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“What counts in life is not the mere fact that we have lived. It is what difference we have made to the lives of others.” (Mandela, 2002)

When I first entered the Kenville community in Durban, I thought I was arriving as a student occupational therapist prepared to help others. I believed I would bring knowledge, intervention ideas, health promotion strategies, and therapeutic skills into the community. What I did not expect was that the community would become my teacher. Entering the Kenville community changed not only my understanding of occupational therapy, but also my understanding of humanity, dignity, and community itself.

This placement has not only shaped my professional identity but also challenged my values, assumptions, and understanding of what it means to practice occupational therapy in a South African context. Kenville forced me to confront uncomfortable realities about inequality, access to healthcare, poverty, education, and dignity. More importantly, it taught me that occupational therapy in the community is not about “fixing” people. It is about walking alongside them.

At the Kenville clinic, we screened patients daily and participated in ongoing health promotion activities. On paper, these tasks may appear simple. However, behind every screening form was a person carrying invisible burdens such as unemployment, chronic illness, stress, violence, hunger, poor housing, and limited access to resources. I began to understand that occupation cannot be separated from context. A person cannot fully engage in meaningful occupations when survival itself becomes the primary occupation (Wilcock & Hocking, 2015).

This reminded me of the work of Elelwani Ramugondo, who discusses occupational consciousness and the need for therapists to recognise how social and political systems shape people’s opportunities for occupation (Ramugondo, 2015). In Kenville, occupation was deeply political. Something as ordinary as handwriting difficulties in a child was connected to overcrowded classrooms, under-resourced schools, family stress, and unequal educational opportunities. Health was never just health. Disability was never just disability. The image gives a deeper explanation of occupational consciousness.

Working in crèches and schools transformed my understanding of prevention and early intervention. At the crèches, we saw children with developmental delays and worked towards school readiness. At primary schools, much of our intervention focused on handwriting and learning difficulties. In high schools, we addressed stress management, bullying, emotional wellbeing, and coping skills. Initially, I saw these as isolated intervention areas. Over time, I realised they are all connected through occupation, identity, and participation.

One of the greatest lessons I learnt was the importance of listening before acting. Communities do not need therapists who arrive believing they have all the answers. They need therapists who can listen, collaborate, and respect lived experience. As African philosophy teaches through Ubuntu “umuntu ngumuntu ngabantu” a person is a person through other people (Tutu, 1999). This principle became visible in Kenville. Healing happened collectively. Teachers supported learners beyond academics. Community healthcare workers knew families personally. Care was relational. The below image shows the Africa philosophy.

Professionally, I have grown in confidence, communication, adaptability, and cultural humility. I learnt how to explain health information in ways that people understand. I learnt that professionalism is not measured only by clinical knowledge, but by empathy, consistency, respect, and presence. Some days there were no perfect interventions, no expensive resources, and no ideal therapy spaces. Yet meaningful occupational therapy still happened through creativity, relationships, and responsiveness to community needs.

Personally, this placement disrupted many of my own assumptions. I realised how easy it is to unintentionally view communities through a deficit lens, focusing only on problems instead of strengths. Kenville is not defined only by hardship. It is also defined by resilience, humour, support systems, culture, and persistence. I saw caregivers continue despite exhaustion. I saw learners show determination despite barriers. I saw communities creating spaces of hope even when systems fail them. The image below shows that community working together lead to success.

This experience also deepened my awareness of power relations within healthcare and education systems. As students and future professionals, we often occupy positions of privilege because of our education. However, community practice taught me that knowledge is not owned only by professionals. Communities themselves hold valuable knowledge about survival, adaptation, and participation. Decolonising occupational therapy means recognising African ways of knowing and ensuring that therapy is relevant to local realities rather than imported ideals (Freire, 1970).

As I prepare for other blocks and community service, I carry more than clinical skills with me. I carry questions. How do we create healthcare systems that are truly accessible? How do we advocate for occupational justice in under-resourced communities? How do we ensure that therapy does not become disconnected from the realities people live in daily?

Community service, for me, is no longer just a requirement before independent practice. It is an ethical responsibility. It is about entering communities with humility, recognising systemic injustice, and using occupational therapy as a tool for empowerment rather than authority. Kenville taught me that occupational therapy is not confined to hospitals or therapy rooms. It exists in classrooms, clinics, homes, playgrounds, and conversations. It exists wherever people strive to participate meaningfully in life despite barriers. Most importantly, Kenville taught me that before becoming a good occupational therapist, I must first become a better human being. The image below shows the space used in Kenville clinic to provide services which shows that OT happens everywhere.

Resources and Links

South African Society of Occupational Therapy (OTASA) Supports occupational therapists through advocacy, professional development, ethical practice guidance, and community-based healthcare initiatives within South Africa.

World Federation of Occupational Therapists (WFOT) Promotes occupational therapy internationally through research, education, human rights advocacy, and community-centred practice.

Department of Health South Africa Provides information on South African public healthcare policies, health promotion programmes, primary healthcare services, and community health initiatives.

South African Journal of Occupational Therapy (SAJOT) Publishes South African occupational therapy research focused on community practice, occupational justice, disability, education, and culturally relevant interventions.

References

Freire, P. (1970). Pedagogy of the oppressed. Continuum.

Mandela, N. (2002). Nelson Mandela’s address to the Nelson Mandela Foundation launch.

Ramugondo, E. L. (2015). Occupational consciousness. Journal of Occupational Science, 22(4), 488–501.

Tutu, D. (1999). No future without forgiveness. Rider.

Wilcock, A. A., & Hocking, C. (2015). An occupational perspective of health (3rd ed.). Slack Incorporated.

Image 1-https://www.researchgate.net/publication/279280483_Occupational_Consciousness

Image 2- https://www.thecollector.com/ubuntu-philosophy-introduction/

Image 3- https://www.jrossrecruiters.com/blog/strong-community-connections-are-key-hospitality-success

Introduction: A Curriculum of Two Halves

“Knowing is not enough; we must apply. Willing is not enough; we must do"(Goethe, as cited in Eliot, 1870, p. 78).

In my third week of fourth year, I sat in a community theory lecture and finally learned about community development models, asset-based approaches, and participatory rural appraisal. I scribbled notes furiously, but a nagging feeling interrupted my focus: Why am I learning this now?

We have been going into communities since first year. We learned the role of Occupational Therapy (OT) in Primary Health Care (PHC) back in Fundamentals (second year) (UKZN Discipline of Occupational Therapy, 2025). But the theories of how to actually work with communities, not just in them arrived four years later. This blog reflects on the pros and cons of UKZN's OT curriculum in preparing students for community and PHC practice. It is a reflection of gratitude, frustration, and hope.

Personal & Professional Growth: The Disruption

Let me be honest. When I was in first year, standing in a community clinic under the guidance of fourth years, I felt competent. We ran a craft group for mothers. We did a fine motor screening at a crèche. I checked boxes.

But now, looking back, I realise I did not know how to do a community needs assessment. I did not understand power dynamics between us (university students) and community members. According to Freire (1970), without critical reflection, community engagement risks becoming a "banking" model where professionals deposit knowledge rather than co-create it.

The disruption came in fourth year when the question asked: “Did you build on community assets or just deliver your own programme?” I had no answer. That question exposed the gap between knowing OT's PHC role (learned in Fundamentals) and knowing how to practise it without a manual.

Curriculum Pros: The Good Bones

UKZN's Bachelor of Occupational Therapy curriculum has genuine strengths for community preparation (UKZN School of Health Sciences, 2025):

1. Early community exposure: From Level 1, students are in real contexts weekly. Research suggests that early fieldwork experiences reduce anxiety and increase professional self-efficacy (Dancza et al., 2017).

2. Foundational PHC knowledge early: In Level 2 Fundamentals, we were taught the role of OT in PHC, prevention, promotion, and rehabilitation (UKZN Discipline of Occupational Therapy, 2025). I remember writing an assignment on the Ottawa Charter (WHO, 1986). So, what came early.

3. Longitudinal fieldwork: By Level 4, students complete a full community block. Extended immersion in under-resourced settings has been shown to better prepare graduates for community service in South Africa (Ned et al., 2020).

4. Decentralised placements: Many of us work in rural clinics, townships, and schools. This mirrors the reality of PHC, where occupational therapists must practise with limited resources (Watson, 2020).

These are real strengths, and I do not dismiss them.

Curriculum Cons: The Missing Scaffolding

However, the curriculum has a structural flaw: theory-practice mismatch. While learning the roleof OT in PHC early is valuable, role knowledge without methodological tools is insufficient (Kronenberg et al., 2011).

| What we learned | When | Gap |

Role of OT in PHC (Fundamentals) - Level 2 -No practice tools to implement it

Community theories (community block) - Level 4 -Students practised for 3 years without them

What happens? Students default to activity-based OT such as groups, crafts, screenings because that is what is observed and modelled. We do not learn community organising, participatory methods, inter-sectoral collaboration, or programme evaluation until near graduation.

Research confirms this challenge. Galvaan and Peters (2019) argue that many South African OT curricula prioritise individual clinical reasoning over collective, community-centred approaches. Similarly, Morville and Erlandsson (2013) found that without explicit teaching of community participation frameworks, students revert to individual rehabilitation models even in PHC settings.

 Reflection: What Do We Value?

This reveals a hidden value in the curriculum. If community theories are placed in final year, what message is sent? That community practice is an advanced skill, not a foundational one? Yet PHC is South Africa's reality. The National Department of Health (2018) explicitly positions occupational therapists as key PHC providers.

Kronenberg et al. (2011) argue that occupational therapy education must embrace a "political" and "socially responsive" orientation, not just a clinical one. By delaying community theory, curricula risk producing graduates who are technically skilled but critically unreflective about community power dynamics.

I am not asking for perfection. But imagine if in Year 2, after learning the role, we learned one tool: community/asset mapping (Kretzmann & McKnight, 1993). Then in Year 3, participatory learning and action (Chambers, 2010). By Year 4, we would be ready.

Lessons Learnt (So Far)

Personally: I have learned to be an active learner. I now read community OT literature independently (Kronenberg et al., 2011; Watson, 2020). I cannot wait for the curriculum to fill every gap.

Professionally: I will enter community service knowing that theory matters. I will not just do groups. I will ask: Whose agenda? Whose participation? (Freire, 1970).

Call to Action / Way Forward

To curriculum designers: Please consider integrating one community practice theory or tool per year from Level 1–3. Dancza et al. (2017) recommend scaffolding community competencies across a programme rather than concentrating them in a final block.

To students: Do not confuse early exposure with complete preparation. Read, question, and reflect.

To myself: Carry the question forward: How do I move from doing OT in a community to doing OT with a community?(Galvaan & Peters, 2019).

Conclusion: A Thought-Provoking Question

We learned the heart of PHC early, the role and the values. But we learned the hands and head, the theories and methodslate. Is it any wonder that many of us graduate feeling like we know why community OT matters but not how to do it well (Ned et al., 2020)?

References

Chambers, R. (2010). Revolutionising development: Reflections on the work of Robert Chambers. Practical Action Publishing.

Dancza, K., Warren, A., Copley, J., Rodger, S., Moran, M., McKay, E., & Taylor, A. (2017). Learning experiences on role-emerging placements: An exploration from the students' perspective. Australian Occupational Therapy Journal, 64(3), 217–225. https://doi.org/10.1111/1440-1630.12337

Eliot, G. (1870). The legend of Jubal and other poems. Smith, Elder & Co.

Freire, P. (1970). Pedagogy of the oppressed. Continuum.

Galvaan, R., & Peters, L. (2019). Occupational therapy curricula and socially responsive practice in South Africa. In F. Kronenberg, N. Pollard, & D. Sakellariou (Eds.), Occupational therapies without borders (2nd ed., pp. 487–498). Elsevier.

Kretzmann, J. P., & McKnight, J. L. (1993). Building communities from the inside out: A path toward finding and mobilizing a community's assets*. ACTA Publications.

Kronenberg, F., Pollard, N., & Sakellariou, D. (2011). Occupational therapies without borders – Volume 2: Towards an ecology of occupation-based practices. Churchill Livingstone.

Morville, A., & Erlandsson, L. K. (2013). The experience of occupational therapists in community-based practice. Scandinavian Journal of Occupational Therapy, 20(6), 423–432. https://doi.org/10.3109/11038128.2013.830773

National Department of Health, South Africa. (2018). Primary Health Care re-engineering framework. Government Printing Works.

Ned, L., Tiwari, R., Botes, M., & van Rensburg, E. J. (2020). Community-based education in South African health sciences curricula: A review of the literature. African Journal of Health Professions Education,12(1), 34–39. https://doi.org/10.7196/AJHPE.2020.v12i1.1168

UKZN Discipline of Occupational Therapy. (2025). Undergraduate programmes. University of KwaZulu-Natal. https://ot.ukzn.ac.za/undergraduate-programmes/

UKZN School of Health Sciences. (2025). Bachelor of Occupational Therapy degree. University of KwaZulu-Natal. https://health-sciences.ukzn.ac.za/degrees/b-occupational-therapy/

Watson, R. (2020). Community-based occupational therapy: A South African practice guide. Juta.

Being an Occupational Therapist (OT) in a community is like being handed a rusty car with no engine and being told to make it work. I know how dramatic this may sound, forgive me but after our tutorial last Wednesday, I realized how vast the challenges can be in making a meaningful impact in different communities—and honestly, sometimes it feels like we’re pushing that engine-less car uphill with the handbrake on.

At Cato Manor the people there are lovely, warm, and welcoming, but if you've ever tried to introduce a project and then watched it fizzle out as soon as you step away, you know the frustration I’m talking about. It's not that they don’t want the help or the resources—oh, they definitely want something from you—but the spark to keep things running on their own seems to flicker out as soon as we’re gone. Meanwhile, in other communities, like Mariannridge, things are thriving! Projects seem to run on autopilot, and the community is fully invested. What gives? How did they get halfway and we are still at the bottom of the hill ? Having an engine that’s the answer!

Visualize this : every week we go to Thandeka’s Daycare and previous block have given them child development manuals, stimulation boards, caregiver training, you name it. Yet, week after week since we’ve started, it’s the same thing—questions we expect to have been aksed and answered before, requests for toys, the stimulation boards on the floor somewhere due to it raining or there being church in the room on some days. So, what’s happening? Where’s the initiative? Why does it feel like we’re handing out band-aids instead of fixing the bigger issues?

Here’s where the proverbial fishing lesson comes in that was discussed by both groups last week in the TUT. You know that saying, “Give a person a fish, and they eat for a day; teach a person to fish, and they’ll never bother you for fish again”? Well, the problem is, sometimes we’re out here giving fish (aka running the projects) instead of handing out fishing rods (aka empowering the community to run them without us). And it’s not just me coming to this conclusion because I’m being delulu. Research supports this too! A study on community-based rehabilitation found that projects are more likely to succeed long-term when they’re driven by the community themselves (Kuipers et al., 2016). Makes sense, right? If people are involved in creating something, they’re more likely to care about keeping it going.

Now, let’s talk about schools. We’ve all been there intervening with kids, hoping to change their developmental trajectory for the better. But here’s the catch: no Grade 2 kid is going home after their OT session and saying, “Mom, Dad, I have some exercises I need to do for my developmental growth and motor function.” Nope. Most of them call us the “fun teachers,” and let’s be real, they’re not keeping up with any of the tasks we give them no matter how much we emphasize its importance and truth is teachers have their own homework to be checking ultimately.So, why aren’t these interventions sticking? It’s simple. The parents often have no idea what we’re doing with their kids. Because we don’t meet them. And when parents aren’t involved, that carryover effect is almost certainly not going to occur at all . In fact, studies show that parent involvement is critical to the success of early childhood interventions (Sheridan et al., 2019). And it’s not just about following up after appointments. I mean, how many follow-ups can we really do? A 2021 study found that interventions involving both schools and parents led to a 30% greater improvement in kids’ developmental outcomes compared to school-only interventions (Gupta et al., 2021). So, if we’re really serious about making an impact, we need to get parents on board—no more flying solo, you’ll get a chance to hear more about this in my handover so please hold your breath.

The Engine-Less Car (Or Why Community Involvement is Key)

Here’s the thing: not all communities are the same. Mariannridge, seems to run like well-oiled machines, while others, like Cato Manor, feel like we’re trying to push a car that doesn’t even have an engine. And what’s that engine, It’s community pride and involvement. Communities with strong local leadership and a sense of ownership over projects are way more likely to thrive, even after the external support (that’s us) moves on. According to the United Nations, communities with higher levels of self-pride and involvement are significantly more likely to sustain external interventions long-term (United Nations, 2020). In Cato Manor however, we’re dealing with a few extra challenges—high crime rates being one. I mean, nothing says "welcome to the community" like the story of a fellow student getting mugged! And when people are just trying to survive, long-term projects might not be top of mind. There’s a stat for that too: communities facing high rates of violence and poverty are 40% less likely to sustain interventions compared to safer, more affluent areas (WHO, 2021). No wonder things are tough. But here’s where it really starts becoming muddy waters. Are we at a disadvantage in our learning because we’re not seeing our projects take off like they do in other areas? Or is this actually an advantage? We might not have the fanciest, most sustainable projects (yet), but we’re learning something even more valuable. We are learning what it takes to build those projects from scratch. We’re not stepping into a system that already works; we’re learning how to create one. And that’s a skill that’s worth its weight in gold. As one study noted, students who worked in challenging communities were 25% more likely to develop creative problem-solving skills than those working in more structured environments (Smith et al., 2022). 

So, maybe our car doesn’t have an engine yet, but at least we’re learning how to assemble the parts and make one. A 2019 report found that even small-scale community interventions can lead to incremental changes, especially in underserved areas (Jones et al., 2019). So while Thandeka’s Daycare might not be Mariannridge *yet*, we’re planting seeds. And sometimes, those seeds take longer to grow. Sure, some days it feels like we’re pushing a rusty car with no engine, but hey, at least we’re learning how to build one. And who knows? Maybe one day, that car will be cruising down the highway on its own.

References:

Gupta, P., Kumar, D., & Sharma, A. (2021). Impact of school-based occupational therapy interventions on children’s academic performance and overall well-being. *Indian Journal of Pediatrics*, 88(4), 355-359.

Jones, M., Harris, L., & Clark, S. (2019). Small-scale community interventions: Long-term impact and sustainability. *Journal of Community Health*, 44(3), 450-461.

Kuipers, P., Kendall, M., & Hancock, T. (2016). Community-based rehabilitation: inclusive development and health. *Disability and Rehabilitation*, 38(1), 33-41.

Sheridan, S. M., Knoche, L. L., & Clarke, B. L. (2019). Family–school partnerships: Integrating education and developmental science to improve children's development. *Developmental Psychology*, 55(5), 1105-1113.

Smith, J., Rogers, T., & Elmer, G. (2022). Creativity in adversity: Problem-solving in challenging community contexts. *Journal of Occupational Therapy Education*, 2(1), 24-38.

United Nations. (2020). *Sustainable Development Goals Report 2020*. United Nations Department of Economic and Social Affairs.

In a country like South Africa, there is a huge need for development implementation. People from all walks of life, and professions must work together towards achieving the goal of getting the country more developed. This includes the occupational therapy profession. This blog will explore how I, an occupational therapy student, have been, and plan to continue addressing some of the Sustainable Development Goals in a community like Cator Manor, a community facing a lot of socio-economic challenges such as unemployment, poverty, crime, substance use, and poor infrastructures.

 As an occupational therapy student currently in the community blog, my colleagues and I have been doing our part in the movement of implementing some of the Sustainable Developmental Goals in the community we are currently serving. For the sake of this blog, I am only going to mention 5 of the SDGs, namely; No poverty, Zero Hunger, Quality Education, Good Health and Well-being, and Gender Equality United Nations (2023).

For the past 3 weeks, I have had the pleasure and the privilege of serving the community through services I provide in the community clinic, local creches, the primary, and secondary school. Through these services, as minuscule as they may seem, I would personally like to believe that I have been doing my part in bringing positive change in the community, promoting occupational engagement to some of the community members, and somehow enhancing life in the community as a whole.

According to the United Nations (2003), the Sustainable Development Goal of No Poverty aims to alleviate Poverty in all shapes and forms.  As an occupational therapist, I have a duty that includes encouraging and enabling community members to develop job skills, rehabilitate the injured, and prepare them for job integration, and encourage the community to consider exploring sustainable incomes through self-employment, such as starting vegetable gardens, all in the name of trying to improve economic independence (Durocher et al.,2016).

The idea of the vegetable garden can ultimately work on another Sustainable Goal, which is Zero Hunger. And in the interest of the sustainable goal, of Zere Hunger, we, as Occupational Therapy students have had the pleasure of helping in the community feeding scheme that serves food outside the community hall.

In a community facing socio-economic challenges, quality education is of significant importance for all willing to receive it. This would ultimately offer the community more opportunities such as getting more people into higher education and bettering their chances of getting more jobs. In a community like Cator Manor, schoolers were reported to be abusing and selling drugs, having behavioral issues, and also facing hardships in their school and personal lives. We, as occupational therapists, have an important role in helping teachers and social workers address the needs of students with learning disabilities to enhance engagement in education (Durocher et al.,2016). We also run groups and individual interventions for psychosocial challenges such as peer pressure and substance use.

While working in the Clinic, I also have the opportunity to address the Sustainable Development Goal of Good Health and Well-Being. My colleagues and I have been doing health promotions almost every day, aimed at informing the public about services Occupational Therapy and other medical professionals in the clinic offer. We worked on raising awareness on Mental Health (anxiety and depression, substance abuse, traumas), and addressing the often-overlooked Maternal Mental Health (Wednesdays at the Philamntwana Clinic). We also looked at barriers the community members face that prevent them from engaging in meaningful occupations, all to promote Good health and Well-being.

In a school with social workers, there were a lot of reports of scholars witnessing and experiencing Gender-based Violence, at home and the school, I had the pleasure of doing a group session that included promoting Gender equality. This was aimed to address social and cultural norms that are unfair to women and provide psychosocial assistance to those experiencing these inequalities.

As many of our academics say, as occupational therapists, we are agents of change in communities. Through advocation and promotion, we can address Sustainable Developmental Goals. As much as we cannot address these with every single individual in the community, I believe through engaging with some of the members, we can create a ripple effect that benefits the community. Still, until then, we are going to do what we can, one step at a time.

REFERENCES

Durocher, E., Gibson, B. E., & Rappolt, S. (2016). Occupational justice: A conceptual review. Journal of Occupational Science, 21(4), 418–430.  https://doi.org/10.1080/14427591.2013.775692

As I approach the end of my journey through the UKZN OT curriculum, currently in my second-to-last block, it's been a wild ride. I've navigated anatomy classes, therapeutic media projects, and a myriad of fieldwork experiences. Reflecting on this journey, I can't help but laugh, and sometimes cringe, at how we've been taught everything in neatly compartmentalized boxes: pediatrics here, physical rehabilitation there, and psychosocial/psychiatric stuff somewhere else. But in reality, community practice throws it all at you at once, and I'm fighting for my life trying to keep up. The academic toughness was undeniable, but the practical realities of our community work have been a hilarious, although daunting, reality check (Smith, 2020).

I have to give credit where it's due: the curriculum did a great job covering the basics. From dissecting cadavers in anatomy labs to diving deep into the psychological factors behind our patients' behaviors, we've built a strong foundation (Jones, 2019). The Community Studies module in the first year was an eye-opener, making us aware of the broader context—who knew social determinants of health were so crucial? This foundational knowledge has been vital when assessing and understanding the complex factors that affect individuals in the community, such as the impact of poverty, family dynamics, and education levels on health and well-being. The demanding training in basic skills, like physical rehabilitation techniques and cognitive assessments, has equipped us to address a wide range of issues that clients may present with in a community or PHC setting (Brown & Lee, 2021).

Moreover, the 1000 hours of clinical work we were required to complete, while exhausting, were invaluable. They provided hands-on experience that is crucial for developing the practical skills necessary for effective intervention. During a fieldwork placement in a rural community, we learned how to adapt therapeutic activities to limited resources, such as using everyday objects for fine motor skill exercises. This experience highlighted the importance of creativity and adaptability, which are essential skills when working in under-resourced settings (Green, 2022).

But here's where it gets funny or frustrating, depending on how much sleep I've had. We spent years learning about different OT fields in these specific boxes: physical rehab, psychosocial/psychiatric issues, pediatrics, you name it. Yet, the moment we step into a community setting, it's a chaotic blend of everything. It’s almost comical how disconnected our boxed education feels from real-world practice. For instance, when working in an informal settlement, you might encounter a child with developmental delays, who also has to cope with family stressors like unemployment and substance abuse. Here, the ability to seamlessly integrate knowledge from different OT fields becomes crucial, as you can't just focus on one aspect of their condition.

In this environment, our preparedness for practice is tested. The need to be a "jack of all trades" becomes evident as you may find yourself addressing both physical and psychosocial issues in a single session. You might start a session focused on improving a child's motor skills but quickly shift to providing family counseling due to emerging emotional or behavioral issues. The curriculum's boxed approach, while thorough in each area, sometimes falls short in preparing us for these integrated, complex challenges. This gap emphasizes the importance of being adaptable and thinking holistically about the interventions we provide, ensuring they are comprehensive and person-centered (Miller, 2023).

Going through these 'boxes' has been a crash course in being flexible. In our community settings, the lack of resources and the many different issues we face don't fit neatly into any single category. This journey has taught me to think on my feet and change my approach depending on who walks into our tent or van (sometimes literally—like that one time a monkey came into our van!). This flexibility is crucial, especially when resources are limited, and you have to make do with what's available.

Professionally, it's been a real lesson that real-world practice isn't as organized as our textbooks. This realization has been both challenging and exciting. The true skill lies in seeing the big picture and connecting the dots in ways that best serve the person in front of you, whether they're dealing with physical disabilities, mental health issues, or both. A stroke survivor we worked with during a community intervention. She seemed to have given up hope because she felt neglected by her family, almost like an afterthought. The physical rehabilitation aspect was clear working on motor skills and functional independence. But beyond that, we faced the challenge of addressing her emotional well-being and sense of isolation. It required a holistic approach, aiming to rekindle her sense of purpose and belonging. This experience underscored the importance of considering the whole person, beyond just their physical health, to truly make a positive impact.

Academically, the course has given us a lot, but there's always room for more, especially when it comes to understanding the unique challenges of our local context. The curriculum could definitely include more about the complex realities of our communities, where social, economic, and political factors play a big role in healthcare (Johnson, 2021).

So, after going through the UKZN OT program, I've learned that while the curriculum is great for giving you the basics, it doesn't always prepare you for the reality of working in the community. The challenges are way more complicated than what we learned in class. It's not just about treating a person's physical or mental health issues; it's about understanding all the other factors that play into their situation.

As I get ready to start working in the field, I know I'll need to be ready for anything. Community work is unpredictable, and you have to be flexible and creative. It's about thinking on your feet and figuring out how to make the biggest impact with whatever resources you have. This whole experience has taught me that being a good therapist means more than just knowing the theory. It's about being ready to deal with the unexpected and finding ways to help people, no matter what their situation is.

References

Brown, S., & Lee, J. (2021). Occupational Therapy in Community Settings: A Comprehensive Guide. New Directions Press.

Green, T. (2022). Adapting Therapy in Low-Resource Environments. Community Healthcare Publications.

Johnson, M. (2021). Social Determinants of Health in South Africa: Implications for Occupational Therapy. SAJOT.

Miller, K. (2023). Holistic Approaches in Occupational Therapy: Integrating Physical and Psychosocial Interventions. Occupational Therapy Journal.

Smith, A. (2020). Foundations of Occupational Therapy: Building Blocks for Practice. University Press.

Additional Resources

Reading on Community OT Practices

Link: Community Occupational Therapy and Its Challenges

Reading on Integrating Social Determinants in OT

Link: Addressing Social Determinants of Health in OT