Nkule🫧

Imagine a world where everyone can live a healthy life, receive a quality education, find meaningful occupations, and participate fully in their community regardless of their circumstances. While this may seem like an ambitious vision, it is the aim behind the United Nations Sustainable Development Goals (SDGs), which provide a global framework for creating a more equal and sustainable future by 2030 (United Nations, 2015). Although these goals are global, meaningful change also begins within local communities by the combined efforts of healthcare professionals, educators, community organisations and community members. As an Occupational Therapy student placed at Cato Manor Community, I have realised that working towards the SDGs is not only about large-scale government initiatives. It can also be seen in everyday actions such as promoting health at community clinics, supporting children at school, helping individuals recovering from substance use to return to meaningful roles, promoting inclusion, and working with other professionals and community members. This blog reflects on five SDGs that were relevant to my community placement: Good Health and Well-being (SDG 3), Quality Education (SDG 4), Decent Work and Economic Growth (SDG 8), Reduced Inequalities (SDG 10), and Partnerships for the Goals (SDG 17).

SDG 3: Good Health and Well-being

Good Health and Well-being aim to ensure healthy lives and promote well-being for people of all ages (United Nations, 2015). This was one of the main goals reflected in our work at Cato Manor Clinic. We conducted health promotion for mothers and children, saw outpatients for assessment and intervention, and provided mental health education. We also educated caregivers about developmental delays and postpartum depression. These activities are important because early identification and education can support people to seek help before problems become more serious. The World Health Organization (WHO, 2022) also highlights that maternal mental health can be included in routine maternal and child health services and that early identification and support can benefit both mothers and children.

Our experience was like what is recommended in the literature because we used health promotion and education to increase community knowledge. However, we noticed that some caregivers had limited knowledge about developmental delays and postpartum depression. This showed me that access to a clinic does not always mean that people have enough knowledge about health conditions. Therefore, continued community education is important. Our outpatient rehabilitation also contributed to SDG 3 because rehabilitation helps people remain independent and participate in meaningful activities, education and work (WHO, 2023).

SDG 4: Quality Education

SDG 4 focuses on inclusive and equitable quality education and lifelong learning opportunities (United Nations, 2015). Our work at the crèche, primary school and high school showed me that education is not only about academic performance. At the primary school, we supported learners experiencing cognitive and physical difficulties that affected their participation in the classroom. We worked on areas such as handwriting, fine and gross motor skills and colour concepts, and made referrals when learners required additional support. This is consistent with South Africa's inclusive education approach, which aims to identify and address barriers to learning so that learners can participate equally in education (Department of Basic Education, 2024).

At the creche, we identified less opportunities for sensory and play stimulation and came up with a music wall project. At the high school, we provided education on cyberbullying, examination stress and career choices. These experiences showed me that quality education also requires learners to have the skills, support and environment needed to participate. However, the limited resources we observed at some schools can make this difficult. This is also reflected in South African evidence showing that many schools still experience shortages of resources and support services for learners with disabilities (Statistics South Africa, 2025). Therefore, Occupational Therapy can contribute by addressing individual barriers while also helping to improve the environments in which learners participate.

SDG 8: Decent Work and Economic Growth

SDG 8 promotes productive employment and decent work for all (United Nations, 2015). This was particularly important at SANCA, where we worked with individuals recovering from substance use. Substance use can affect a person's ability to maintain routines, relationships and work roles. Our group and individual interventions focused on areas such as productive routines, time management and preparation for returning to the workplace and community. Rehabilitation supports people to regain independence and participate in meaningful life roles, including work (WHO, 2023).

Our intervention therefore supported clients in rebuilding some of the skills needed to return to productive roles. However, I also realised that Occupational Therapy alone cannot guarantee successful employment. Factors such as stigma, unemployment and the availability of suitable work opportunities can affect whether a person is able to return to work. Therefore, rehabilitation needs to be supported by families, workplaces, communities and other services.

SDG 10: Reduced Inequalities

SDG 10 aims to reduce inequalities and promote equal opportunities for all (United Nations, 2015). During our placement, we worked with people who experienced different barriers to participation. At the clinic, rehabilitation services were provided to community members, while home visits allowed us to reach people who were unable to attend the clinic because of their circumstances. At the schools, we supported learners experiencing barriers to learning so that they could participate more fully in the classroom. We also worked with individuals at SANCA to reduce some of the stigma associated with substance use.

These interventions relate to community-based rehabilitation, which aims to improve access to health, education, livelihood and social opportunities for people with disabilities and their families (WHO, 2010). My experience showed me that reducing inequality does not always require a large intervention. Sometimes it means taking services closer to the person, adapting an activity, providing education or creating an opportunity for someone to participate.

SDG 17: Partnerships for the Goals

SDG 17 recognises that sustainable development requires partnerships between different sectors and people (United Nations, 2015). None of our community interventions were done by Occupational Therapy alone. We worked with physiotherapists, speech and language therapists, nurses, educators, social workers and community health workers. Community health workers also helped us identify people who could benefit from home visits. This teamwork allowed us to address needs that were beyond the role of one profession.

We also identified opportunities for future partnerships. We are to approaching sponsors to support the completion of the music wall at the creche and improve the primary school environment through educational paintings. This reflects the idea that sustainable community development requires collaboration and involvement from different stakeholders. The WHO community-based rehabilitation guidelines similarly emphasise collaboration between people with disabilities, families, communities and different sectors to promote inclusion and participation (WHO, 2010).

Conclusion

My community placement has shown me that the SDGs are not only global goals that are addressed by governments and large organisations. They can also be worked towards through everyday community-based Occupational Therapy. Health promotion, rehabilitation, educational support, vocational rehabilitation, home visits and multidisciplinary teamwork all contribute to improving participation and quality of life. My experience showed me that challenges such as limited resources, stigma and unequal access to services can make sustainable development difficult. Therefore, Occupational Therapy has an important role in contributing to the SDGs by working with people, communities and other professionals to create opportunities for health, learning, work, inclusion and participation.

References:

• Department of Basic Education. (n.d.). Inclusive education. Government of the Republic of South Africa. https://www.education.gov.za/Programmes/InclusiveEducation.aspx

• United Nations. (2015). Transforming our world: The 2030 Agenda for Sustainable Development. United Nations Department of Economic and Social Affairs. https://sdgs.un.org/2030agenda

• World Health Organization. (2022). WHO guide for integration of perinatal mental health in maternal and child health services. https://www.who.int/publications/i/item/9789240057142/

• World Health Organization. (2024, April 22). Rehabilitation. https://www.who.int/news-room/fact-sheets/detail/rehabilitation

• World Health Organization. (2023, March 7). Disability and health. https://www.who.int/news-room/fact-sheets/detail/disability-and-health

Looking back on my four years at UKZN, I can confidently say that one of the biggest lessons the occupational therapy curriculum has taught me is to always think beyond the hospital. From the first year, we have been encouraged to assess and treat a patient while already thinking about discharge. Every intervention we plan should prepare the client for the environment they will return to, the people they live with, and the occupations that are meaningful to them. This way of thinking has helped me understand that occupational therapy is not only about treating a condition but also about preparing a person to participate in everyday life after leaving the hospital.

Throughout the course, we have also been taught to make our interventions as client centred as possible. Rather than focusing only on what the therapist thinks is important, we are encouraged to understand what the client wants to achieve. If a client cooks on an open fire or bathes using a basin at home, then my intervention should prepare them to safely perform those activities in the way they will do them after discharge. This reflects the client-centred approach in occupational therapy, where clients are recognised as experts in their own lives and actively participate in setting meaningful goals (Townsend & Polatajko, 2013). This has helped me appreciate the importance of adapting therapy to the client's real-life environment instead of expecting the client to adapt to the hospital environment.

Another strength of the UKZN curriculum is its emphasis on sustainability. Almost every project, assignment and intervention we have completed has required us to think about whether it is affordable, sustainable and appropriate for the community. This has shaped the way I now approach occupational therapy. Instead of immediately thinking about expensive equipment, I first think about what is already available in the home, school or clinic and how those resources can be used creatively. This aligns with the principles of Primary Health Care, which emphasise appropriate technology, affordability and sustainability in healthcare (World Health Organization, 1978).

I remember collecting empty cooldrink bottles from my residence during my paediatric block because the hospital did not have skittles for one of my therapy groups. Instead of seeing it as a limitation, I used the bottles to create the activity. My supervisor appreciated this creativity, and it reminded me that many South African clinics and schools are under-resourced. As occupational therapists, we need to provide effective interventions using the resources that are available rather than waiting for ideal conditions.

The curriculum has also strengthened my clinical reasoning. Through countless case studies, presentations, reports and blogs, I have learnt that successful intervention depends on understanding the client as a whole person. We are expected to know far more than a diagnosis. We consider the client's family, values, interests, occupations, home environment and physical abilities before making clinical decisions. Clinical reasoning allows us to integrate assessment findings, client values and environmental factors when planning intervention (Schell & Schell, 2019). Although this process can sometimes feel overwhelming, it has prepared me to think critically and provide individualised interventions instead of following a standard treatment plan.

Another strength of the course is the wide variety of clinical placements. I have worked in physical rehabilitation, paediatrics, mental health, community settings and different hospitals serving diverse populations. These experiences have exposed me to clients from different backgrounds and with different occupational needs. As a result, I feel more confident adapting my approach depending on the setting and the person I am working with.

Despite these strengths, my community placement has shown me that working at a Primary Health Care level requires a different way of thinking. In hospital settings, my focus was usually on the individual patient sitting in front of me. Community practice has challenged me to think about the needs of the whole community. Instead of asking how I can help one child, I now must think about programmes that can benefit an entire crèche, school or community organisation and continue long after we have left.

One challenge I identified is that community practice only becomes a major responsibility in fourth year. Although we were exposed to community settings in earlier years, most of that experience involved observing fourth-year students rather than planning and leading our own interventions. Looking back, I think earlier opportunities to independently manage community projects would have helped me develop confidence before entering my final year placement.

I also realised that I was not fully prepared to deliver health promotion programmes. Health promotions are a very important part of occupational therapy. “Health promotion requires health professionals to enable people to improve and maintain their health through education, participation and supportive environments” (WHO, 1986). During my previous placements, I had very little experience standing in front of a group to educate communities about health-related topics. As a result, I initially lacked confidence when planning health promotion sessions during this block. Although I understand the theory behind health promotion, I have realised that confidence only develops through repeated practice.

Another area where I would have benefited from earlier exposure is home visits. Before fourth year, I had only accompanied a senior student on one home visit. At the time, I did not fully understand what to observe or how to assess the home environment. During this placement, I have realised that home visits are about much more than checking on a client's progress. They allow occupational therapists to recommend home modifications, assess accessibility and understand the client's daily life in ways that cannot be achieved by simply drawing a floor plan during an assessment.

Finally, this placement has broadened my understanding of the occupational therapist's role within the community. When I was told that one of our community sites would be a public library, I struggled to understand how occupational therapy could contribute in that setting. After reading about occupational therapy in community libraries, I realised that libraries can promote health, inclusion, mental well-being and participation for people of all ages. This experience challenged my understanding of our scope of practice and reminded me that occupational therapy extends far beyond hospitals and clinics (University of Alberta, 2020).. Community practice requires us to collaborate with community organisations and stakeholders to improve participation and well-being where people live, learn and interact.

Reflecting on my journey so far, I believe the UKZN curriculum has given me a strong clinical foundation, particularly in client-centred practice, clinical reasoning and sustainable intervention. However, my community placement has also shown me that confidence in community practice develops through experience. As a future occupational therapist, I hope that earlier opportunities for independent community work, health promotion and home visits will better prepare future students for Primary Health Care practice. This placement has reminded me that community occupational therapy is not only about treating individuals, but also about working alongside communities to create meaningful and lasting change.

References:

1. Townsend, E. A., & Polatajko, H. J. (2013). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation (2nd ed.). CAOT Publications ACE.

2. World Health Organization. (1986). Ottawa charter for health promotion.

3. Schell, B. A. B., & Gillen, G. (Eds.). (2019). Willard and Spackman's occupational therapy (13th ed.). Wolters Kluwer.

4. University of Alberta. (2020). Occupational therapy in public libraries.

5. University of KwaZulu-Natal. (2026). Occupational therapy undergraduate programme. https://ot.ukzn.ac.za/

Before beginning my community placement, I understood maternal and child health, mainly in terms of medical care and developmental milestones. However, this understanding changed when I encountered a grandmother at my new placement, Cato Manor Clinic. She came with her grandchild, who was diagnosed with Down syndrome. I was struck by the grandmother's level of understanding of the condition of grandchild and how she knew some of the terms that medical professionals use when working with children. As we continued the conversation, she then mentioned that she was the one who was responsible for taking the child to the nearest clinics and hospital when required. They have been attending physiotherapy and occupational therapy at the Cator Manor clinic since the child was born. This made me realise that maybe that is why she is so educated about the condition, the presentation of the child and home programs. This showed me the impact of continuous access to healthcare and caregiver education. It demonstrated that quality maternal and child healthcare goes beyond treating the child. It helps the caregivers with the knowledge and confidence to support the child's development.

This experience made me go back to World health organisation’s article that highlighted the importance of person-centred quality care that continuously engages families and communities (World health organisation, 225). The WHO states that by improving newborn, maternal and child health is only about providing health care services but enables families and communities to participate in care and decision making (World health organisation, 2025).

In some communities, developmental disabilities may be misunderstood or explained through cultural or spiritual beliefs. This encounter reminded me that occupational therapists must provide evidence-based education while remaining respectful of each family's beliefs and values. This time it was the complete opposite. This made me appreciate how we, as occupational therapist not only treat the condition, but we also educate and become a voice for families for them to understand health conditions. We challenge misconceptions while also respecting the client’s beliefs and value. Therefore, improving the child’s functional ability, independence and quality of life.

This encounter further reinforces the importance of understanding that a geographical community tells us where a person lives but we must also acknowledge that, the clients we treat also have their own communities that they belong to (Richards and Galvaan, 2018). This was part of our group’s presentation this week. The way information is presented to every client matters. Although developmental conditions such as Down syndrome may be understood differently across communities, it is important for occupational therapists to approach families with respect and openness.

I am reminded that community occupational therapy is as much about enabling caregivers as it is about treating children. When caregivers understand a child's condition and the goal of therapy, they are better equipped to continue interventions at home which therefore gives opportunities for development long after the therapy session has ended.

As a future occupational therapist, I hope to continue approaching families with curiosity rather than assumptions, recognising that meaningful intervention begins with listening and understanding their lived experiences.

References:

1. World Health Organization. (2025). Strategic objectives for the development and implementation of maternal, newborn and child health quality of care programmes. World Health Organization. https://iris.who.int/

2. Richards, L., & Galvaan, R. (2018). Developing a socially transformative focus in occupational therapy: Insights from South African practice. South African Journal of Occupational Therapy, 48(1), 3–9. https://doi.org/10.17159/2310-3833/2017/vol48n1a2