Malaysia suffers from serious lack in occupational therapists

But for some people, a car accident, a workplace injury or some other misfortune could result in injuries that make all these actions that we take for granted a major challenge. For some patients, the road to full recovery can be a long uphill road.

To regain use of their motor organs, patients’ most important healthcare professional is the occupational therapist (OT). According to the World Federation of Occupational Thera-pists (WFOT), occupational therapy is a client-centred health profession concerned with promoting health and well-being through occupation.

The primary goal of occupational therapy is to enable people to participate in the activities of everyday life.

“At the end of the day, it’s about quality of life as well. Often, people with disabilities or are injured lose the ability to do things that healthy people do, so it’s about restoring that ability so they can be active and participate in a meaningful life,” said WFOT president Marilyn Pattison who was in Kuala Lumpur recently to meet with industry peers. WFOT has 84 member countries currently, including Malaysia.

Pattison added that occupational therapists not only work with individuals, but some also with a community group, a city and even a country as a whole.

Worldwide, registered OTs number about 450,000 and the average worldwide ratio of OTs per head of population is 4:20,000.

 In Malaysia, there is a shortage of registered therapists, with just 1,400 or a ratio of 1:20,000. This shortage is also common in many countries due to the profession’s level of maturity.

“For some countries, it’s due to a lack of awareness of the profession and therefore, young people are not necessarily exposed to it. [This happens] especially if occupational therapy is at the stage of development where [OTs] are hidden away in hospitals, so unless a person has an injury, he or she won’t be exposed to an OT,” said Pattison, who is based in Western Australia.

“Occupational therapists are needed in hospitals, but what happens when people are discharged? There has to be follow-up and OTs are cost effective because we can actually speed up the process of getting them discharged from the hospital and assist them towards becoming independent at home,” she explained.

An ageing population will also lead to the need for more OTs, especially in countries like Japan, even though it has the highest number of OTs in Asia right now with 37,000.

With older people, falls are a big issue. Modern society is also witnessing fewer families looking after the older generation, even in Asia.

“The home delivery system [home care] needs to be looked at in Malaysia. We need elderly day-care centres. These will save the government money. The key is being able to keep people in their homes,” Prof Nathan Vytialingam, president of Asia Pacific Occupational Therapists Regional Group, said.

“In Malaysia, we have health clinics all over and if those clinics have OTs, people don’t have to come to hospitals. So, it’s a matter of creating positions there and then hospitals won’t be so crowded,” he added.

However, occupational therapy is slowly gaining recognition in Malaysia.

 

Raising awareness

One of WFOT’s jobs is to track the development of the profession in different nations. Government support, awareness and understanding of the profession spur this development.

“As the profession develops and starts to be practised more in the community, a broader range of people get access to them and the profession then becomes more recognised.

“In Australia, the profession is very well-known because we work throughout the community, from children to the elderly. We also work with people who are well because they can still be prone to lifestyle diseases like diabetes and stroke, which in themselves can be very disabling.

“So on one end, OTs put in interventions that help people get better or manage their injuries or disabilities. Then we also work with people who have no symptoms, but are still vulnerable, so our role is also about injury management and prevention,” she said.

In rehabilitation, one profession cannot provide all the solutions.

One aspect that is often overlooked in occupational therapy is mental health care. According to the World Health Organisation, one in four people develop some kind of mental illness at some point in their lives.

In their work, occupational therapists use what is known as a bio-psychosocial approach. “We look at a person physically, mentally and also within his or her social environment.”

Without doubt, occupational therapists’ jobs are demanding and require patience. “It’s very rewarding to see the outcomes we get with some of our clients. People are amazing, actually. I also often bump into people years later who will come up to me and say, I remember what you said,” Pattison said with a smile.