#competent ots

When I first heard about the Sustainable Development Goals (SDGs), they felt distant. They sounded like something meant for world leaders, policymakers, and global organisations, not something that would show up in my everyday work as an occupational therapy student. Seventeen goals. Ending poverty. Ensuring health and well-being. Reducing inequality. Transforming the world. They felt big. But somewhere between home visits, school screenings, and sitting on tiny plastic chairs in Early Childhood Development (ECD) centres, my perspective began to shift.

I started to realize something important: The Sustainable Development Goals are not only achieved in global conferences or policy documents, but they are also achieved in communities through small, everyday actions (United Nations, 2015; United Nations, 2023). I began to see how occupational therapy fits into this global vision from the United Nations. The screenings we conduct, the conversations with teachers, the education we provide to caregivers and teachers, and the home visits we make may seem small in isolation. But together, these actions quietly contribute to something much bigger. They contribute to the sustainable development of our communities or society (OTASA, 2015).

Good Health and Well-Being (SDG 3)

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1946 as cited in WHO, 2010). This definition highlights that health is not only about treating illness but also about promoting well-being, preventing problems and supporting people to function in their everyday lives. During our community block, much of our work contributing to Good Health and Well-Being took place at the local clinic, where many community members access primary healthcare services. The clinic environment allowed us to engage directly with community members and address health issues through education, screening, and health promotion.

One of the areas we focused on was maternal mental health. Many mothers experience emotional and psychological challenges during pregnancy or after childbirth, but these challenges are often not openly discussed or addressed. Through health promotion activities at the clinic, we provided information about the importance of maternal mental well-being and how it can affect both the mother and the child’s development. We also engaged with caregivers about the importance of developmental screening for children. Many parents are unsure about when to seek help if they notice developmental concerns. During our health promotion sessions, we emphasised the importance of bringing children for early screening and assessment if caregivers notice difficulties with development, learning, behaviour, or participation in daily activities.

These conversations aimed to increase awareness and early help-seeking, which is an important part of preventive healthcare. These experiences reinforced the idea that promoting health does not always require complex interventions. Sometimes it begins with something simple: sharing knowledge, raising awareness, and encouraging people to seek help early. Through these small actions, occupational therapy can contribute meaningfully to improving health and well-being within communities (OTAS, 2015).

Quality Education (SDG 4)

Education plays a critical role in shaping a child’s future opportunities. However, learning does not occur in isolation. It is deeply connected to a child’s motor skills, sensory processing, cognition, emotional regulation, and ability to participate in the classroom environment. During our visits to schools and ECD centres, we worked alongside teachers to identify children who might be experiencing challenges that affect their learning. We conducted developmental screenings in ECD centres and primary schools, assessing areas such as attention and concentration, early learning skills, fine motor development, visual-motor integration and participation in classroom or play activities.

What stood out to me was how many children had never been assessed before. Some teachers had noticed that certain children struggled with concentration, holding a pencil, or following classroom routines, but these concerns had never been formally explored. Through our screenings, we were able to identify children who may require further assessment, provide feedback to teachers and caregivers and suggest classroom adaptations or strategies. Some of the most meaningful moments were not the screenings themselves, but the conversations with teachers afterwards. Together we discussed simple strategies that could support children in the classroom, such as incorporating movement breaks or introducing activities that strengthen the hand muscles needed for writing. These moments reinforced something important: occupational therapy supports education by supporting participation. Education is not only about delivering curriculum content. It is also about ensuring that children are able to engage in the occupation of learning.

Reduced Inequalities (SDG 10)

One of the most visible realities in the community we worked in was inequality in access to healthcare and rehabilitation services. Many families face barriers that make accessing occupational therapy services extremely difficult, including financial constraints, transport challenges, work commitments and long waiting lists at hospitals. For some parents, missing a day of work to attend a hospital appointment simply is not possible. Others live far from healthcare facilities and cannot afford regular transport. As a result, many children who require support may never receive an assessment or intervention.

Our school-based screenings helped bridge part of this gap. By screening children directly within the school environment (with parental consent), we were able to reach children who might otherwise never access occupational therapy services. Similarly, home visits allowed us to support individuals who could not easily leave their homes. Some community members we visited were wheelchair users, bed-bound individuals and people with severe mobility challenges. For some individuals, leaving their home was extremely difficult due to environmental barriers such as stairs, uneven pathways, or inaccessible transport. By bringing occupational therapy services into homes, schools, and community spaces, we were able to meet people where they are. This experience reminded me that equitable healthcare requires outreach, flexibility, and community-based services.

Sustainable Cities and Communities (SDG 11)

A sustainable community is one where individuals are able to live, move, and participate safely within their environments (UN, 2015). Through our home visits, we were able to see how the physical environment can either support or limit participation. Some homes had structural barriers that made mobility extremely difficult. In some cases, individuals who used wheelchairs were unable to leave their homes independently due to stairs or narrow entrances. During these visits, we worked together with caregivers and community members to explore practical strategies such as positioning techniques, pressure care education, environmental adjustments and adaptive ways of completing daily tasks.

Often the changes we suggested were small, but their impact could be significant. A small positioning adjustment could help prevent pressure sores. A different way of completing a task could increase independence. Occupational therapy frequently focuses on adapting environments and tasks to support participation in daily life. When people are able to function safely and independently within their homes and communities, those communities become stronger and more sustainable.

Partnerships for the Goals (SDG 17)

One of the biggest lessons I learned during this experience is that community-based OT practice cannot happen in isolation. Every activity we implemented required collaboration. We worked with teachers in primary schools, ECD teachers and workers, community healthcare workers (CHWs), clinic staff, Mariannridge Coordinating Committee (MCC) and caregivers and families. These partnerships helped ensure that the activities we implemented were relevant, practical, and sustainable.

Rather than simply introducing activities and leaving, we aimed to ensure that community members understood why the activity was important, how it supports development and participation and how they could continue implementing it independently. Sustainability is not about doing something once. It is about building knowledge, ownership, and confidence within the community, so that the work continues even after we leave (UN, 2015).

Before this experience, the SDGs felt like distant global ambitions. Now they feel much closer. A screening in a classroom. A home visit. A conversation with a teacher. A small adaptation to a daily activity. These moments may seem ordinary, but they contribute to something much larger. They contribute to healthier communities, more inclusive education systems, and improved access to care. Occupational therapy often works at the level of individuals, families, and communities, but the impact of this work extends far beyond those immediate interactions. It contributes to a global vision of sustainable development (UN, 2023).

This experience reminded me that occupational therapy is not only about rehabilitation. It is also about advocacy, prevention, empowerment, and community development. Sometimes the work we do may feel small. But when viewed through the lens of the Sustainable Development Goals, these small actions become part of a much larger movement toward a healthier and more inclusive world. So perhaps the real question is this: When tiny, everyday interventions such as a screening, a conversation, a home visit contribute to something far bigger, how intentionally are we using our skills to leave a lasting mark on the communities we serve and the world beyond?

References

Occupational Therapy Association of South Africa. (2015). Position statement on occupational therapy in primary health care (PHC). South African Journal of Occupational Therapy, 45(3), 58-59. dx.doi.org https://doi.org/10.17159/2310-3833/2015/v45n3/a11

United Nations. (2015). Transforming our world: The 2030 agenda for sustainable development. https://sdgs.un.org/2030agenda

United Nations. (2023). The Sustainable Development Goals Report 2023. https://unstats.un.org/sdgs/report/2023