Occupational Therapy

“Aspects of globalization jeopardize health by eroding family-based social systems, denigrating the environment with pollution of the water, air, and land, and by disseminating consumerism accentuating the gap between the rich and the poor” (Wiedman, p. 46).

As globalization continues to reshape societies, the connections and relationships that communities once had with their health care system, is reorganized.  In chapter 2, Globalizing the Chronicities of Modernity Dennis Wiedman discusses how “sociocultural processes at the global, individual, and local community are the causes of” various metabolic disorders known at MetS (Wiedman, p. 51). According to the World Health Organization, MetS (Multiple Metabolic Syndrome) is composed of a cluster of conditions including diabetes, which is now recognized as a public health concern, and generating worldwide research. Rather than looking at these disorders from a genetic and biological standpoint, Wiedman explains that the body’s response to modernity are reflections of the ongoing “limitations and suffering” that are “socially and culturally defined” (Wiedman, p. 38). With recent studies indicating that disorders such as diabetes and hypertension are reversible, the enthusiasm among communities with the resources to implement these “lifestyle changes” seems promising. While some individuals have the ability to choose what they eat, or how they live, many do not. With failing infrastructures, economic inequalities and challenging “daily occupational situations,” certain populations are at a greater risk for disease and stress. 

While governments and businesses try to “stabilize, and standardize” the routine of their techniques used to control our health, the institution grows along with the “people involved” (Wiedman, p. 45).  These people involved become forced into a standard of what health should look, and feel like. Wiedman proposes that as individuals move in sync with the “globalized time” of modernity, the risk of developing chronic disease increases. These socially assembled patterns of activity challenge the community of health professionals to look further into the “larger parameter of life situations” (Wiedman, p. 48). One important group of professionals that are involved in helping people with chronic diseases are occupational therapist. 

Occupational Therapy focuses on "culturally relevant treatments and opportunities to improve health and well-being for all categories of people, in the United States and around the world."

-Gelya Frank

 World War I: Occupational Therapy

During World War I  hundreds of "reconstruction aids" (occupational therapist) were trained to help with wartime injuries. This was a time in history that OT was forced into clarifying what role they played in the medical field.

Bedridden soldiers work on knitting 

while injured.

Toy making in a psychiatric hospital.

 How do we “enhance opportunities for people and families with chronic conditions to live meaningful, purposeful lives” (Frank, p. 231)?

In chapter twelve, Chronic Conditions, Health, and Well-Being in Global Context, occupational therapy and medical anthropology are brought together to propose, that a closer relationship between the two is beneficial to each profession, and important in knowing how to work with chronic conditions. Occupational therapy, along with many other professions that participate in helping individuals and populations with debilitating diseases and disabilities, face the challenge of creating treatments that are “tailored to each individual’s unique needs and interest”  (Frank, p. 232). While occupational therapy attempts to heal the body by taking into account the “everyday lived experiences and meanings,” and taking a more holistic approach, their ties to the biomedical world are further separated.  Although similar in focus, medical anthropology and occupational therapy have different approaches that if brought together could have powerful effects on changing the way chronic conditions effect everyday life.  By breaking down the terminology, and looking at the connection between the social environment and the biological individual, new frameworks for occupational therapist to work in are created. Like many professions, this therapy has protocols to follow, “diagnostic categories, reasoning procedures, treatment goals” and unique techniques used for intervention (Frank, p. 234). It focuses on helping people fully participate in activities in spite of physical and mental limitations regardless of age, sex or status. By adding in the knowledge and research that medical anthropology can offer, I believe that occupational therapist will have a more well rounded approach to working with the body. Just like medical anthropology, it can be hard to visually understand what occupational therapy is, and what this profession actually does.  
 

Therapy for rehab can take place at multiple locations. Patients might be seen in inpatient hospital settings, outpatient private clinics, schools or at their own home. Because occupational therapists serve individuals and communities with various health concerns, their work environments change and vary according to the needs of the individual and population. As chronic health problems are disrupting lives, more interventions are needed to help give opportunities back to those with disabilities and illness. “To promote practice with populations ignored or actively oppressed by mainstream institutions,” the Occupational Therapy without Borders group has formed (Frank, p. 239).  These therapists collaborate with NGO’s and local community leaders to work on creating a sustainable economy, while focusing on the positive aspects of “health,” instead of the negatives of disease.  This is one way OT is beginning to reach outside the standard medical model of focusing on just the individual. As this profession helps to bring “meaningful activity” back into the lives of the chronically ill and disabled, an increase of healthy, able body citizens will start living successful, independent lives again. By enhancing opportunities in communities, and seeking to understand the environmental barriers that contain, and prevent certain groups of people from being successful, occupational therapy will open new doors for empowerment and survival. Dealing with health at the global or local level, takes “deeper conversations” that include professionals in many health fields including nursing, public health and anthropology (Frank, p.244).  One of the first steps in understanding the field of occupational therapy is having more knowledge around techniques used in this healing method, and the physical and mental disorders that could benefit from this work. By realizing what the full potential of occupational therapy is, the closer we get to decreasing health disparities among marginalized populations.




The two videos below demonstrate how occupational therapy can be used in outpatient private settings, as well as looking at international work that has been done by graduate students. 

Sources:

• Dennis Wiedman, 2010. “Globalizing the Chronicities of Modernity: Diabetes and the New Metabolic Syndrome.” In Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. Pp.38-53.

• Gelya Frank, Carolyn Baum, and Mary Law. 2010. “Chronic Conditions, Health, and Well-Being in Global Contexts: Occupational Therapy in Conversation with Critical Medical Anthropology.” In Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers university Press. Pp. 230-246.

• Otis Historical Archives. Occupational Therapy World War I era. National Museum of Health and Medicine, 14. Feb, 2011. <http://www.flickr.com/photos/27337026@N03>.

• Sensory Integration Therapy Part One  YouTube. <www.youtube.com/embed/qtszqdr4GW4>.

• UNM Occupational Therapy Students YouTube. <www.youtube.com/embed/ku4sBTnpyF0>.