal, 2001). The effort we put into trying to change these factors slowly will not make a difference to the entire community but making a difference to one person at a time will create the ripple effect to initiate change and development (Oka, 2020). An important quote sums up this point beautifully “I alone cannot change the world, but I can cast a stone across the waters to create many ripples.” – Mother Teresa.

I realisation which came to me during these few weeks was a reiteration of the saying which was emphasised to us during our week of community lectures – “your group is only as strong as its weakest member”. I never understood the importance of teamwork, communication and having a strong relationship with your group members until this block. Lack of communication and unity can be detrimental to progress and development whilst good teamwork and accord can immediately speed up growth and provide a better and healthier environment to work in. The illustration below shows how the group can only get to the top if all our team members are with us

The vast amount of thing I learnt do not feel like ‘lessons’, they feel like lifestyle changes because they have actually changed me and who I am as well as how I conduct myself. I am not oblivious to the fact that I still have a lot more to learn in this block and I have yet to perfect all the skills and lessons which I have gained but I have come to realise that as long as you keep trying and remain resilient throughout the process, you are assuring that you do justice to the OT profession for yourself and for the people who need it. A quote that forges a way forward for in the community as OT’s, by someone who has had such a huge impact on the community of South Africa: “The best way to find yourself is to lose yourself in the service of others.” – Mahatma Gandhi

References:

Oka, C. (2020). Make a difference one person at a time. The-s-word.

Perspectives on Kwa-Zulu Natal. (2001). Gender inequalities in South African society. Profile KwaZulu Natal.

[ot3blog]

Working Towards a Brighter Future: The OT Way

One of the first things we are thought when we enter our first year of Occupational Therapy is to look at a client holistically. Back then it didn’t seem like that big of a deal but through the years and especially in the community block, I am able to see the gravity of what that concept means when it comes to OT intervention. It involves looking at what the source of the pain is, it involves looking at the client and all their lifestyle choices and occupations, most importantly it involves looking not just at the individual but also at the community. This and seeing as I am currently in my community block at the moment ties in with the fact that we as OT’s have an important role and duty when it comes to developing the communities which we are placed at. Developing the community and promoting the health and wellbeing of the individuals of the community go hand in hand. With reference to the sustainable development goals, I will be discussing how I intend to work towards using them to develop the community of Inanda.

The 17 sustainable development goals were created in 2012 at the United Nations Conference. The purpose of these goals was to help combat the urgent environmental, political, and economical issues which our world faces. The way in which these goals were formulated was to ensure that everyone can contribute towards them and every contribution no matter how big or small would have some impact on the world (NTU International, 2021). This concept is extremely relevant to us in the community as one of our main purposes are to not only develop and improve the community but to also ensure that all our work and progress with the community is sustainable so that it does not just end when we leave the block. Our impact on the community needs to be long-term.

The first out of 5 goals which I’ve chosen to implement in the community of Inanda is SDG goal number 3 – good health and well being. This may be the most obvious goal for me to choose as a health professional because ensuring healthy lives and promoting well-being of all ages is the purpose of my degree. Working at Inanda on this community block itself is contributing to achieving this goal as we are now giving people access to health care services which they would not have been able to receive under usual circumstances. I also aim to go beyond the usual scope of practice and do home visits for the clients in order to formulate the most effective treatment plan which improves their health. I also work toward this goal by doing health promotion everyday at the Inanda Seminary Clinic wherein I strive to educate people at the client about different health conditions, risks and the services offered to them – some important topics which should be addressed here is maternal and child health, substance abuse and mental health. The full targets for this goal is shown below

The second SGD which I will focus on during the community block is goal number 5 – gender equality. This is something that’s always been emphasised and pressed upon with our community module even being called a ‘feminist module’. The way in which we as OT’s can promote gender equality is empowering women of these communities who live in patriarchal and traditional societies where they are thought that they are worth less than men and that they have domestic ‘duties’ which they are solely responsible for (Perspectives on Kwa-Zulu Natal, 2001). We can empower them with skills and education to be able to function better independently in these societies as well as promote shared domestic responsibilities in their households. Achieving equality in this context also includes educating men in the community against discrimination and violence against women in the community and advocating on behalf of the women in the community for equal rights and opportunities.

Statistics which show gender equality in the world:

The third SDG which I feel is important is goal number 10 – reduced inequalities. It is no secret that South Africa is one of the most unequal societies in the world with us also having the highest Gini coefficient in the world to further emphasise this fact (Aljazeera, 2022). There is unequal distribution and access to food, healthcare, education, wealth, opportunities, and wealth and these are extremely visible in Inanda. Most of the people here are living below the poverty line and are either unemployed or have very low paying jobs. They also only have access to clinics who are not equipped to offer them enough health care services with a doctor only coming in once a week at Inanda Seminary Clinic which is a great disadvantage to the many people who visit the clinic on a daily basis. There are a sufficient number of schools in the area but due to the circumstances of the area and the community, many children drop out of school at an early age and engage in substance abuse. People who also experience disabilities (mental or physical) are also unemployed due to the places around them not providing opportunities for them to engage in work despite their condition. My role as an OT in this context is to educate clients on their basic human rights and basic workplace rights to equip them with the skills and education in order for them to advocate for themselves for better opportunities which they deserve. Advocating on behalf of people with disabilities or dysfunctions who are able to work is also my duty as an OT – this also includes educating places of employment about people with disabilities and how they are as equally a functional member of society as deserve to be granted the same opportunities. With regards to healthcare, it is important to treat all clients equally and give them the same respect and effort, referring and giving them proper recommendations is also an important part of practice.

Other targets for this goal:

Tying into the above, the fourth goal which I have chosen is goal number 8 – decent work and economic growth. Working towards this goal in a place such as Inanda where there is so few job opportunities and new businesses and economic growth, would include promoting policies to support job creation as well as decent work and equal pay (Simonetti, 2018). It also includes promoting ethical work practices that does not discriminate under any circumstances. Empowering and educating individuals in the community to seek out or create their own work is very important as it is seen that after living in a cycle of low socio-economic factors, people give up and do not see hope for growth in the future.

Economic growth and decent work targets:

 The fifth and final goal which I will be implementing in the community block is the SDG goal 11 – sustainable cities and communities. This goal is the whole purpose of the community block – to develop and bring together the community in order to make them inclusive, safe resilient and sustainable. We do this by implementing projects which will facilitate growth and coming together of the community. An example of this is us developing the Inanda Wilderness Park and inviting community members to use their park and the space which belongs to them. This goal also covers a vast area of topics and targets as seen below:

 The effectiveness of the SDG’s depends on local government and leaders implementing them in the communities. As a current worker in the community, I take on the responsibility of implementing these goals to the best of my ability and in conjunction with my peers and the community members. The experience which I have had in the community has also helped me formulate more realistic methods of implementation of these goals with emphasis on the sustainability because at the end of the day we are only as effective in the community as the difference sustained when we are not there.

For more information on the 17 SDG's please visit

References

Aljazeera. (2022). South Africa most unequal country in the world: Report. Aljazeera.

NTU International. (2021). The Importance of the Sustainable Developmental Goals. NTU International.

Perspectives on Kwa-Zulu Natal. (2001). Gender Inequalities in South African Society. Profile KwaZulu Natal.

Simonetti, P. (2018). SDG 8: What policies are needed to achieve Goal 8. International Trade Union Confederation.

[ot3blog]

P-O-S-I-T-I-O-N-A-L-I-T-Y

Who are you?

A simple question, right?

Wrong.

Who we are is a question which encompasses so many factors, choices, views, beliefs, and experiences? It is a question which I don’t think we will ever really have an exact answer to. It is difficult to try and think about why we do things in a certain way and why we think in a certain way and I for one sometimes think that we wont ever know the full extent as to what makes us, us. It is however something which we need to keep thinking about in order to grow and develop. Do you ever find yourself thinking back to a moment few years ago and thinking ‘why did I think it was okay do that’ or ‘I can’t believe I used to be like that’? This is because as you grow and develop, your experiences and knowledge change who you are, and you are able to learn from them and thereby change your own positionality.

Our Positionality influences how we interact with others, make decisions, and interpret others’ actions and it consists of many contributing factors (Pollock, 2021) – this also ties in as to why the title of this blog is broken up – to try and show how our positionality is broken up and made up of so many things.

Below is an image which shows the different make ups of our positionality

With regards to my own positionality, I am a young Muslim female who has grown up in an average socio-economic background and I am currently in my 4th year studying Occupational Therapy. I am also of the Indian culture. These are the factors which largely influence my positionality. I mentioned my religion first as I feel it has the most influence in my life and on my beliefs. I attended an Islamic school for most of my life and to be honest this gave me very little exposure to the real world, and it shaped my views of the world in an idealistic way according to my own beliefs. Upon finishing school and entering the diverse and culturally rich university environment, my positionality underwent a huge change. I became more open, and my thought process also became less naïve and more realistic to the world which I was living in. I still hold my religious beliefs in high regard, but I have found that whilst practicing OT and whilst interacting with others, I am able to look past my own beliefs and see the client/person in their own context and respect that. This is especially shown whilst working with make clients, in Islam I am thought modesty and restriction when it comes to interacting with the opposite gender. During fieldwork, I was first hesitant and reserved when it came to the idea of working with male clients, however as I learnt more about OT and as I got used to this practice, I became more comfortable and willing to work with males. This is important as I was able to look past my own positionality and sort of adapt it and develop so that it does not limit or affect my work as an OT

Growing up in an average socio-economic household also put me in a place of privilege which I have always been grateful for, but I have not always known how it affected my views. Going into a community such as Inanda which has such a low-income rate and high poverty rate, I was also able to see how my background affected my positionality. I sort of had a generalised idea of what a household consisted of and when dealing with clients I was able to realise that I was wrong in this. In the context of a community such as Inanda, something as simple as asking a client ‘when do you go to bed’ can be extremely wrong when the client does not have a bed to sleep in, realisations like these are actively shaping my positionality right now and I am extremely grateful for this.

With regards to OT and my positionality personally, studying OT has shaped my positionality in so many ways. It has given me an immense amount of knowledge especially with regards to interacting with people appropriately – mainly clients. The experiences which I’ve gained in fieldwork has also helped improve the way I speak and address client who are different from me. It has thought me to respect traditional practices and views as well as to take these into account when planning and implementing treatment for a client in order to make it more appropriate for them.

The image below shows how we need to have a growth mindset in order to progress and develop as human beings

Living in South Africa has also had a great affect on my positionality. South Africa is a country which to put into simple terms, has been through a lot. It was colonised by the Europeans and when they left in the 20th century, controversial legislation of land ownership was passed to ensure that the majority of land would remain in the hands of white farmers (Piotrowski, 2019). This was also the stem of the whole apartheid era which lasted from 1994 when South Africa was declared a democratic country. After apartheid things did change with regards to racial injustice, people of colour were then given more opportunities and legislations were put into place to try to correct the injustices of the past. Even though change was made, the extent of this change really did not go very far. After apartheid, white people still remained in positions of power and kept their high-income jobs and houses whilst the people of colour still remained in low-income jobs and areas as seen explicitly in the Inanda community, this cycle in some ways is still carrying on (Malala, 2019). How this affects my positionality is that in a way, I still feel that we live in a divided society, we are still dealing with the injustices and trauma of the past and this motivates me more to give everyone the equal treatment because I know that some of these people are experience a health care and economic system which has been unfair to them, everyone deserves excellent health care treatment and I want to help make this difference to their lives.

Below is the link to a beautiful poem by Masizi Kunene which depicts the reactions of people of colour to an apartheid free South Africa

The reason why it is so important to be aware of and consider your own positionality when working in communities such as Inanda, is because the people who live in these communities experience a different reality from your own. They have different home environments; they grew up with different kind of parents who were not always able to provide the best for them and then they themselves got caught up in this cycle because of the lack of change and opportunities (Lynsey Bourke, 2009). We need to consider and change our own positionality in order to see things from their own perspective and to plan treatment more appropriately and not to pin our own views and beliefs on the people we work with. In a community such as Inanda it is important not to plan an idealistic treatment programme but a REALISTIC one. It also applies to treating your client with respect no matter how much you disagree or think that they are doing the ‘wrong’ thing, planning treatment according to their own views is what OT is about.

In conclusion,

References  

Lynsey Bourke, S.  B. (2009). Feildwork Sttories: Negotiating Personality, Power and Purpose.  Academia.

Malala, J.  (2019). Why are South African cities still so segregated 25 years after  apartheid? Johannesburg: The Guardian.

Piotrowski, A.  (2019). Colonialism, Apartheid, and Democracy: South Africa's Historical  Implications on the Land Reform Debate. Journal of Interdisciplinary  Undergraduate Research.

Pollock, M.  (2021). What is Positionality. Engineer Inclusion.

[ot3blog]

Maternal and Child Health. Is it Important to Society? Of course it is. But why?

Like any informative text we start off with definitions, because how will we ever understand if we don’t actually know the basics?

Let’s start off with the term maternal health. Now your general Google search will tell you that maternal health is the term used to describe the physical health of women whilst they are pregnant, during childbirth and during the postnatal period (WHO, 2022). This definition is obviously correct, but it does not describe the entirety of the word. Maternal health also refers to the mental state of women during the pregnancy, childbirth, and postnatal period. It also includes the care and the quality of the care which they receive during this period.

Child health then refers to the health and wellbeing of the child from childbirth to adolescence. As we know health in general does not merely refer to the absence of disease but also the social, physical, mental, and emotional state and wellbeing of the child.

So, let’s get into why were actually here today. We are discussing the question of why maternal and child heath is important to society. This is a very broad and layered topic and immediately many ideas and concepts rush into my mind so bear with me as I lay out my thoughts, opinions, critical reasoning, research, and experience in order to try to fully encompass and speak about the entirety of this topic.

Think about how women are the foundation of society. This may seem like a naïve comment to make taking in the fact that we do live in a patriarchal society but what I am referring to is that women are responsible, not entirely but mostly for bringing new life into this world. The people they make become our future leaders, workers and each generation of women is responsible for creating the next generation of people. In this regard, why maternal health is important is because the well-being of mothers then determines the health of essentially the next generation of people. It can also help predict the future public health challenges for families, communities, and the health care system (ODHP, 2020). Pregnancy itself can help identify existing health concerns for women and then help prevent it from affecting the health of the child and the mother (ODHP, 2020). However, these can only be prevented if women are getting the proper care during the process of pregnancy and childbirth.

"If you want to know how strong a countries health system is, look at the well-being of it's mothers." - Hillary Clinton

Some essential statistics to take into consideration are worldwide, 250,000–280,000 women die during pregnancy and childbirth every year and an estimated 6.55 million children die under the age of five. The majority of maternal deaths occur during or immediately after childbirth, while 43% of child death occurs during the first 28 days of life (Lassi et al, 2014). These stats are in conjunction with women not being able to receive or not having access to essential health care services. In a South African context there are many reasons why a woman may not access healthcare whilst pregnant; there is the obvious reason of poverty and not being able to afford health care but with this comes location, many people live in remote areas where they would have to travel long distances in order to gain access to basic health care services. This also hinders pregnant women’s will to actually access these services as they are not eager to travel long distances or are not able to afford to travel these distances especially whilst pregnant. South Africa is a 3rd world developing country, our public health services are not able to gain the amount of funding which it needs in order to deliver a high quality of service. Their level of service has resulted in pregnant women being treated harshly, them being refused or turned down when they come to access health care and also experience treatment delays due to the high influx of people and low amount of health care providers (Human Rights Watch , 2011). Women are then forced to give birth in undesirable conditions and experience complications during pregnancy and birth which become fatal to them but could have been prevented had they been accessing proper health care.

For more information about maternal health-care system in South Africa please visit

The image below displays the WHO checklist of what is needed in order to improve maternal health.

The implications of the above would be that poor pregnancy and childbirth care, both mothers and children will experience health complications after the birthing process. This then leads on to the topic of child’s health and why exactly maternal health is important to society. In a South African context, the mother is mostly expected to take care of the child whilst the father is the financial provider or whilst the father is absent. If a woman experiences long term complications (physical and mental) from her pregnancy, then she would not be able to take care of her child properly or raise them in a healthy way. This then affects the child’s upbringing and development, these children also experience deficits in cognition, attachment, emotional skills, and social skills (Cherry, 2021).

A child not being able to reach their full potential due to poor health or development then this impacts the development and progress o the community which they live in. Every generation is responsible for a new stage of development of their own society. Furthermore, it also prevents the child from being functional in a community setting. Community involvement is also beneficial to the child – it helps them grow emotionally, intellectually, and physically, it also gives them a sense of belonging which is essential to the building of their identity (Children's Bureau, 2021)

Poor maternal and child health in this community would mean that children are faced with difficulties as a result of complications during the pregnancy and birthing period due to poor maternal health. Difficulties that children face would then hinder their development and function in a society and the mother would then have the responsibility of taking them to constant clinic appointments or her facing difficulties in raising the child due to their illness or disability. They may also not have access to the proper services in their communities such as Occupational Therapy intervention. OT intervention will be very beneficial and applicable to these children but in communities such as Inanda, mothers do not have access to Occupational Therapists to regularly take their children to and they also do not have the funds to travel and pay for an OT. This also emphasizes how important this community block is to the community, we are providing them with essential services which they may not have accessed on a regular basis, and this is then further helping develop and empower that community.

For more information on why child health is important to society please visit

I would like to end off this discussion with an important quote by Kofi Annan which I hope emphasizes the importance and impact of maternal and child health and really helps you think more deeply about this concept: “Children are the future of society, and their mothers are the guardians of that future.”

References  

Cherry, K.  (2021). Characteristics and Effects of Uninvolved Parenting.  verywellmind.

Children's  Bureau. (2021). Benefits of Community Involvement in Early Childhood.  all4kids.org.

Human Rights  Watch . (2011). South Africa: Failing Maternity Care. Johannesburg :  Human Rights Watch.

ODHP. (2020). Maternal,  Infant and Child Health. HealthyPeople.gov.

WHO. (2022). Maternal  Health. WHO.

Zohra S Lassi, R.  A. (2014). Essential interventions for maternal, newborn and child health:  background and methodology. Biomed Central.

[ot3blog]

ADVICE TO MY FUTURE SELF AS A PERSON AND AS AN OT Reflecting on my journey as a person as well as an OT is something I find myself doing very often. I reflect on the past and try to make a better present so that I may have a brighter future. I currently work hard to the best of my ability so that I may enjoy and be happy with my future. I’m not necessarily happy or satisfied with my life at the moment, however I am able to look at the bigger picture and work towards the greater good to ensure my long-term health and fulfilment.

The advice which I would give myself as a person and as an OT go hand in hand. I have found that who you are also influences your treatment methods and it influences the way which you build repour and trust with your client. I would remind myself to always be patient and calm with myself as well as with other people. I have realised that not everyone is as put-together as they seem on the outside and that there is a lot more to people than what meets the eye. With this in mind, comparing myself as well as my progress with other people is a very unhealthy trait which results in self-destructive and people pleasing behaviour.

A major and maybe controversial topic which I would also give myself advice on is the ethics and professionalism of an OT. I have seen the repercussions of a neglectful OT at a healthcare facility, it robs so many clients from receiving the proper health care and treatment which they have basic human rights to, this results in a decrease in their quality of life and could even lead to a more sever medical and functional prognosis for them. As a health professional this is extremely unethical and goes against every code which we’ve sworn to abide by. OT’s become neglectful of their jobs when they spend too much time at a facility and start to only do the bare minimum tasks and display a decrease or lack of creative ability in their work. This type of workplace behaviour occurs a lot in long term care facilities and institutions where patients have chronic conditions and spend their everyday in the facility. With this regard I would advise myself to always remember why I chose to do OT in the first place and the potential differences and lives I could change for the better. I would also advise myself that it would go against every single one of my morals and values to neglect my career as well as the clients which are under my care. I have a responsibility and duty to be the best OT that I can and uphold a high standard of treatment

Overall, the advice which I would emphasize to my future self is to live a good life, fulfil all my goals which I set out to achieve and make valuable relationships and friendships which will motivate me to do better and be better so that I may live a life which I will be able to reflect on one day and be proud of how I lived and what I have achieved. I hope to always relinquish in the happiness of successfully treating a client and I hope to always learn from the more difficult clients. Strive to be better and always work on myself as there will always be room for improvement and learning

[ot3blog]

Occupational Barriers Experienced in Mental Health

The term mental health refers to our emotional, psychological and social well being - it affects how we think, feel and act.  Approximately 10.7% of the worlds population suffered from mental health illnesses in 2017 (Dattani et.al, 2021). I for one relate so much to this topic as I was once part of the 10.7%, I know first hand about some of the challenges and setbacks which poor mental health brings however, I am also aware that everyone’s experiences and struggles with mental health are different and the effects of them vary from person-to-person.

There are many different conditions which are recognized as mental illnesses, some of the most common ones are; anxiety, mood disorders, eating disorders, personality disorders, impulse control and addiction disorders and PTSD (Casarella, 2021). These illnesses can then further affect every aspect of your daily life such as your sleeping patterns, your education and career, relationships, health and concentration. You may then lose interest in things your once found interesting or you may feel so consumed by the illness that your other responsibilities and commitments get neglected. 

Occupational Barriers experienced in mental health is a very broad topic. Each aspect of mental health can propose to be a barrier to different occupations of yours. For example, eating disorders will affect your eating and feeding and will then lead to you not having the proper amount of nutrients which your body needs to be health and this could then lead to decrease in your energy levels as well as deterioration towards your physical health. This will then prevent you from engaging in your other ADL’s and IADL’s. 

There is also some stigma attached to mental health in certain communities, as a result of this, people may feel a sense of shame or insecurity when it comes to seeking help for mental illness. The stigma and discrimination can also make difficulties worse and make it harder to recover. This stigma comes from lack of understanding, fear ad misinformation. The effects of this stigma on people who do experience mental illness include; reduced hope, lower self esteem, increased psychiatric symptoms and difficulties with social and work relationships. To reduce the stigma associated with mental illness we as individuals can talk openly about mental health, educate ourselves and others encourage equality, show compassion and normalize mental health treatment.

The above paragraph has also motivated me to speak more openly on the effects which my past metal illness has had on my occupations. A while back, I suffered from depression. It filled me with feelings of sadness and worthlessness. As it progressed, my symptoms became worse and I reached a point where I was unsure of why I had to keep on living. At this point, I started to neglect my school work, my responsibilities and chores such as cleaning up and keeping the space around me tidy, the relationships which I had with my family and friends also suffered and I found myself inappropriately taking out my emotions on others, my sleep pattern was disrupted as well - I would stay awake for 2 days at a time and then sleep for an inappropriate time and then repeat the cycle. All of these factors led to a decrease in the quality of my life, this as well as the lack of my engagement in productive occupations further contributed to my feelings of depression. It took a long while for me to be able to seek the help which I needed, this was partly due to the stigma I felt attached to mental health illnesses as well as my already low self-esteem. Looking back at this time, I have a lot of regret as well as feelings of insecurity as to what my life had become and how I neglected my duties and education as well as the people around me.

I know that a lot of people have had similar experiences as to what I have and we are able to see the direct link and effects which poor mental health as opposed to good mental health has on your occupations and life in general. There is great importance and benefit in seeking help. Treatment involves psychiatric counselling or could include getting the necessary pharmaceutical option. The correct treatment can help can help a persons condition improve or help a person to live well and engage in occupation despite their illness. 

[ot3blog]

Trick or treat – unpacking the good, bad and the ugly of a pandemic

Covid - 19. A word associated with pain, isolation, sadness and trauma. It is a virus which has upturned our whole lives. In a space of just a few months, the very fabric of the reality which we were living in was changed drastically. Our norms, our traditions, our celebrations and our daily routines were all basically forced to go out the window and what we got in return? Illness, confinement and challenges. Of course all of the measures which were put into place after the pandemic occurred were to keep us all safe and to reduce the risk of spreading of the virus however, it still meant that we had to change and adapt our whole lives to fit what was to become the new normal for us.

For me as a university student, the start of the pandemic filled me with a lot of anxiety due to the uncertainty of the future, mainly my academic future. I can clearly remember being at the start of my second year and wondering if I would be able to finish this degree which I was just starting to get in the know about. For weeks I was confined to my home just trying to picture how life was going to be as a student in the pandemic, it is safe to say that my overthinking however much accurate it was, did not prepare me for this rollercoaster of a ride which was studying a health science degree in the middle of a pandemic.

When learning shifted online, it took me a long while to get the hang of virtual classrooms and not being able to visualize and get the same experiences which I would have gotten in a classroom. The struggles that came with online learning include poor internet connection at times, the distractions which came from being at home such as family members and the feelings of having other things to do instead, my pets demanding my attention whilst I was in lectures or writing tests as well as the difficulty in paying attention because all of the lectures sounded monotonous and it was hard to find it interesting and captivating. Some of the better things about learning online were; not having to wake up early and get dressed to travel to university, being able to re-listen to the lectures when they were recorded, also being in the safety of my home while chaos was erupting in the world around me was a major advantage. 

Just when it felt like I had achieved and adapted to some sense of normalcy, learning started to move back to campus. This then became a lot more challenging for me as after spending months at home, I had to start getting up early, getting dressed, going to campus, being overly cautious with hygiene and safety and then heading to hospital in the middle of a pandemic to complete a clinical fieldwork block, trust me it was as tough as it sounds. 

The past 2 years have been the most challenging years which I have ever experienced. It’s been like that for the entire world and the fact that we were in this together did help in the sense that we could all relate to the same situations so in a way, we were all there for each other. A lot of people including myself sought refuge online, whether it was scrolling through Instagram or tiktok or even just texting my friends, it did help break the sense of monotony and eased my feelings of anxiety whilst being at home.

Although the pandemic continues to affect and challenge my life, everything that I’ve been through and all of the mechanisms I’ve developed to cope through everything really help me live a life which is somewhat normal and which I have come to find a sense of calm in...at least for now.

[ot3blog]

Standing on the edge of becoming an OT – Reflections on my journey thus far

 Entering the last semester of my 3rd year evolved many feelings in me – for one, I was still wrapping my head around the fact that I had come so far in my OT journey and for another I was quite nervous yet excited to begin my psych block. Due to the COVID-19 pandemic, my first psych block at the beginning of my second year was cut short after only 1 session with my clients. As a person, I’ve always had a keen interest in psychology and the ways which the human mind works, as an OT the idea of being able to practice and actively help people again was also very welcoming and I very much looked forward to it.

My past experiences as an OT student have immensely benefited me not only with regards to being an Occupational Therapist but they’ve also changed who I am as a person. I have learnt that everyone has a different background and that no two clients are alike, OT is about getting to know who they are in order to make treatment more specific and relevant to them and that I feel is the most important aspect of OT – it makes people feel seen.

The best part of my journey so far was seeing new client and then learning their backgrounds and building repour with them. It also felt nice to actually see myself make a difference to other peoples lives. My journey thus far has not been easy – it’s been filled with challenges, setbacks and difficulty however moments like those have made it all worth it. I have and will always try to learn the most about my degree and career so that I can be the best Occupational Therapist that I can.

http://aboutoccupationaltherapy.com.au/

[ot3blog]

Reflect on Cultural Humility

The last week of hospital had me feeling all different emotions - a sense of happiness and contentment washed over me as I knew I had made somewhat of a difference to my clients life and had contributed to their path to recovery by assisting in their rehabilitation and intervention. Both my clients have also made an impact on me as an OT and treating them has thought me many valuable lessons about the OT practice as a whole. This experience was one which I really enjoyed and which I am immensely grateful for.

Something that stood out and was a big part of my assessment and intervention plan was cultural humility. Cultural humility is the ability to maintain an open stance in relation to cultural aspects that are most important to the client. Cultural humility was formed in the physical healthcare field and adapted for therapists, social workers, and medical personnel to learn more about experiences and cultural identities of others and increase the quality of their interactions with clients. It also involves humble and respectful attitude toward individuals of other cultures that pushes us to challenge our own cultural biases, and realize that we cannot possibly know everything about other cultures, and approach learning about other cultures as a lifelong goal and process.

I practiced cultural humility and also learnt alot more about it in these weeks of fieldwork. Both my clients had different values and were of different cultures as a whole than what mine is. I tried my best to enquire and learn as much as I can about their cultural practices as well as about what rules, values and morals they base they lives off of or hold dear to them.

Learning about this was very important for their intervention planning as I was then given an idea of what to work towards and also how to plan my treatment so that I respect the clients cultural preferences. This was also important in goal planning for them as I needed to know what life was like before their injuries and what they hope life after or with treatment and intervention could look like for themselves.

Taking all of this into account, I was able to plan my treatment process and even along the way, I learnt more about the clients and even had to adapt my plans as I found out new information about them. I also had to accept and embrace the fact that I dont and will never know every single thing about the client or their cultural beliefs and preferences but I had to try my best to find out what exactly drives them and what their veiws, opinions, morals and traditions are so that I can work towards intervention that respects these factors and includes them in the process.

This week of feedback from my supervisor was also very helpful. Firstly my final demo, it went much better than my previous attempts and I feel that this is due to the fact that I was able to gain a better understanding of the client and knowing about his previous intervention as well as about his personal history helped me plan a session that was very therapeutic and realistic for him.

I chose to focus my treatment on leisure activities as the client has gained alot of function since he has been at the hospital and he is ready for discharge as soon as his home situation improves. I feel that focusing on leisure activities will give the client something to do at home as well as help him discover new hobbies and explore many other activities - this will help him bring more meaning to his life, as well as find things that are important to him and which he values doing. Leisure activities which he enjoys and is confident in can also help raise his self esteem and overall sense of achievement for him.

Overall, I am happy with where my treatment has gone and I am confident that I have peaked my clients interest in OT and also in carrying on the things we learnt in our sessions and finding new hobbies as well has building relationships through these hobbies and gaining an overall sense of contentment.

[ot3blog]

Reflect on how you have used evidence based practice to guide your intervention

Going back to hospital after midterms and our break took some adjusting to. I was assigned to a new patient for my finals and thereby had the task of getting to know this new patient as well as doing research and intervention planning based on his condition. I also had to carry on my first clients intervention and continue planning sessions with him as well as seeing him on every fieldwork day.

My newest patient is diagnosed with Quadriplegia - a C7/C8 - Spinal fracture. He has good shoulder and elbow ROM in both upper limbs, however his left hand has a greater degree of movement and therefore, he relies on and mainly uses his left upper limb. He also has fine motor skills in his left hand and is able to use a smartphone as well as a laptop independently. With regards to his lower limbs, he has some hip flexion and knee extension. The patient developed contractures in his elbows and knees and this also limits his ROM as well.

Assessing and intervention planning were both very challenging and interesting learning experiences. The patient had an incomplete fracture which meant that he had more movement and function than that which is normal for C7/C8 injuries. Due to this, I was tasked with doing extensive assessments to gain adequate knowledge of his condition as well as abilities and limitations. The research I did on the diagnosis was also very helpful as it allowed me to determine realistic goals and expectations for intervention.

The client had been at the hospital since 2014 and has received extensive therapy as well as nursing care to help him. He has shown great improvement since he was first admitted and is ready to be discharged once his home situation is resolved. It was also stated that the client has reached the plateau of his treatment and taking this into account, I decided to focus intervention on leisure and work activities for the client. 

I chose to focus on these aspects as  they are also very important occupations. Leisure allows people to relax from the other demanding occupations, it provides an opportunity to for people to gain physical and mental equilibrium. Leisure can also enable self actualization through freedom of choice. It could allow the client to develop new hobbies for find new interests to occupy his time as well as to add more significance and meaning to him. 

Research also shows that freedom of choice also makes occupation more meaningful, a sense of accomplishment or achievement can also occur as a result of reaching a goal or an end product. Leisure can also improve perceptions of health and well being - these tend to be orientated orientated towards others, so social support and self-determination during leisure activities are important buffers to stress and also helps to reach a state of contentment. 

With regards to the work aspect, I am focused on trying to help the client gain access to higher education through an online tertiary institute. The client has the ability to attend online classes as well as cognitive aspects that will allow him to study as a whole. After he studies, he will be able to engage in work as an occupation, as well as earn an income to support himself. Engaging in work will also increase his sense of independence and allow him to feel a sense of accomplishment at being able to take care of himself more. 

Overall this week has proven to be very challenging, thought provoking and productive for me. I look forward to further assess and treat the client and i hope to achieve the goals which I’ve set to work towards during the fieldwork block.

[ot3blog]

Reflect on collaborative practice - multidisciplinary team and teamwork. Reflect on how you’ve been a health advocate

This week of fieldwork was a my most challenging yet informative one so far. I was tasked with preparing an activity with my client for my midterm demo. The activity had to be one that was relevant, therapeutic and meaningful for the client. I chose the activity of feeding for this as the client is currently completely dependent in it and it would make a big difference to him if he were able to make some progress towards doing it independently.

With regards to my intervention planning and choosing which activity I would use, I first communicated with the physiotherapy department about what their intervention planning for the client was and what goals they were working towards. I also spoke to the nurses in the clients ward about which activities would make a big difference to him and also which ones he had the potential to do if given the proper attention and commitment to do so. Communications wit the different departments were very helpful and I feel that this is a very important aspect in the field of healthcare. It ensures that the patients receive more holistic treatment and it also benefits patients as healthcare workers will have increased access to their medical history and this reduces chances of medical errors and poor program planning.

Actively administering intervention was also very satisfying for me as an OT student. I was able to actively work towards improving the clients aspects such as JROM, muscle strength, endurance as well as frustration tolerance. I also observed aspects which required more attention and which I would then plan to work on with the client such as his frustration tolerance as well as elbow flexion. I then payed attention to his neglecting of his left UL and only depending on and using his right UL, I took note of this and planned to address this during our next session of light exercise and for further long term planning.

The client was happy with the nature and outcomes with this weeks sessions. He communicated with me throughout the session and also aided in suggesting ways of grading of the activities (using strap on weights during exercise). He expressed his feelings of accomplishment and joy at working towards gaining some independence back. 

Feedback this week really thought me the importance of structuring and how it contributes towards the outcome of the activity. I learnt that the client should not be given more support than he actually needs, this factor will improve his problem solving skills as well as push him to go further (within his limits) and speed up the intervention process.

I factor in all the things I’ve learnt during fieldwork and use this knowledge to help me become a better health advocate. I work toward helping people with disabilities gain more independence in their lives through OT. I’ve discovered the importance of communication with other disciplinary teams who have association with the client so that I am able to plan holistic treatment and also so that all aspects of the clients health is paid attention to whilst treatment is occurring. This will improve both the safety of the client as well as the quality of treatment for them. 

[ot3blog]

Reflect on what client centered means to you?

My second week of fieldwork was a very informative one for me. For one, I learnt that my client had a lot more function and mobility than i had initially thought and for another, I was able to gain a more in depth understanding of who my client is and what he values and cares about.

The interview process of the client was very important as it helped me learn what goals to work toward for him and what activities and intervention methods were relevant to him. It also helped with the holistic intervention process. I a

Initially, I thought that intervention planning was going to be hard and that there would not be many activities that the client would be able to participate in. It was after observing his aerobics session as well as after doing standardized assessments such as ROM, muscle strength and sensation, that I realized that he was capable of a lot more than I had initially anticipated. This helped me plan his sessions more carefully and allowed me to explore a wider range of treatment methods for him. 

An activity that we did that stood out was the feeding activity. I chose this activity as  the client did have the sufficient ROM as well as muscle strength in his right upper limb to participate in it but also because he had expressed a lot of interest in becoming more independent in his ADL’s and this for him was a big step. He was able to successfully engage in and complete the activity with moderate assistance. This was a very meaningful and important experience to the client and he was filled with a sense of accomplishment at being able to complete the activity. It was also a very satisfying moment for me as a therapist to see him progress and achieve a goal that meant so much to him.

Feedback from my supervisor this week was very informative and I learnt a lot from it. For one, I was able to critically evaluate my sessional write ups and observations and deductions with the feedback I received and took into account the aspects which I needed to change or improve on. My supervisor also helped me with an  clinical aspect which I found some difficulty in - muscle tone. She explained as well as showed us the different between increased muscle tone and contractures and provided good examples and demonstrations on both. Feedback on my feeding activity was also taken into account and I am aware of what adaptations I would need to make to the activity to make it more suited to the client whilst also changing it up and taking grading into consideration.

Overall, this week was a valuable experience, mainly with regards to intervention. Learning theory and then having to administer what you’ve learnt are two very different things. I’ve had to figure out how to adapt what I’ve learnt to make it suit the individual client and his condition and abilities. I've also had to do a lot more research on quadriplegia to gain an idea of what realistic goals would look like for my client. I hold all the things I’ve learnt in very high regard and I will remember and know to take all of this into account during my practice.

For more on occupational therapy and client rights visit otasa.org.za

[ot3blog]

Topic: From theory into practice: Your first week of fieldwork. How does treating make you feel.

Going into my third year and starting this physical fieldwork block, I was very nervous yet very excited at the same time. For one, I had more insight into OT practice than I did in my last fieldwork block and for another, I was going to be able to start administering treatment. The idea of doing this was and is very motivating and satisfying as this is the reason I chose to study OT in the first place, to make a difference. 

The week started of with me having a post pregnancy complications patient with a CVA but due to unforeseen circumstances, I had to be given a different patient on my second day of fieldwork. My client is a quadriplegic, who has no movement from the neck down. This presented as a new challenge to me as I had never worked with a spinal cord injury before, it allowed me to do more research on the topic and to get more insight with regards to quadriplegia. I learnt that with this disability, intervention is focused more on preventative measures such as making sure the client is comfortable and ensuring the condition as disability does not worsen. 

Throughout my assessment and intervention process, I also aim to focus on the clients hands and arms and trying to determine whether there could possibly be some movement in that area. I will conduct assessments such as ROM, sensation, muscle tone as well as positioning on to get a wholistic view and idea of a plan to work towards. I will also focus on helping the client use other assistive devices to help with ADL’s or in general.

Overall this week has been very productive for me and has pushed me to think out of the box and unconventionally as to how I would go about working with this client. Getting to know more about quadriplegia and what it means to live a meaningful life after has also been a good and eye opening experience for me. I hope to progress further during this fieldwork block as an OT, I am also grateful for the experience that I gain from this and the significance it holds on my path to becoming an OT.