Bhutan Association of Occupational Therapists

10/01/2024

4/1/2023
WFOT Associate Membership

21/12/2023

Towards better Writing for CWD...

31/05/2023

Steps towards simple AT
products.Completed the intial phase of assesment.
Aiming towards use of simple AT products to open new door ,create opportunities and enable the CWDs to realize the functional goal that were previously unattainable.

29/05/2023

when you got up this morning you probably didn't realize that you were going to put your greatest superpower into action and that's doing. So what I'm going to share with you today is some of the insights that I've gained from my work as an occupational therapist.The things that you did this morning that probably you bathed almost definitely you dressed and you made your way here. They may seem kind of ordinary and familiar things that you probably do automatically without thinking about them and they are things which we take very much for granted obviously until some of the things might go wrong. The things that we do are the things that take us to another time, they take us to another place .There's three things I'm going to share with you today. The first thing about doing ,which I think is something worth sharing .Doing is very complex and there are three things that really make up”doing”. The first thing is that we do things with our bodies and our bodies obviously are made up of lots of different parts and it's the site of our emotions and it's the sites of our thoughts.It is designed to do so many different things.Our bodies can move in all sorts of directions and can coordinate in lots of different ways.Something as simple as dressing requires all sorts of body movements, large ones and really quite tiny ones and all of that coordination is extremely complex and we don't kind of think about it until it goes wrong. I mean if you've ever hurt your fingers or perhaps you've broken a limb you might have an idea of how and what that means even just doing ordinary tasks. We have lots of things about our body that help us to do things in quite extraordinary ways. For example at the ends of our fingertips we have a sensor which allows us to recognize objects without looking at them by touch and that sense is something which helped me to do up my zip this morning. We have this incredibly finely tuned machine at our disposal .The second thing is, doing is amazing and complex and there are so many different things we do ,we want to do and we are expected to do.Those are “occupation”and we are thus called occupational therapists .There are so many different things to do and we have invented so many different things to do way beyond what we need to do in terms of our survival as human beings .This kind of tells us something interesting about ourselves. we hate being bored and we want new things to do all the time, so we've invented things like arts,religion etc.The things we do is very complex and it take place in environment and that environment can be an enabler or a barrier to the things that you want to or need to be able to do.if we have a look around well just think about where we are and all the buildings around us. We've created them to do things in there and it is there because we have such a big drive to do.Doing gives meaning to our life and when we do things it helps to form our identity.The things that we do give us a sense of who we are, it gives us labels by which we can call ourselves. Closely aligned to that is the roles that we inhabit .The roles we assume in our life give us identity . Doing bring us into being .We want to have a story that we can tell about ourselves and those stories those narratives of our live.That's why as an occupational therapist I would say that there's a big link between the things we do and our health and wellbeing.Being able to do the things are a source of health and well-being and of course the opposite is true as well .if those things are taken away from us the loss can be quite severe. If you lose your job due to disability, you lose your role and you can lose your identity,also if you think about people who lose mobility maybe they become a wheelchair user ,obviously losing the function of your body is distressing but actually from working with people what we find is that it's the potential loss of roles and meaning in their life is additionally distressing and that's actually where my profession of occupational therapists come in because we are experts in doing and we appreciate the importance of the doing to people's meaning of their lives .Therefore when we work with people to restore their ability to do the things they want to, need to be able to do ,this is very much about restoring that meaning .The last thing that I wanted to share with you about doing is that it's transformative and this really is exciting .This phrase doing being becoming was coined by an occupational therapist called Wilcock .I've thought about this is for an awful long time but there is this incredible dynamic aspect of being a human which is that when we do things we are bringing ourselves into being, we have an experience of who we are and when we bring that person into being then that is who we become in that moment .it's transformative cycle.

Ps:Random Insights

Dechen Tshomo
OT

26/05/2023

Meetings to discuss on designing simple writing aids for student with special need with bhutan fab lab...keeping high hopes..

20/05/2023

17/5/2023
Integrated goal planning for ECCD kids with special needs with perkins international education consultants,ECCD facilitater,OTs and SLPs .

26/04/2023

It has been three years since the government approved the National Policy for Persons with Disabilities. The policy was to bring proper coordination between stakeholders to create an inclusive society for persons with disabilities. However, they still lack coordination. This was raised during the tw...

25/04/2023

25/04/2023

Study tour to Chennai (Empower Conference)
Self reflection

The study tour has opened my eyes to vast possibilities and enthusiasm within me to take simple yet broader initiatives in my settings through my prior learning and experiences.From listening to experienced leaders and champions of disabilities to visiting the places where the disabled are groomed to be abled had given me a satisfying answers to my long unanswered questions that google and readings couldn't. I was overjoyed to picture my patients with every potential AT solution witnessed but was saddened by the reality of difficulties in procuring the AT devices and ignorance of its importance in the country.

The first day of the conference had all the exciting workshops but Sadly all were scheduled at the same time.I could attend to Prof. Shovan's workshop on Designing of Frugal Devices to enhance the functionality of a compromised hand.I was amazed to realize how simple yet impactful solutions can be created through indigenous and locally available resources.The lessons learned in the workshop is something that i can see myself doing in my day to day clinical work . I am pleased to receive the positive responses from the professor and hopeful to receive the guidance in initiating the plans for designing the frugal hand devices in my setting for the pediatric population. I am touched and grateful to you for feeling my difficulties of being a lone learner and practitioner and introducing me to prof Shovan.Having him as a guide and mentor would be a dream for every learner.

Attending the AAC workshop refreshed my knowledge on the SETT framework used for designing and fitting AT devices and also cleared my misconception on using AAC.I Learned more about the AAC and the role that the different professionals play in customizing the AAC according to the user needs.The importance of AAC and its idea has not yet reached our country and is still considered a last resort with a negligible number of its users.I really hope to collaborate with the SLPs in the hospital to Introduce a successful AAC programs for childrens enrolled for interventions.

The keynote presentation and invited talks in the conference took me into new dimensions of assistive technology from the innovation,marketings and advancement to users feedback and testimonies.It has enlightened me about the significant roles of every stakeholder from policy makers to the end users and their collaborative approach in building an inclusive society and mainstreaming the PWDS which is much needed in a country like ours .I couldn't help myself from envying the, AT facilities,Expertise,mainstreaming programs and the attitude of PWDs presented in the conference.It has driven my imagination of how accessible and better a place would be for the disabled, if things like attitude,designs,policies and collaborations from the conference can be replicated everywhere.

The visit to Viidhya sagar and museum of Possibilities brought sense and life to what I have read and learned until now.To see and feel how things are actually done in real is something i have always longed for.From early intervention to the independent living and community integration , adaptation,compensation,modification and use of AT,the two places by itself resonates a success stories of diabled being no more disabled.I was astonished about how the institute are carefully structured and organized with every attention to the accommodating diverse kind of disability.The early Intervention session at Vidyasagar organized by different rehabilitation profession was a simple manifestation of a efficient multidisciplinary approach towards achieving a common goal set for every children with special needs. This is something I wish to make it happen at the hospital I work at as the current practice of rehabilitation professionals working in isolation is inefficient in meeting the goals of functional outcome of the CWDs.

The museum of Possibility would be dream come true for every disabled individual with every possible solutions for their disability.The variety of assistive technologies from low technology to high technology across various life domains of( Live, Work and Play ) and range of disability build with the element of universal element really define its possibility.To have one of its kind at our country would serve as a model for all the stakeholders working in the field of disability and diabled people themselves for independent living and mainstreaming PWDs.Exploring the low tech devices have provided me with an idea of simple adaptation and designs that i can adopt as well as encourage the local carpenters to make.

I was stunned to witness 80+ AT product exhibitions and innovation aimed at problem solving the challenges of PWDs.I was glad to connect with few of those startup organizations which were of my field of interest and those i thought would feasible in our country.I am motivated towards studying each of those products in the market in details to effectively suit the patient i come across from different walk of life.

The visit to QUEST learning center was something new and different for me. The idea of self-directed learning and designing one's own learning journey is truly revolutionary and a great initiative towards pursuing an educational experience independently with just the right involvement of parents and teachers and without the curriculum restriction and distinct subject and textbook boundaries.Applying the same concept of curiosity driven learning in the field of pediatric rehabilitation would be an asset towards achieving functional outcomes.The displayed works and creativity of children put together under particular themes of kindness of children at Kindness Carnival portrayed significant role the children play in humanity and their special way of spreading kindness. Observing the little children proudly operating stalls of their self made products reflected their creativity and excitement of having been given a chance to take part in a larger platform.

Visit to Chetena ARM Library is one of a kind that houses adaptable books for any child with a print disability.From seeing the books , I realized how the handcrafted context based story books would serve as an incredible way of expression , learning fundamental skills and concepts and carving an imagination for print disabled as described by Dr.Namita in the EMPOWER conference.The exciting stories of different themes coupled with the fun tactile and visually rich materials and activities used for storytelling can be a fun way of learning and ingraining the lessons learned.
As i Listened to people who have never let their disability take charge of their life and saw them navigate successfully through daily activities,I aspired to plant the same attitude and make the same changes in every disabled person I come across in my practice.

I am bombarded with multiple ideas of implementing many programs from the study visit and but deprived of ideas of initiating it.i am really interested initiating the following programs:

Multidisciplinary early intervention session similar to Vidhya sagar at National Referral Hospital
Museum of Assistive Technology at National Referral Hospital
Designing frugal hand devices
Driving interest of SLPS towards AAC
Designing adaptive devices with the help of local carpenters
Designing few tactile books to be kept in my clinics
Having a collection of simple adaptive devices made locally.

Doing it alone is impossible and therefore would require the inputs of my colleagues,Agency and ministry as well partnership outside the country ,particularly in the area of assistive Technology.

What could be some next steps with support and partnership?

Assistive Technology has entered the field of disability and started to make lives better long ago but it has not yet made its way to our country, owing to lack of awareness,training professionals and acceptance of its usage in various sectors.

Bringing AT services to the country needs an introduction of proper channels of assessing the needs of users and procuring the right and legitimate AT products.This could work out through having an AT expert committee from within and outside country to asses the user needs and fit the right AT product as well as study the AT products.Partnering with well established AT company to ensure quality product and services are delivered.

Seeking the Partnership of Museum of Possibility and support from the Ministry of Health,Bhutan, in creating a museum of AT in the National Referral Hospital.Rehabilitation professions would be in a best position to propose the idea to MoH.

Designing and making adaptive equipment with the support from local carpenters.Supports from the experienced ones from outside would further aid in designing the prototype.

Dechen Tshomo
OT