Last year, occupational therapist Nasiba Chowdhury, shared an article in our August 24 issue reflecting on her experiences of visiting refugee camps and considering the impact that the role of occupational therapy could have in these spaces
I write these reflections from my naive but growing understanding of humanitarianism. In light of the conflict in Palestine, I have been reflecting on humanitarianism and the role of occupational therapy. Through this reflective piece, I try to make sense of some of my experiences whilst visiting refugee camps and reflect on my thoughts on perhaps the need for an occupational therapy perspective within humanitarianism.
Humanitarian crises have occurred in the past and continue in the present. Many people suffer as a result, the Palestinian suffering is only one example that is very much prevalent today. There has been and there continues to be a need for a conscious, continuous effort to reduce the suffering of others and improve their quality of life. Humanitarians provide support and aid directly or indirectly and whilst there can be several ways of doing so, it is about saving lives, alleviating suffering, and maintaining human dignity. That, to me, is very much in line with the principles of being an occupational therapist. We promote occupational justice – that is, everyone has the right to engage in occupations in order to live a life with meaning and purpose. Humanitarian crises can infringe on these rights and prevent people from accessing occupations and living a life with meaning and purpose. Visiting refugee camps provided me with only a small insight, but it was certainly an eye-opening experience into the complexities of the refugee crisis and the implications on individuals’ health and wellbeing. It left me wondering about the scope of occupational therapy.
During my first food distribution, I remember feeling mixed emotions. Part of me felt this adrenaline ready to do what I could to help, with volunteers from all over the world; regardless of our backgrounds we were there with a shared purpose, and I felt a great sense of belonging. After I laid out my table of tea, sauces, and spices, I looked up and saw just row after row of people queuing – the adrenaline I felt had dissipated and the reality was simply disheartening. These individuals were human beings who had a right to dignity and respect and needed help and I just wanted to give. During our field training, we were advised to be mindful of how much we give, to ensure there was enough for everyone. I was told “watch the spices, they are really popular”, and so I watched the spices. Every now and again, a small hand weaved its way through the men and women and into the bowl of spices. After several successful heists, I saw her face, she had to be no older than five, cheekily grinning and laughing. Whilst taking in the little moment of joy and laughing with her, it hit me, there were children here and children are born into these camps. Could there be a place for occupational therapists to work with children in camps, could we get in early and do preventative work, is there a place for us to support mothers and families? I met many refugees from various countries who were left displaced after fleeing their country. I met a man who shared his story, pointing at the colour of my skin, he introduced himself smiling and stated “look, you and me, we are the same”. He described himself as an educated man, a skilled engineer who had left his home in desperation stating, “people think I chose this, there was no choice”. This loss of role coupled with the difficulties in attaining work left me thinking about the impact this would have on his health and wellbeing and what could be done to support him regaining that role or perhaps developing new roles whilst in this state of displacement.
I was involved in arranging essential aid such as wood, tents, food, clothes, and medical aid. We spent the majority of one day preparing sacks of firewood and tents for the evening distribution. The following morning, we learned how the firewood had been confiscated and the tents were taken and deliberately damaged before being disposed of. I remember feeling shocked and confused as to what warranted such a strong and unhelpful reaction. When reflecting with my peers I learned that this was a typical reaction of some people who did not welcome refugees and I could not help but think, is there more that can be done to tackle how others perceived refugees and how could we promote healthier dialogue and productive solutions? Part of me felt disheartened and questioned whether our efforts were in vain if the aid did not reach the ones who needed it, and I questioned whether there was more that could be done to create sustainable solutions. As occupational therapists, we appreciate individuals' environments and their impact on engagement in meaningful occupations. This stigma, society's views on refugees, policies, and legislation related to the treatment of refugees are very much a part of a refugee’s environment. So, I wonder as occupational therapists how would we explore a refugee’s environment to facilitate and support meaningful engagement in occupations?
Outside one camp, I visited a centre where I could picture an occupational therapist working. The centre offered a range of activities from cooking, art and crafts, woodwork and social groups. Refugees were able to access these activities for enjoyment, to build and gain new skills and roles, as well as have the opportunity to utilise their existing skills and strengths and engage in occupations, express themselves, and retain their identity.
Within another camp I met an occupational therapist who was working with refugees assessing their physical health and providing aid and equipment where possible. Being from a mental health background myself I was intrigued to find out whether there were any occupational therapists providing support with individuals’ mental health. From one of the other tents, I saw my friend carrying a little girl who looked impressed with my friend's nail varnish. I happened to make eye contact with this girl, who then called me over, but before she let me hold her, she inspected my nails and sadly I did not gain her approval and she bid me farewell. Whilst I learned to put a bit more effort in with my nails, I also realised that this girl was being looked after whilst her mother was in a session for her mental health and was receiving psycho-social support. There were no mental health occupational therapists in this camp but there were initiatives addressing mental health needs.
This label of ‘refugee’ was another important point of reflection for me. I can see the positives of having this label in the sense that people are recognised with this status, which may afford them certain rights and support, however equally, this may result in the lack of rights, support and prejudice, and discrimination. But, the occupational therapist in me wanted to know who are the individuals, the person behind that label. I met one lady who was a refugee but also, an amazing artist. Through her artwork, she learned to cope with her trauma, expressed herself, and also earned a living. This is one of her pieces I was able to purchase – she described this as colourful, something that reminded her of good times, a festival or a celebration of some sort. She gave me this piece and said “take this painting back with you, at least then I know my art can travel even if I can’t myself”.
When visiting a school within a refugee camp I met a young girl, who was a refugee but also an aspiring lawyer who wanted to support refugees with their legal cases. I met a boy who was a refugee but also an aspiring politician who wanted to change policies and legislation for refugees - he even stood up and told us a little bit about himself as if he was giving a speech. I could see that amid crises, displacement, and suffering there were clear occupational gains, whether that was through exploring new occupations such as art, to cope with trauma and as a form of self-expression, or whether that was gaining the motivation and inspiration to pursue new roles such as in politics and law.
I personally gained a lot from my visits and I left with reflections and questions about the role of occupational therapy within humanitarianism. Hopefully, this has given you a flavour of humanitarianism through my eyes as an occupational therapist.
If you would like to contact Nasiba to share your thoughts or ask questions, please email Nasiba.Chowdhury@outlook.com.