A rights-orientated approach
People on the move have the right to claim their human rights regardless of the refugee or migration status.
The importance of occupational opportunities
Health is largely created and sustained outside the health system where people occupy their every day lives. Intentionally creating and enabling occupational opportunities is a powerful tool that can be used to:
- promote health and healing,
- assert and enjoy human rights, and
- adapt to and drive change.
The importance of sustainability and impact
As a growing but scarce health resource (WFOT, 2018), occupational therapy research and practice needs to consider how to position services strategically.
Increasing the sustainability and impact of occupational therapy with displaced populations is an ethical imperative because the scale of the need is vast.
The number of people forced to flee their home in search of safety due to war and persecution is a historic high of 68.5 million people (United Nations High Commissioner for Refugees (UNHCR), 2018), almost double that of 10 years ago (UNHCR, 2008).
Occupational therapy in practice
People are already actively working to adapt and develop to meet occupational challenges. Occupational implications of displacement are many, and may include:
- new roles (e.g. widows or children who become head of households),
- lost roles (e.g. loss of worker role prolonged by language barriers), and
- changed roles (e.g. cultural and religious practices in a new context).
Occupational therapists analyse the person, occupation, and environment and look for strengths, resources, and possibilities, whilst also considering changes due to displacement such as:
- poor health (e.g. typical human diversity, additional risk of physical or mental trauma from adversity and displacement)
- mismatched life skills (e.g. new language new skills to find somewhere to live need to develop to match the new context)
- environmental barriers (e.g. national laws impacting the right to work, or no recognition of prior work experience or qualifications)
It goes without saying that occupational therapists can’t work safely or ethically if they do not respond appropriately to linguistic diversity using the language support of an interpreter as needed.
Communication is a precondition to being able to account for cultural diversity in professional reasoning and practice (Darawsheh, Chard & Eklund, 2015).
Darawsheh, W., Chard, G. & Eklund, M. (2015). The Challenge of Cultural Competency in the Multicultural 21st Century: A Conceptual Model to Guide Occupational Therapy Practice. The Open Journal of Occupational Therapy, 3 (2), p 1-22. Retrieved from: https://doi.org/10.15453/2168-6408.1147
United Nations High Commissioner for Refugees (UNHCR). (2009). Statistical Yearbook 2008: Trends in displacement, protection and solutions. Author. Retrieved from UNHCR website: http://www.unhcr.org/4bcc58cf9.html
United Nations High Commissioner for Refugees (UNHCR). (2016). Statistical Yearbook 2016. Author. Retrieved from: http://www.unhcr.org/en-au/statistics/country/5a8ee0387/unhcr-statistical-yearbook-2016-16th-edition.html
World Federation of Occupational Therapists (WFOT). (2018). Human Resources Project. Retrieved from: http://www.wfot.org/ResourceCentre.aspx