#sdhs

What is hope? Is hope the illusion that keeps us in faith, fingers crossed, breath-held, waiting for change to knock at our door?

Take this journey with me through the OT student lens in community practice, digesting the lived realities of communities versus sustainable development goals (SDGs). In 2015, the United Nations established the seventeen global goals with an understanding of the interrelatedness of the social, economic, and environmental factors that affect everyday life and aim to alleviate inequalities, poverty, climate change, and ecological unsustainability by the year 2030. The goals were adopted from the Millennium Development Goals, hoping to overcome the gap in what was not accomplished in 2015. When poverty is considered, it is vital to include the interconnected links to the vicious cycle of hunger, crime, disease, inequalities, and a harsh standard of living. The person's understanding in exercising their human rights to accessibility, equality, fairness and opportunities.

Picture retrieved from:(The Global Goals, 2022)

One of the key projects we are running at Kenville is the KITE project. It incorporates vocational rehabilitation and gender inequalities eradication. It aims to upskill women in entrepreneurial skills while providing financial support. Consequently, it promotes the value and voice of a woman in a household, with the ability to provide for herself and her children. It eliminates the patriarchal influence and power dynamics of a male figure being the sole provider. It challenges the projection of the societal norms of gender roles. The project's success over the years has enriched the seller's lives, proving its effectiveness and the goals of eradicating gender inequality among women, children, and hunger. Sustainable development goals two and five strive for gender equality, no hunger, and nutrition and food security. Hence, this project aimed to tackle the social barriers in the social determinants of health to promote social equality and ensure inclusion, a positive support system, and a source of income. Additionally, the provision of affordable clothes assists in meeting the community's needs and fundamental human rights to dignity and self-image through the eyes of the community.  The implication into practice is to be transformative as therapists, highlighting the need to be intentional in acquiring the challenges and barriers the community faces. Consequently, relevant projects must be established to meet the needs and multifactorial influences consisting of cultural and personal factors to ensure sustainability. Below are numbers of grant-dependent homes in South Africa, retrieved from (Statistics South Africa, 2023)

Goal two is significantly impacted by the climate conditions South Africa is subjected to. The aftermath of the floods in KwaZulu Natal left the vulnerable communities in crisis regarding food prices and housing. Therefore, it magnifies the issues perpetuating poverty and poor living conditions in communities. For example, in Kenville, one of the creches is being closed due to health hazards, instability, and the high possibility of the informal settlement falling over. Therefore, it has detrimental effects on the livelihood of the owner, parents, and children, with the owner losing a source of income, which is an obstacle for the parents in the support system in raising the child. At the same time, they work, and a lack of stability for the child to explore, learn, and grow within the environment. Our role in working towards the sustainable development goal is to bring services to the children, providing opportunities for growth and learning, diversifying their skills development, and shaping their behaviour and livelihood.

SDG 3 ensures healthy lives and well-being by promoting accessible and quality healthcare services. This incorporates universal health coverage, including essential services that include health promotion, disease prevention, rehabilitation, and palliative care. Hence, it encompasses the goals and principles of the National Health Insurance Plan. The lack of immunization and resources in clinics depicts the regression toward reaching this goal by 2030. Therefore, vulnerability to preventable diseases and infections for both mother and child contributes to the high maternal mortality rates of 86 deaths per 100,000 live births in 2018.

We, as OTs, contribute to this goal through comprehensive primary healthcare services that encourage community participation, economic building, and poverty eradication. In community practice, we conduct daily health promotion talks with the clinic crowd to raise awareness of our services and role in the clinic and the community. The elaboration of the projects to support the needs of the community. The individual sessions contribute to providing healthcare services by ensuring mental and physical health and well-being. Furthermore, reducing the stigmatization and non-compliance of HIV and AIDS reduces the epidemic through education and psychosocial support. The goal further includes the prevention and treatment of substance use. I encountered three gentlemen who appeared to be under the influence. At that moment, the theory left me underprepared for the realities of communities with high drug usage and normalized. Education and insight-building seemed to impact treatment like water off a duck’s back. Therefore, alarmed by my unpreparedness and lack of ideas for bridging the gap.

Sustainable Development Goal four aims for equality in education, which, through the primary school project, can address the factors that limit equal opportunities in acquiring knowledge and learning. To support individual students in building academic tools to strive academically, targeting the learning difficulties and barriers that hinder effective participation in school-related activities and social environments. Furthermore, the target is to eliminate gender disparities in education to promote a non-violent and inclusive environment, including PLWD. We encountered a case of a mother reporting gender inequality and mistreatment that led to her child not attending school, which violated their constitutional rights to education. Therefore, highlights the setbacks in the transformation of our country and the lack of structures to protect the rights at a community level.  Unfortunately, a follow-up session was not conducted, leaving us with “what ifs”. A learning opportunity to understand the importance of treating the person as if it were their last session at a community level.

Combined with goals sixteen and five, they encompass gender equality and inclusivity in the community, fostering fundamental human rights and peace. George (2020) states that “Patriarchal culture and the historical precedent of inequality have exacerbated the inequality that exists between men and women in South African society.” An everyday tale in the context of our communities, women being stripped of their values and rights. Jewkes (2002) proposes the ideology that the driver of gender inequalities and gender-based violence is driven by cultural and societal norms that regard male superiority and reinforce gender roles and the hierarchy, with women being oppressed to low social value and power as expected. Therefore, the sustainable goal of equality for women and children is disputed. As observed in the community of Kenville, women object to the gender roles of carers and nurturers of life yet are incapable of making informed decisions. For example, a mother and child were screened, and upon assessment of the child, developmental delays were observed. Hence, occupational therapy services are needed to support the child's development. The mother and child are foreign nationals, so the mother detains vital information, including their names. Furthermore, the mother was hesitant and required permission from the spouse regarding a follow-up session but ultimately refused to share her number to make a follow-up session. Consequently, the encounter made me think about what I could have done more. We babbled about advocacy, but at that moment, I failed to advocate for the rights of that mother and child. The take-home was, where do I start when I have provided the education and risks? What now? How can I convince this mother about the need for occupational therapy to ensure positive health outcomes? Find out more about the staggering information on GBV in the link below:

Regarding personal growth, researching sustainable development goals has enlightened me to think about how a national problem can cause a huge ripple effect in vulnerable and marginalized communities with limited resources and a high burden of poverty. The experience has encompassed critical perspectives on the importance of comprehensive primary healthcare. Transitioning from only formulation solutions on paper to becoming the agents of change requires advocacy and internally driven principles in ensuring quality and holistic healthcare services. The experience is dotting but an eye-opener of the diverse hats we wear as Ots.

In conclusion, sustainable development goals are indicators of an evolving and transforming process overcoming historical inequalities and barriers to achieving liberation inequality in services and resources, aligning with human rights, and encouraging the participation of individuals in social, economic, and political structures. We, as OT, teach and equip communities to identify the socio-political and socio-economic factors that hinder the fullness of human beings, causing occupational injustices, and to understand the multifactorial influences of people’s context at play. Give them the tools to start their own gardens of knowledge and awareness to reap the fruits of choice and optimum well-being.

George, L. (2020, July). Gender-Based Violence against women in South Africa. Ballard Brief. https://ballardbrief.byu.edu/issue-briefs/gender-based-violence-against-women-in-south-africa

Jewkes, R. (2002). Intimate partner violence: causes and prevention. The Lancet, 359(9315), 1423–1429. https://doi.org/10.1016/s0140-6736(02)08357-5

Maluleke, R. (2019). Inequalities trends in South Africa: a multidimensional diagnostic of inequality. https://www.statssa.gov.za/publications/Report-03-10-19/Report-03-10-192017.pdf

Statistics South Africa. (2023). Sustainable Development Goals: Country Report 2023. https://www.statssa.gov.za/MDG/SDG_Country_report.pdf

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