#otinmaking

Pictures from Google Images: an indication that lessons learned can be negative or positive.

TITLE:  Standing At the Edge of the Community Block!

4 weeks down the line, things are coming to an end. Knowledge and insight were gained throughout this new and eye-opening experience. Buckle up as I take you through my journey at Mariannridge Community and on the peak of my personal and professional growth.

My heart was pumping and beating out of my chest as a box of community fieldwork was opened. Anxious, as not knowing what to expect and how this period would be navigated consumed my thoughts. This has been a period of nothing but 4 weeks of a roller coaster. Working in communities like Mariannridge changes one perspective on how they view and deliver their treatment. In a hospital setting, treatment and recommendations are based on the picture of the context the client had painted. Being in the community, physically, instilled that your recommendations must be realistic and can be applied. Prompting questions and going as far as asking for pictures will give a clear picture you would have gotten when paying a visit. For example, in some areas within this community having rails is impossible so suggesting the build rails is no longer realistic, and due to their financial status, it won't permit them to have one. Community is a reminder that OT intervention must not be textbook treatment-centered but reality-based treatment.

This block teaches sympathy, that even when you go to other places as an Occupational Therapist you need to understand why other things happen, why other people will miss their doctor's appointments. 70% of individuals we have been seeing in this community- to attend their appointments, they need to hire private cars which is also expensive whilst they struggle with finances. Not only sympathy but client-centeredness, being in the client's shoes. So, this teaches one that you can’t send people because they were late for their appointment.

Collaboration with community workers or stakeholders is important. This is what makes the lives of individuals in the community better. Understanding the streams of communication with stakeholders is important, as we had an incident where we nearly approached sponsors without talking to specific members which might have caused a rift between them and us. Being able to make relationships with the community social workers, and caregivers made the carryover and intervention a success and holistic as they were also people willing to intervene. Collaboration with political members must be approached with caution as they can use Health Workers for their political benefits not the community, this was picked up during one of the Project Managers' meetings.

Being exposed to working with kids, which I never had a chance to do before, opened an opportunity to learn that you need to be able to adapt everything and be smart and not fall into their tricks. For example, they might say their hand is paining when they are supposed to write which is likely to be a lie. When this was happening in a section destructing them was the best idea and went back to the activity. Working with children from the community with low socio-income you need to be aware that their parents might be struggling also which then affects the child, especially with school. If they are willing, working with them would automatically benefit their children. This is unlikely to happen as sometimes it is hard for them to admit that their children need assistance. Discovering sites such as the OTToolbox came in handy in treatment planning https://www.theottoolbox.com/.

Finally working at SANCA (Alcohol and Drug Rehab, https://sancadbn.org.za/)  with high-functioning individuals with substance abuse, painted an image that they never woke up one day and decided to be addicts but events led them to that. We need not see them as addicts but as individuals with unmet needs.  The intervention provided in groups aimed at addressing areas that resulted in them being on drugs not forcing them to stop. There's also a trend noted that with these individuals, most must have lacked love. It is easy to fall into addiction and we may preach self-love but if we don’t get it from people, we value such as parents it causes shame and doubt. Loving and being caring can still bring hope to 1 individual who feels loved.  Can visit this page for assistance if affected by someone's use of substances: Al-Anon Family Groups South Africa, https://www.alanon.org.za/.

Not only do you have to put your theory into practice but integrate with the real situation in front of you. With all season lessons are learned, and so is with this block. These were lessons learned and are to be used not for a short period but for a lifetime, being sympathetic, understanding and kind, realistic, collaborative, and effectively communicating.

Images from google images

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

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

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

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

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

Remember it takes one step

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

Total Number of Words: 899

References

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

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

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

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

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

Images from Google Photos.

Health issues concerning women cannot be separated from issues of social development and their right to improve health status (Walters, 2024). Maternal health and child health refers to the health of women and the child during pregnancy, childbirth, and postnatal period until adolescence, WHO (2019). According to the South Africa 2023 government health report, maternal mortality is a health issue that must be addressed. In this report, it was further stated that women residing in informal or low-income communities have the least access to health care and have a maternal mortality rate of 200 per 100000 compared to other communities' rate of 32. According to WHO (2024), facts sheet maternal deaths occurred almost every 2 minutes in 2020, summing to almost 800 women dying from causes related to pregnancy and childbirth that could have been avoided.

According to WHO (2024), over 40% of pregnancies in developing countries miscarriage, induced abortion, and other factors lead to illness, complications, or permanent disability for mother or child. During pregnancy, factors that may affect the mother and child's health are malnutrition, lack of income hindering access to health services (such as access to the clinic due to lack of transportation), and lack of education or adequate information on how to ensure a safe and healthy pregnancy.

With only one week at this site, where the student therapist has been placed for academic practice, during community assessment members mentioned that water outage is an everyday thing that affects engagement in occupations and affects them psychosocially (stress and anxiety) as they sometimes do not know when they will be back again. Water is an important source of living and an everyday need. Insufficient and inadequate clean water may impact the mother's health and child resulting in deficits in development and increased chances of the mother being anemic (Omer, 2024).  Advising the mothers to store water in bottles and buckets for days when they do not have water would decrease the chances of health problems, during health promotion workshops in the clinics as there have not been any treatment or assessment provided to pregnant and new mothers.

Due to nutritional problems and status mothers are more likely to be anemic as they do not receive enough nutrients, (buying what would sustain them for the whole month is also important) which increases the chances of delivering a low-birth-weight infant. Due to not the baby receiving enough nutrients- (which affects baby development in the uterus which may later result in poorer cognitive skills). Suggesting other ways of growing vegetables will seem unreasonable as they live close to each other and they don’t always have water. A high number of substances used in this community affects the mother and child's health, due to the decreased employment rate this is what most community members turn into.  As they continue with the substances during pregnancy, this may affect the mother and their children resulting in conditions such as withdrawal symptoms in the baby after birth, and cognitive and behavioral problems. This as an OT student must inform my preventative approach to the community adolescents on ways to cope with depression, and anxiety as it is also one of the risk factors for substance use. Sites such as SADAG can also be recommended to the youth of this community as they have access to cell phones.

During birth poor management during labor and delivery results in complications or disabilities, which may lead to conditions such as cerebral palsy.  Experiencing hunger, and diseases will cause negative consequences such as the inability to concentrate. With the knowledge and skills as an OT student that I have, promoting health awareness to young children in this community would be appropriate as the teenage pregnancy trend is noted, raising awareness on how incomplete development of the pelvis poses a risk of hypertensive disorder which results in maternal mortality.

Malnutrition and, disease expose children to poor mental & physical growth. Then poor mental & physical growth exposes children to poor performance at schoolwork which has been noted in most of the schools in this community. Learning difficulties amongst students in these schools, the Red Flag workshop was established by other OT student that aid in informing teachers about students that needs further assessments and referrals to special needs schools.  Raising awareness on this should be prioritized to be avoided where it could.Poor, large families further exposing to disease and malnutrition and the cycle continues to the next generation.

With the possibility of the mothers going back to substances after childbirth as a way of coping due to stress on how they could take care of their children, this often leads to child neglect which sometimes affects the psychodynamic formulation of the child. As the student therapist has never had a chance to work with mothers and children, this block is expected to be an eye-opener considering real-life situations. The treatment programs or interventions will aim to facilitate health and safety during pregnancy and after birth. And informing mothers on signs that may be indicators of the need for therapy intervention. Remember health is not the absence of disease but complete physical, mental, and social well-being, WHO (2024).

867 WORDS

References

Addisse, M. (2023, January). Maternal and Child Health Care. https://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_notes/health_science_students/LN_maternal_care_final.pdf

Caudill-Slosberg, M. A. (2024). Maternal and Child Health. The Human Journey. https://humanjourney.us/health/global-health/maternal-and-child-health/?gad_source

Omer, S. (2024, February 6). Global water crisis: Facts, FAQs, and how to help. World Vision. https://www.worldvision.org/clean-water-news-stories/global-water-crisis-facts#:~:text=Maternal%20and%20newborn%20health%3A%20The

Walters, V. (2004). The Social Context of Women’s Health. BMC Women’s Health, 4(Suppl 1), S2. https://doi.org/10.1186/1472-6874-4-s1-s2

WHO. (2024, April 26). Maternal mortality. Www.who.int. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality/?gad_source=1&gclid=Cj0KCQjw6PGxBhCVARIsAIumnWZ0Tm-8KHcVXeiQOcVhq63-bstxrekYj4QatRp51cXGZLM6ba4Mco4aAnhLEALw_wcB

World Bank. (2023). World Bank income groups. Our World in Data. https://ourworldindata.org/grapher/world-bank-income-groups#:~:text=Low%2Dincome%20countries%20are%20those

World Health Organisation. (2023). Health and Well-Being. Www.who.int; World Health Organisation. https://www.who.int/data/gho/data/major-themes/health-and-well-being

“The nationwide lockdown is necessary to save the lives of thousands, even tens of thousands, of our people”  the South African president said during his first speech during the outbreak of Coronavirus in South Africa. According to the World Health Organisation https://www.who.int/health-topics/coronavirus#tab=tab_1 ,  it is an infectious disease caused by the SARS-CoV-2 virus where one infected will experience mild to moderate respiratory illness, some recover and unfortunately,  some pass away. To minimize the spread of the disease social distancing, quarantining, sensitization, or frequent washing of hands is advisable. Early during the outbreak period in South Africa, this was said to save thousands of lives instead peoples’ lives were more in danger.  He emphasized everyone to stay home and be safe, unfortunately, those who were experiencing GBV and running away from their abusers were forced to be in the same environment or space with them. Many citizens were left unemployed, and still are, due to businesses shutting down resulting in high numbers of depressed individuals.

People were forced to adapt new ways of getting entertained or staying in touch with the outside world. Here comes TikTok and Instagram or Facebook.  According to Hum (2021) https://www.frontiersin.org/articles/10.3389/fhumd.2021.684137/full , there was a higher increase in engagement on social media during COVID-19 than in any other year in history. People were not only entertained but they also learned the importance of taking care of one's health, as a physical and spiritual being. This period was an eye-opening to society and the world at large. Learning how important it is to take care of your mental health and looking after those who are around you.

During this period people started sharing their struggles, some were academic struggles. Please visit my first blog to read more about my struggles at https://www.tumblr.com/mzeken/726054270181457920/i-may-not-be-there-yet-but-im-closer-than-i-was?source=share&ref=_tumblr. These social media platforms created awareness on cases such as depression, gender base violence, and anxiety. These platforms assisted with the destigmatization of mental illness.  As people started sharing what they were going through even those who didn’t know that they were depressed started seeking for help.  During covid 19. I was battling with depression as I felt shame, guilt, and a disappointment as I couldn’t pass all my modules. I knew then when my family started looking or taking serious mental health that I would have their support. Even though they didn’t know much about my case the way they viewed and sympathized with other people gave me hope that even if I share this with them, I will not be alone in overcoming this.

There is this famous quote that says there is a lesson in every storm. Even though we lost significant others, our lives changed forever, some in the same circumstances got to know about platforms that can assist us with mental health problems or mental illness such as  SADAG https://www.sadag.org/index.php?option=com_content&view=article&id=11&Itemid=114 and learned the importance of taking care of our mental health. I hope you take care of your health too before it is late. Unfortunately, we have come to an end of my writing to you. I hope you have enjoyed my blogs. If you missed some of my blogs, visit my page and enjoy my pieces online on Tumblr at https://www.tumblr.com/.

537Words.

Image from Google (meme generator)

What once seemed impossible, and not for me, feels more tangible and right in front of my eyes these days. Me becoming an Occupational Therapist.  This is a journey for me, and I am feeling every step of the way. Steve Maraboli once said the road to success is always under construction. Fasten your seat belt as I take you through my journey up until this far.  I have always wanted to be something in the Health and Sciences profession, but I couldn’t figure out what until I overheard the title of OT.

In every classroom either in primary or high school there will always be a high-flyer. I overheard one from my matric class stating that she will be an OT if not a medical doctor. The title of being an OT fascinated me as I have never heard of such before and never knew that it existed in my town hospital, Ingwavuma Mosvold Hospital.  I did not only end up applying for OT via CAO but getting to meet an interesting local OT.  She explained to me what occupational therapy is and the areas under occupational therapy (geriatrics, pediatrics, psychiatry, general physical conditions, and medico-legal. Occupational therapy is defined in the OTPF as the therapeutic use of everyday life occupations with persons, and groups for the purpose of enhancing or enabling participation. I never knew what OT is until my first year. I knew the definition but didn’t understand the concept nor was I able to describe it to others and it all started making sense in my second year (https://carrieschmittotd.com/wp-content/uploads/2021/04/AOTA-Occupational-Therapy-Practice-Framwork-OTPF-4th-edition.pdf.).

I did my first year in 2020, and there was the outbreak of covid which resulted in no longer having contact classes on campus but moving back home and adjusting to online learning. This was a hard time for me given the area I am from (connectivity issues, electricity problems. Basically, deep rural areas). With being unable to attend and do my work I ended up not passing all my modules as I was also not submitting on time. I got depressed as had my goals that after 4 years this degree must be put in motion and helping others. I did not even know about sites like SADAG (https://www.sadag.org/. ) that could have helped me cope with depression. Having to swallow the pill that my friends passed did not cause more only heartache but also negatively affected my self-esteem. If I knew what Occupational Therapists are capable of, I would have also seen one for myself for anxiety management and time management sessions.  Sometimes I do get very anxious and depressed I use the skills that I was taught during lectures and have been sharing with others not only my patients on practicals but also family.

Time went by and did my second year, 2022 as during 2021 I was redoing the module I failed. Started going on practice putting the theory into practice. With the lecturer, helping friends, supervisors, and sites like OT rex on YouTube (at  https://www.youtube.com/@OTRex) helped me understand what our focus as Ots is and how we also use activities as assessment tools and interventions. It made me realize that what is normal in me, my family, my culture, or my community may not be normal for others. This emphasized the importance of being open-minded, respectful, sympathetic with others, non-judgemental, and patient.

This journey has been a roller coaster for me. It does happen that you put in effort on your work and marks don’t reflect that, you are reminded of your failures. Then this calls one to go back to their drawing board and strategies.  It is when you keep on pushing. We are no longer driven by the clock but the passion. Looking at the differences we can make in other people’s lives, we must keep on keeping on. Khalid once said, “You can do anything if you put your mind to it” Eastside. This time around I feel like I am closer to being a certified Occupational Therapist with no student at the end compared to 2020. I am standing on the edge.  For more information on what occupational therapists do please visit this page: (https://www.aota.org/-/media/corporate/files/advocacy/state/resources/practiceact/ot-definition-for-aota-model-practice-act.pdf. )