Changing India, Changing OT……

by let's OT

As a part of the essay competition for the AIOTA conf OTICON’12, i  wrote an essay on ‘Changing the aspects of Occupational Therapy with current and future India’.  here’s what i think about the topic, would like to know what you think…..please do give feedback.

 

Long years ago we made a tryst with destiny….

…. these were the very first words of the first speech made by the Prime minister of Independent India Jawaharlal Nehru, on 14th Aug’1947 at the stroke of midnight. India has come a long way since its rendezvous, to become one of the fastest growing economies in the world.

60 years ago, a profession had its tryst with destiny when an American women wearing an Indian saree and a hospital coat was seen moving in the corridors of K.E.M Hospital, with odd looking things, strings and frames in her hands; who at the age of 45 to decided to learn and bring a health care profession to India for the betterment of the needy. A freedom fighter, a socialist, a Gandhian, an educationist, Dr. (Mrs.) Kamala.V.Nimbhkar started an Occupational therapy school in India, the first in Asia. The profession has come a long way since then, with 25 occupational therapy schools across India, 49 years of All India Occupational Therapy Association (AIOTA) and an independent occupational therapy journal ‘The Indian Journal of Occupational Therapy’.

But there is still something lacking.  Something that is not allowing the profession which deals with humans as BEINGS to establish its own BEING.  As Dr.Anil .K.Shrivastava mentions his concerns in the editorial IJOT (07):

 

It is unfortunate that despite its great relevance the voice of Occupational therapy has been quiet incomparison to other professions.’

     Once entitled as ‘Sone ki Chiddiya’ (The golden bird), India has had its ups and downs; from the heart wrenching partition, to the dreadful Indo-Pak and Indo-China war, the destabilizing political emergency, the obstinate Kargil war, the disastrous Bhuj earthquake to the tragic Tsunami. The depressing stories of the displaced Kashmiri pundits and the Tibetan refugees. The insurgening Godhra riots, the revolting Naxalite movement and the recent heartbreaking Mumbai Terrorist attack, each of these events uniquely influenced our profession and its growth.

Every profession, especially a developing one is influenced by the change of the environment in which it thrives. Change in countries policies, rules influences the growth of the profession

India’s health care system has changed swiftly  with the formation of the Rehabilitation Council of India(RCI), Person with Disabilities Act(PDA), Worker’s Compensation Act, various programmes like Sarvashiksha Abhiyan, Inclusive education, Learning Disability Certification, Kangaroo Mother Care (KMC), Technology Intervention for Elderly(TIE), National Social Assistance programme, Health Insurance policies and many more such programmes.

As these changes continue our profession has to examine its strengths, vulnerabilities and opportunities to compete with the growing India.  As Mrs.Indira Kenkre wrote in the Editorial IJOT(91):

 

‘Change is an incentive for growth, it makes us more responsive’

   

      To deal with these changes, a profession needs a firm base against which to judge its practice, research and theory and to avoid being swayed by fashions and pressures. Occupational Therapy in India from the time of its inception has been struggling to have a strong base of support. Due to the professions close proximity with the medical model, the basis of the profession has shifted from person centered practice to medically oriented one, ingenious crafts were replaced my mechanical equipments; and meaningful occupation was sidelined by emotionless exercises.

This shift was survival driven, in accordance with Darwin’s Theory of Survival of Fittest; which states that an individual or community succeeds in continuing its species if it is better adapted to immediate, local changing environment.

 

 

The environment is changing again, the International Classification of Functioning, Disability and Health (ICF) puts the notion of ‘Health’ and ‘Disability’ in a new light. It acknowledges that disability is a universal human experience. It has shifted its focus from cause to impact of the environment on the person’s functioning. Simultaneously the medical community in India is shifting from medical prognosis to Functional prognosis with the use of outcome measures like FIM and Quality of Life used as standard evaluation and research tool.

With this transpiring shift, the occupational therapy community is also responding effectively. With the formation of the Occupational Therapy Council for the states of Delhi and Maharashtra, release of approximately 5 occupational therapy books by Indian authors in last two years, foundation of the students body at national (Association of Occupational Therapy students) and at state level (Maharashtra association of Physiotherapy and Occupational therapy), strategic planning by AIOTA to market the profession, three new enquires for starting new OT schools during last year. Things are surely changing and changing for the good.

According to The Planning Commission of India, by 2025 an estimated 189 million Indians will be at least 60 years of age triple the number in 2004. 10 to 20 people in every 1000 people will suffer from mental illnesses and 3 to 5 times more of emotional disorder. Cardiovascular and lifestyle diseases are expected to increase dramatically. Even though only 10% of India’s population, today has health insurance covered, this industry is expected to face a tremendous growth over the next few years.

Successful professions plan wisely and determine their own destinies. A masterplan needs to be designed to deal with these future predicaments. The American Occupational Therapist’s Association (AOTA) has set up the ‘Centennial Vision’ to make

 

Occupational therapy a powerful, widely recognized, science driven and evidence based profession with globally connected and diverse workforce meeting society’s occupational needs.

    YES, we need change; changes to compete the ever changing India, changes which challenges the basis of our profession, changes which will give rise to a stronger profession.

  • The very definition of OCCUPATION in our country, where it means job or career, needs a change.
  • Moving beyond the medical model towards the person centered use of Occupation as therapy.
  • Redefining Occupational Therapy according to India’s social, cultural, political and economical interplay.
  • Understanding the application of terminologies which move in the depths of the term OCCUPATION i.e. occupational science, Occupational justice, Occupational apartheid, Occupational deprivation, Occupational alienation, Occupational ecology, Occupational imbalance and many more such terms will evolve to define the professions application in various aspects of life.
  • Creating Occupational Therapy Scientist, who will make the profession’s practice strongly evidence based with cutting edge research.

Occupational Therapy is on the path to compete with the future India, but we need to plan and implement wisely. The responsibility lies on each one of us, to make a difference in our own way for the betterment of the profession.

 

“Change will not come if we wait for some other person or some other time. We are the ones, we been waiting for.

 We are the change we seek.”

—- Barack Obama.

 

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