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The taskmasters

With around 8 per cent Indian households having at least one disabled person, there is a growing need for occupational therapists countrywide. Rahat Bano reports

education Updated: Mar 18, 2010 09:31 IST
Rahat Bano

In addition to doctors, nurses and physiotherapists, there is a category of health professionals who help patients get back on their feet, so to speak. They are the occupational therapists. They can employ one of the many activities, or ‘occupations’, in their kitty, for example, enabling a paraplegic (one whose legs and lower body have paralysed) strengthen his back muscles by ball activities. They make stroke patients, who cannot even do simple tasks like putting on clothes, regain normal hand movement. They train cerebral palsy-affected kids to attain postural balance by using swinging devices. They give splints (a device for immobilising a limb or the spine) to patients who have suffered burns, so that the skin doesn’t contract and normal mobility is restored once the body part is healed.

In other words, an occupational therapist tries to help a patient improve the quality of his/her life. S/he “guides the patient, through the use of sensory, motor, perceptual and cognitive activities to achieve optimal function in all spheres of his/her life — routine activities of everyday life and return to work. The aim is to make the individual integrate with the community,” explains Ona P Desai, associate professor, occupational therapy (OT) and head, department of rehabilitation sciences, Jamia Hamdard.

Occupational therapists treat a wide array of disorders/diseases, such as developmental delays, learning disorders, autism, paralysis, spinal cord and head injuries, arthritis, congenital dislocation of hips, osteoporosis in women, depression, and schizophrenia. They also treat dementia, Parkinson’s and Alzheimer’s cases.

Anil K Srivastava, president, All India Occupational Therapists’ Association and head of OT services, CSM Medical University, Lucknow, says occupational therapists also render their services in sports, ergonomics, occupational health, disaster management, health insurance, and abilities/ disabilities assessment to identify the jobs that the patient can be trained for.

The role of an occupational therapist has extended. There are doctors who believe in a ‘holistic’ team approach, which means involving physiotherapists, occupational therapists, medical social workers, psychologists, or speech therapists, as required.

According to Desai, there’s a greater need for occupational therapists today. “About 70-80 occupational therapists pass from institutions in Delhi every year but the demand is five to ten times that. Within two-three months of their post-graduation and sometimes even when they are studying, our students are able to secure jobs,” says Desai. Yet, these largely are trends in urban areas. The experts say there’s still not enough public awareness about OT across the country. Desai says that some medical interest groups and foundations in Delhi are attempting to sensitise people in other cities and towns about rehabilitation of the disabled, through workshops and seminars.

Srivastava points out that a large part of India’s population can benefit from OT. “Findings of the National Sample Survey Organisation survey carried out in 1991 suggest that nine per cent rural and seven per cent urban households in India have at least one disabled person (the average household size is 5.8 people). It is also a fact that only 1 per cent of the population living in rural areas has access to some kind of rehabilitation service. That signifies the need for occupational therapists and the challenging role they have, both in urban and also rural settings.”

More than India, the scope is in countries like the US, the UK, Ireland, Canada, Australia, Malaysia, Singapore, as also in the Middle East. A lot of OT graduates migrate either for jobs or further studies to such developed countries. Jamia Hamdard teachers say that about 30-40 per cent of their graduates go overseas.

Says Akhilesh Kumar Shukla, lecturer in OT, Pandit Deendayal Upadhyaya Institute for the Physically Handicapped, New Delhi, “There is a regular demand for occupational therapists in India but a strong demand is from the US, Russia, the UK, Australia, Canada and certain eastern countries. Most of our graduates go abroad. The government has to do something because trained people are needed in the country.”

What's it about?
Occupational therapy is an allied health science, which involves helping people with physical or mental disorders/disabilities to attain maximum level of functioning. Occupational therapists enable patie- nts/subjects achieve this through a variety of purposeful and adaptive ‘occupations’ (read tasks or activities). The caseload of occupational therapists is dominated by paediatric cases including cerebral palsy, autism, learning disabilities, behavioural and emotional problems. And in adults, the common conditions are paralysis, hand, head and spinal cord injuries and other orthopaedic, neurological and psychiatric conditions

Clock Work
The average day of an occupational therapist depends on the place s/he works in. In a teaching hospital, it can be as follows:
9 am: Reach OPD. Do evaluation and treatment of 15-25 patients.
1 pm: Lunch
2 pm: Give lectures. Do research work. Guide research students
5 pm: Call it a day
In a large hospital
9 am: Deal with OPD patients
2 pm: Visit patients in the in-patient department and the ICU
5 pm: Call it a day

The Payoff
As per the sixth pay commission, the starting (basic) salary of an occupational therapist is Rs 9300-38,600 a month (with a grade pay of Rs 4200) in a government hospital. In Delhi/NCR, the take-home is about Rs 22,000-25,000 a month. In private clinics, the pay of graduate in OT could be Rs 6,000-25,000 a month. In independent practice, the income is generally about Rs 30,000 - Rs 50,000 a month; however, it can vary depending on the quality of services you provide

Skills
.
Scientific aptitude
. Strong inter-personal skills
. Ability to work with people of all ages and with various medical devices
. Humanitarian approach to work with patients, children and persons with disabilities

How do i get there?
Take up physics, chemistry and biology at the plus two level. You need to clear a written test for entry to a four-and-a-half-year Bachelor’s programme in occupational therapy. Though you may find a job with a Bachelor’s degree, it’s desirable to take a Master’s degree in a specialisation of your interest

Institutes & urls
. Pandit Deendayal Upadhyaya Institute for the Physically Handicapped, New Delhi
www.iphnewdelhi.in
. Jamia Hamdard
www.jamiahamdard.edu
. Christian Medical College, Vellore
http://home.cmcvellore.ac.in
. National Institute of Rehabilitation Training and Research, Cuttack
http://nirtar.nic.in/hrd.htm
. National Institute for the Orthopaedically Handicapped, Kolkata;
www.nioh.in
. KEM, Mumbai
www.kem.edu
. GGS Indraprastha University, Delhi,
www.ipu.ac.in

Pros & Cons
. Multi-dimensional/ multi-speciality areas to work
. Huge future scope
. Can set up independent, either generalised or speciality, practice
. Good income with low investment
. Satisfaction at enabling patients achieve normal functioning
. Great scope for research
. Takes four-and-a-half years to earn a Bachelor’s degree and two to three years for specialisation/post-graduation
. Limited awareness of occupational therapy in India

OTs Facilitate Rehab

A senior practitioner talks about the scope of their work

Other than hospitals, special schools, vocational rehabilitation centres and NGOs, is there any new area where occupational therapists can work?
Occupational therapists function as clinicians, educators, consultants, researchers, administrators, and private practitioners in a variety of set-ups, both in the government and private sectors. They also provide expertise in normal schools (for improving general mental, physical, educational health of normal kids). They work as ergonomic consultants for ergonomically designing special economic zones, cities, private and public buildings etc, as sports performance consultants and in industries for injury prevention programmes and job training. Occupational therapists work in community-based rehabilitation projects, private clinics, old age homes, leprosy and cancer rehabilitation (centres).

What are the latest trends in occupational therapy in India?
Training in special techniques and approaches are required to develop new skills like sensory integration therapy, neuro-developmental therapy for developmental disorders and learning disabilities, specialised clinics for hand therapy, gericare and very recently, disaster management (treatment and rehabilitation of disaster survivors within the community) and designing and fabricating the assistive technology like self help adaptive devices, indigenous hand splints for functional restoration etc.

How do you see the profession faring in India?
In India, though there is an imbalance in the healthcare system, occupational therapists have a major role to play in rehabilitating individuals. Legislation, in the form of a Central Council for Occupational Therapy is a significant requirement for instant academic and professional uniformity and growth of the profession in India.

Which countries have the maximum demand for OT?
Almost all parts of the world need great numbers of occupational therapists, and Indian occupational therapists are especially in demand. USA, Canada, Ireland and the Middle East have very huge demands. Other destinations include the UK, Malaysia, Australia and New Zealand.

Dr Anil K Srivastava President, All India Occupational Therapists’ Association Interviewed by Rahat Bano