doi: 10.56294/ri202353
REVIEW
Occupational therapy in trauma recovery for women and children in Gaza: A Holistic and interdisciplinary approach
Terapia ocupacional en la recuperación del trauma para mujeres y niños en Gaza: Un enfoque holístico e interdisciplinar
Sabina Khan1 
*
1University of St. Augustine for Health Sciences. United States of America.
Cite as: Khan S. Terapia ocupacional en la recuperación del trauma para mujeres y niños en Gaza: Un enfoque holístico e interdisciplinar. Interdisciplinary Rehabilitation / Rehabilitacion Interdisciplinaria 2023;3:53. https://doi.org/10.56294/ri202353.
Submitted: 02-08-2023 Revised: 05-10-2023 Accepted: 21-11-2023 Published: 22-11-2023
Editor: Prof.
Dr. Carlos Oscar Lepez
ABSTRACT
Trauma recovery for women and children in Gaza is a multifaceted challenge requiring a holistic, culturally attuned, and collaborative approach. Occupational Therapy (OT) plays a pivotal role within interdisciplinary teams in addressing trauma and facilitating healing. This article emphasizes the significance of adhering to trauma-informed care principles and implementing culturally competent interventions tailored to the unique experiences of this population. Navigating through the intricate terrain of trauma recovery, advocating for the integration of interdisciplinary care to address the far-reaching effects of trauma is vital to facilitate healing for this population. Understanding the core principles of trauma-informed care, emphasizing safety, trust, choice, collaboration, and empowerment as essential foundations are essential for effective intervention. Occupational Therapy emerges as a key player in this endeavor, bringing a holistic perspective that complements the expertise of mental health professionals, educators, social workers, and community leaders. By focusing on meaningful daily occupations and considering the cultural nuances of Gaza, OT professionals work collaboratively to empower individuals to regain control over their lives and rebuild resilience. Furthermore, age-specific OT interventions for children and occupation-based interventions for women are intricately designed to address the developmental needs and cultural context of this unique population. These interventions emphasize empowerment, self-care, and adaptive strategies to navigate the challenges of trauma.
Keywords: Trauma; Occupational Therapy; Rehabilitation.
RESUMEN
La recuperación del trauma para las mujeres y los niños de Gaza es un reto polifacético que requiere un enfoque holístico, culturalmente adaptado y colaborativo. La terapia ocupacional (TO) desempeña un papel fundamental en los equipos interdisciplinarios a la hora de abordar el trauma y facilitar la curación. Este artículo hace hincapié en la importancia de adherirse a los principios de la atención informada por el trauma y la aplicación de intervenciones culturalmente competentes adaptadas a las experiencias únicas de esta población. Navegar por el intrincado terreno de la recuperación del trauma, abogando por la integración de la atención interdisciplinaria para abordar los efectos de largo alcance del trauma es vital para facilitar la curación de esta población. La comprensión de los principios básicos de la atención informada por el trauma, haciendo hincapié en la seguridad, la confianza, la elección, la colaboración y el empoderamiento como fundamentos esenciales son esenciales para una intervención eficaz. La Terapia Ocupacional emerge como un actor clave en este esfuerzo, aportando una perspectiva holística que complementa la experiencia de los profesionales de la salud mental, educadores, trabajadores sociales y líderes comunitarios. Al centrarse en las ocupaciones cotidianas significativas y tener en cuenta los matices culturales de Gaza, los profesionales de la terapia ocupacional trabajan en colaboración para capacitar a las personas a recuperar el control sobre sus vidas y reconstruir la resiliencia. Además, las intervenciones de terapia ocupacional específicas para la edad de los niños y las intervenciones basadas en la ocupación para las mujeres están diseñadas para abordar las necesidades de desarrollo y el contexto cultural de esta población única. Estas intervenciones hacen hincapié en el empoderamiento, el autocuidado y las estrategias de adaptación para superar los retos del trauma.
Palabras clave: Trauma; Terapia Ocupacional; Recuperación.
INTRODUCTION
Understanding the global relevance and Gaza's unique challenges
Trauma, stress, and the debilitating specter of post-traumatic stress disorder (PTSD) know no borders. These silent yet profound adversaries to mental and emotional well-being afflict individuals worldwide, transcending geographic, cultural, and social boundaries.(1) While the scourge of trauma is a global concern, the way it manifests and its impact on communities is profoundly influenced by the unique contexts in which it occurs. In this editorial, we delve into a world where trauma takes on a particularly poignant form - the Gaza Strip.
Nestled along the Mediterranean coastline, Gaza's turbulent history, marked by conflict and adversity, has indelibly etched the experiences of its residents, particularly its women and children. Against this backdrop, we explore how Occupational Therapy (OT) emerges as an essential cornerstone within interdisciplinary care, playing a pivotal role in nurturing resilience and fostering recovery in a population besieged by persistent trauma. The Global Relevance of Trauma-Informed Care Trauma, whether stemming from war, displacement, natural disasters, or interpersonal violence, inflicts deep emotional wounds(1) that can reverberate across generations. The profound and far-reaching consequences of trauma on an individual's psychological, physical, and social well-being cannot be overstated. Understanding and addressing the complex interplay of trauma-related symptoms, stressors, and resilience factors is an endeavor that transcends national borders.
Trauma-informed care, an approach that recognizes the widespread impact of trauma, emphasizes the importance of creating safe, supportive environments that facilitate healing and recovery. It acknowledges the potential for trauma to disrupt an individual's ability to engage in daily life activities, maintain meaningful relationships, and find a sense of purpose (Dowd, 2020). For children and women exposed to trauma, this disruption can be especially profound, affecting their development, mental health, and overall quality of life. The Uniqueness of Gaza's Trauma Gaza, a sliver of land measuring just 25 miles long and 6 miles wide, has been the epicenter of conflict and geopolitical tension for decades.(2) Its population, primarily composed of Palestinian refugees, has endured a protracted history of conflict, displacement, and economic hardship.
The traumatic experiences of frequent military incursions, bombings, and blockades have left indelible scars on the collective psyche of Gazans, with women and children bearing a disproportionate burden. Women in Gaza often find themselves at the intersection of multiple challenges. As mothers, caregivers, and often the pillars of their families, they grapple with the daily demands of nurturing their children while contending with the psychological and emotional toll of conflict. Many have faced personal trauma, including domestic violence, loss of family members, or displacement, compounding the complexity of their mental health needs. Children in Gaza, too young to fully comprehend the political complexities surrounding them, have grown up amidst the ever-present specter of explosions, gunfire, and the palpable fear that accompanies daily life in a conflict zone. The trauma they experience not only threatens their immediate well-being but has the potential to cast a long shadow over their future development and mental health.(2)
DEVELOPMENT
The trauma-informed approach
Nurturing Resilience and Healing As the adage goes, "It takes a village to raise a child." The same holds true for addressing the trauma experienced by women and children in Gaza. Effective care demands a unified, interdisciplinary approach, wherein various professionals collaborate to address the multifaceted nature of trauma and its impact on daily life. This is where Occupational Therapy (OT) steps into the spotlight. Occupational Therapy, rooted in the belief that meaningful engagement in daily activities is central to well-being, offers a unique perspective and skill set to address trauma-related challenges.(3) OT practitioners are trained to evaluate an individual's physical, emotional, and cognitive functioning and develop personalized interventions to help them fully participate in daily life.
In the context of trauma-informed care in Gaza, Occupational Therapy is not merely an adjunct but a central pillar upon which resilience, recovery, and healing are built. OT professionals work in concert with mental health experts, educators, community leaders, and other disciplines to provide holistic care that addresses the unique occupational challenges faced by women and children in Gaza.(2) As we embark on this exploration, we must unfold the intricate tapestry of trauma-informed care in Gaza, with a particular focus on the invaluable contributions of Occupational Therapy. We will delve into age-specific interventions for both women and children, the synergy of OT with other professions, the importance of culturally competent care, and the broader vision that encompasses advocacy, international support, and the pursuit of holistic healing. Journey through the intricate landscape of trauma and resilience, guided by the belief that through interdisciplinary care and OT's unwavering commitment to meaningful occupation, hope and healing can flourish even in the most challenging of environments.(3)
Interdisciplinary care and trauma-informed approaches
In the realm of healthcare, the concept of "interdisciplinary care" is an acknowledgment of the multifaceted nature of human well-being. It recognizes that individuals are not defined by isolated symptoms or conditions but rather by the intricate interplay of physical, emotional, and social factors. Nowhere is this more evident than in the context of trauma, where the impact extends beyond the individual and affects their entire ecosystem.
Interdisciplinary care
Interdisciplinary care is not a new idea but one that has gained increasing recognition in recent years as we deepen our understanding of how health is shaped by a complex interplay of factors. It goes beyond the traditional model of healthcare delivery, which often focuses on isolated symptoms and conditions, and instead embraces a holistic approach.
This approach recognizes that effective care involves multiple dimensions of health and well-being, including physical, mental, emotional, and social aspects. In the context of trauma, whether stemming from war, violence, or other traumatic experiences, an interdisciplinary approach becomes paramount.(3) Trauma is not just an isolated event but a life-altering experience that can affect every facet of an individual's existence. It can disrupt daily routines, relationships, and even one's sense of self. Thus, addressing trauma effectively requires a comprehensive understanding of its far-reaching effects.
Trauma-informed principles in practice
To navigate the complex terrain of trauma, a trauma-informed approach has emerged as a guiding framework. At its core, trauma-informed care acknowledges the widespread impact of trauma and seeks to create an environment that fosters healing and recovery. Several key principles underpin trauma-informed care:
· Safety: Recognizing that individuals who have experienced trauma may have heightened perceptions of threat, trauma-informed care places a strong emphasis on creating physically and emotionally safe environments. In interdisciplinary teams, this principle guides decisions related to the care environment and the interactions between team members and patients. Trustworthiness and Transparency: Building trust is foundational in trauma-informed care. Patients need to feel that their providers are reliable, honest, and transparent in their intentions and actions. In an interdisciplinary context, communication and collaboration among team members play a crucial role in establishing and maintaining trust.
· Choice and Control: Trauma can result in a loss of control and autonomy. Trauma-informed care seeks to restore a sense of choice and control to individuals, allowing them to make decisions about their care and recovery. Within interdisciplinary teams, this principle encourages shared decision-making and respect for each team member's expertise.
· Collaboration and Mutuality: Collaboration is a cornerstone of interdisciplinary care and aligns closely with the trauma-informed principle of collaboration and mutuality. It emphasizes the importance of shared goals, shared responsibilities, and shared power among team members and patients. This collaborative approach helps ensure that care is comprehensive and patient centered.
· Empowerment and Voice: Trauma-informed care empowers individuals to have a voice in their treatment and recovery. It recognizes their resilience and strengths, even in the face of adversity. In interdisciplinary teams, this principle encourages the active involvement of patients in their care plans and decision-making processes.(1,3)
In Gaza, where conflict and adversity have been pervasive for decades, the need for trauma-informed care delivered through interdisciplinary teams is especially pressing. The trauma experienced by its residents, particularly women and children, goes beyond the immediate physical consequences of conflict. It disrupts daily life, challenges family dynamics, and often leaves deep emotional scars. In this unique context, the principles of trauma-informed care must be adapted and applied with cultural sensitivity and an acute awareness of the sociopolitical realities of Gaza. While these principles provide a solid foundation, their implementation requires a nuanced understanding of the specific challenges faced by the population and the collaborative efforts of professionals from various disciplines.
Occupational therapy in interdisciplinary teams
Within the realm of healthcare, the role of Occupational Therapy (OT) is distinct and indispensable. While other medical and mental health professions may focus on diagnosis and treatment of specific conditions, OT has a unique mission: to enable individuals to engage fully in their daily lives, despite any physical, emotional, or cognitive challenges they may face.(4) This mission aligns seamlessly with the principles of interdisciplinary care and trauma-informed approaches, making Occupational Therapy an essential cornerstone of comprehensive care for traumatized individuals.
The role of occupational therapy
Occupational Therapy's core philosophy revolves around the concept of "occupation," which encompasses all of the activities and roles that define an individual's life. This includes not only the typical work-related activities but also everyday tasks, hobbies, self-care routines, and social interactions. Occupational Therapists view engagement in meaningful occupations as central to an individual's well-being and self-identity. In the context of trauma and its complex aftermath, Occupational Therapy plays a pivotal role in helping individuals regain control over their lives and rebuild a sense of normalcy.(4) OT professionals are uniquely trained to assess an individual's physical, emotional, and cognitive functioning and develop tailored interventions that address the challenges they face in their daily activities. This might involve teaching coping strategies, providing assistive devices, modifying environments, or facilitating emotional expression through creative means.
Qualifications and expertise
Occupational Therapists are highly qualified professionals with specialized training in assessing and addressing a wide range of physical and mental health conditions. They possess expertise in understanding how physical and emotional well-being are intertwined and how these aspects influence one's ability to engage in daily life. In an interdisciplinary team, Occupational Therapists bring a distinct perspective that complements the expertise of other professionals. They understand that trauma can manifest in various ways, impacting an individual's ability to participate in occupations that are essential for well-being. By addressing these occupational challenges, OT professionals contribute to the broader goal of trauma recovery and resilience-building.
One of the key strengths of OT is its holistic approach to care. Rather than focusing solely on symptom management, OT professionals consider the person, recognizing that trauma affects not only an individual's physical health but also their mental and emotional well-being.(4) They explore how trauma has disrupted daily routines, strained relationships, and compromised an individual's sense of purpose. This holistic perspective aligns seamlessly with the trauma-informed care principles discussed in the previous section.
Collaboration within interdisciplinary teams
Effective interdisciplinary care requires seamless collaboration among professionals from diverse backgrounds, each contributing their unique expertise to a shared goal: the well-being and recovery of the individual. Occupational Therapists are accustomed to working collaboratively within these teams, recognizing that no single profession can address the complexity of trauma on its own. In the context of trauma recovery, the collaboration between Occupational Therapy and other professions is particularly valuable. For instance, in working with children who have experienced trauma, OT professionals collaborate with mental health experts to address emotional and behavioral challenges.
They may also collaborate with educators to create supportive classroom environments that facilitate learning and emotional regulation. Additionally, OT professionals are skilled in promoting independence and resilience. They empower individuals to regain control over their lives and develop adaptive strategies to cope with trauma-related challenges. This empowerment aligns closely with the trauma-informed care principle of choice and control, which recognizes the importance of restoring autonomy to traumatized individuals.
OT interventions for women and children in Gaza
In the complex landscape of trauma recovery, Occupational Therapy (OT) serves as a beacon of hope, offering tailored interventions that address the unique needs of women and children in Gaza. The impact of trauma on individuals, especially the most vulnerable among them, cannot be overstated. For women, who often shoulder caregiving roles while grappling with their own trauma, and for children, who must navigate the challenges of growing up in a conflict-ridden environment, OT interventions play a pivotal role in nurturing resilience and fostering recovery.(4)
Interventions for children
Children in Gaza, born into a world marked by conflict, bear the weight of trauma that disrupts their development and well-being. Effective OT interventions for children are not only age-appropriate but also sensitive to the specific challenges they face.(5) The table below outlines a range of interventions that Occupational Therapists can provide, categorized by age groups, to address the multifaceted impact of trauma.
|
Table 1. OT Interventions for children in Gaza age group. |
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|
Age Group |
Interventions |
Interprofessional Benefits |
|
Infants (Birth-12 months) |
Sensory Integration Therapy |
Enhances emotional regulation |
|
|
Parent-Infant bonding activities |
Promotes secure attachment |
|
|
Feed and oral motor interventions |
Supports oral motor development |
|
Toddlers (1 year-4 years old) |
Play based therapy |
Enhances socialization skills |
|
|
Early social and communication skills |
Facilitates communication development |
|
|
Sensory regulation activities |
Assists emotional self-regulation |
|
School-Age (5-11 years) |
Coping and emotional regulation skills |
Improves self-control and coping |
|
|
School-based occupational support |
Enhances academic participation |
|
|
Resilience building activities |
Fosters emotional resilience |
|
Adolescents (11 years+) |
Life skills training |
Prepares for adulthood responsibilities |
|
|
Peer support groups |
Provides peer support |
|
|
Goal setting and future planning |
Supports future aspirations.(5) |
Interventions for women
For women in Gaza, trauma often intersects with their roles as caregivers, homemakers, and family anchors. OT interventions for women are not only occupation-based but also interdisciplinary, recognizing the intricate balance between self-care and caregiving responsibilities. The table below outlines a range of interventions for women that are both occupation-based and collaborative, fostering their emotional well-being and empowerment.
|
Table 2. Occupation-based interdisciplinary interventions for women in Gaza |
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|
Intervention Area |
Description |
Interprofessional Benefits |
|
Stress management |
Mindfulness and relaxation techniques |
Support emotional well-being and resilience |
|
|
Collaborative stress reduction planning |
Enhances coping strategies |
|
Self-Care and Empowerment |
Personalized self-care routines |
Promotes self-sufficiency and well-being |
|
|
Support groups for emotional well-being |
Provides emotional support |
|
Family Dynamics |
Conflict resolution strategies |
Improves family relationships |
|
|
Parenting skills workshops |
Enhances parenting and family support skills |
|
Social Participation |
Community engagement initiatives |
Promotes community integration |
|
|
Skill building for income generation |
Supports economic empowerment |
|
Trauma Recovery |
Trauma focused cognitive behavioral therapy |
Address trauma related challenges |
|
|
Collaborative trauma processing sessions |
Facilitates emotional healing |
These occupation-based interventions recognize the multifaceted roles women play in Gaza and the need for self-care and empowerment. Stress management and self-care routines provide women with the tools to cope with trauma while continuing their caregiving responsibilities. Additionally, addressing family dynamics and social participation fosters healthy family environments and community engagement. Occupational Therapy's interdisciplinary approach involves collaborating with mental health experts, social workers, and community leaders to provide comprehensive support for women in Gaza.(4) Together, these interventions empower women to regain control over their lives, nurture their emotional well-being, and contribute positively to their families and communities. In the sections that follow, we will explore the synergy of Occupational Therapy with other professions within interdisciplinary teams, the importance of culturally competent care, and the broader vision for advocacy, international support, and healing for women and children in Gaza who have experienced trauma.
The synergy of OT and other professions
Effective care for traumatized individuals, especially women and children in Gaza, is not a solitary endeavor but a collaborative and interdisciplinary effort. Within the tapestry of trauma recovery, each profession contributes its unique threads, creating a comprehensive framework that addresses the multifaceted needs of those affected. Occupational Therapy (OT) is a vital component of this tapestry, interwoven with other professions to provide holistic care.
Collaboration within interdisciplinary teams
Interdisciplinary care is akin to a symphony where each instrument contributes to the harmonious composition of healing and recovery. Occupational Therapists, as members of interdisciplinary teams, understand the value of collaboration and the synergy that emerges when diverse expertise comes together. In the context of trauma recovery in Gaza, Occupational Therapists collaborate closely with mental health experts, educators, social workers, and community leaders. This collaboration is more than a mere coordination of services; it represents a holistic approach that recognizes the interconnectedness of physical, emotional, and social well-being.
The role of mental health experts
Mental health experts, including psychologists and counselors, provide crucial support for individuals grappling with trauma-related emotional and psychological challenges. Their expertise in trauma-focused therapy, such as cognitive-behavioral therapy (CBT), complements the holistic approach of OT. Occupational Therapists work in tandem with mental health experts to integrate therapeutic techniques that address the emotional and cognitive aspects of trauma. This collaborative effort enhances the effectiveness of interventions, allowing individuals to develop coping strategies, regulate emotions, and build resilience.
Educators and school-based support
For children affected by trauma, schools can serve as both a sanctuary and a source of support. Educators play a pivotal role in identifying children's needs and facilitating their academic and emotional growth. Occupational Therapists collaborate with educators to create trauma-informed classroom environments. They provide guidance on sensory regulation strategies, emotional expression, and social skill development, ensuring that schools become spaces of healing and growth for traumatized children. Social Workers and Community Leaders
Social workers and community leaders are instrumental in addressing the broader social and economic challenges faced by women and children in Gaza. They play key roles in facilitating access to resources, advocating for the rights of individuals, and building strong community networks. Occupational Therapists work closely with social workers and community leaders to identify resources and support systems that can enhance the well-being of women and children. They also engage in community-based programs that promote social participation and income generation, fostering self-sufficiency and resilience.
The complementary nature of professions
The synergy among professions within interdisciplinary teams is grounded in their complementary nature. Occupational Therapy's focus on occupation and daily life activities aligns seamlessly with the emotional and psychological support provided by mental health experts. Together, they address the intricate balance between physical and emotional well-being. Likewise, the collaboration between Occupational Therapists and educators acknowledges the crucial role of schools in a child's development. By integrating OT interventions into educational settings, traumatized children receive comprehensive support that encompasses both their academic and emotional needs. Social workers and community leaders recognize that holistic care extends beyond individual therapy sessions. By partnering with Occupational Therapists, they extend their reach into the daily lives of women and children, fostering empowerment and resilience within their communities.
Cultural competence
Cultural competence in healthcare is not a mere adjunct but a fundamental pillar upon which effective care is built, especially in a region as diverse and intricate as Gaza. Understanding the cultural context, nuances, and sensitivities of the population is paramount to delivering trauma-informed Occupational Therapy (OT) services that resonate with the unique needs of women and children.(4) Culturally competent care is not a one-size-fits-all approach but a dynamic and adaptive process that recognizes and respects the values, beliefs, and traditions of the people it serves.
The significance of cultural sensitivity
Gaza, with its rich history, deep-rooted traditions, and complex sociopolitical landscape, presents a unique cultural context in which trauma-informed care must be delivered. In this context, cultural sensitivity is more than an optional consideration; it is a prerequisite for building trust, establishing rapport, and effectively addressing the needs of traumatized individuals.(2) Cultural sensitivity begins with the recognition that each person's experience of trauma is influenced by their cultural background, family dynamics, and societal norms. It acknowledges that trauma is not a universal experience but is shaped by the individual's identity, values, and cultural affiliations.
Cultural nuances in OT practice
Occupational Therapists in Gaza navigate a cultural landscape that influences every aspect of care, from assessment to intervention. For example, the concept of "occupation" may differ across cultures, and the activities that hold meaning and significance for individuals in Gaza may vary from those in other regions. Occupational Therapists must engage in active listening and open dialogue to understand how individuals define their meaningful activities and daily routines. Moreover, trauma can manifest differently in various cultural contexts. For instance, the expression of emotional distress may be influenced by cultural norms around stoicism or emotional expression. Occupational Therapists must be attuned to these cultural nuances to provide culturally sensitive interventions.(2)
Adapting interventions to cultural context
Culturally competent care involves adapting interventions to align with the cultural context of Gaza. This adaptability extends to both the content and delivery of OT services. It is essential that interventions resonate with the values and beliefs of the individuals receiving care. For children, interventions may incorporate culturally relevant play activities, storytelling, or art therapy that align with their cultural identity and experiences. Occupational Therapists may work closely with families to ensure that interventions are consistent with cultural expectations and goals. For women, culturally competent care may involve recognizing the influence of traditional gender roles and expectations. Occupational Therapists can collaborate with women to identify occupation-based goals that align with their cultural context, such as family caregiving or community engagement.
Respecting privacy and modesty
In Gaza, cultural norms around privacy and modesty are particularly salient. Occupational Therapists must be respectful of these norms in both assessment and intervention. This may involve providing private spaces for therapy sessions, ensuring that individuals are comfortable with the presence of family members or interpreters, and using culturally appropriate attire when necessary. Respecting privacy and modesty also extends to sensitive topics related to trauma. Occupational Therapists must approach discussions about trauma with sensitivity and discretion, allowing individuals to share their experiences at their own pace and comfort level.
Incorporating traditional healing practices
Culturally competent care acknowledges the value of traditional healing practices and indigenous knowledge. In Gaza, traditional healing methods, such as herbal remedies or spiritual rituals, may hold significance for individuals. Occupational Therapists can collaborate with individuals and their families to incorporate these practices into their care plans when appropriate. Moreover, recognizing the role of religious faith and spirituality is essential in Gaza. Many individuals draw strength and resilience from their religious beliefs. Occupational Therapists should be attuned to the spiritual dimensions of healing and, when desired by the individuals, incorporate spiritual practices into their interventions.(2)
Collaboration with cultural interpreters
Language barriers can pose significant challenges in providing culturally competent care. In Gaza, where multiple languages and dialects are spoken, the use of skilled cultural interpreters is invaluable. These interpreters not only bridge language gaps but also facilitate cultural understanding and communication. Occupational Therapists must collaborate closely with cultural interpreters to ensure accurate communication and cultural sensitivity.(4) It is essential to provide interpreters with context about the individual's cultural background and the nature of the OT interventions to enhance their effectiveness.
Continuous learning and reflection
Cultural competence is not static but an ongoing process of learning and reflection. Occupational Therapists in Gaza, as in any culturally diverse region, must commit to continuous self-education and cultural humility. This involves seeking opportunities for cultural immersion, engaging in cultural competency training, and engaging in reflective practice to assess the cultural relevance and effectiveness of interventions. Conclusion: The Heart of Effective OT in Gaza Culturally competent care is at the heart of effective Occupational Therapy in Gaza. It recognizes that the delivery of trauma-informed care must be rooted in a deep understanding of the cultural context, values, and beliefs of the individuals receiving services. By embracing cultural sensitivity, adapting interventions, and respecting privacy, Occupational Therapists can provide care that resonates with the unique experiences and identities of women and children in Gaza. In the subsequent sections, we will explore the broader vision for advocacy, international support, and healing for this population that has endured the enduring challenges of trauma and conflict.(2)
Advocacy, international support, and vision for healing
While the challenges of trauma recovery are daunting, they are not insurmountable. The path toward healing for traumatized women and children in Gaza is illuminated by the collective efforts of advocates, international supporters, and a shared vision for a brighter future. Occupational Therapy (OT) plays a vital role in this vision, serving as a catalyst for resilience and recovery, and it is within this context that the call for advocacy and international support gains even greater significance.
Advocating for trauma-informed care
Advocacy is the bedrock upon which change is built. The advocacy for trauma-informed care in Gaza is a call to action, a plea for recognizing the widespread impact of trauma and the need for comprehensive, culturally sensitive interventions. It is a demand for accessible mental health services and support for women and children who have endured the enduring challenges of conflict and adversity. Occupational Therapists, as advocates, lend their voices to this cause, championing the importance of trauma-informed care within interdisciplinary teams. They share their expertise in delivering occupation-based interventions that nurture resilience and foster recovery.(2) Their advocacy extends to policymakers, community leaders, and international organizations, emphasizing the urgency of investing in the well-being of traumatized individuals.
The role of international support
International support is the lifeblood of healing in regions affected by conflict and trauma. It is a testament to the global community's commitment to alleviating suffering and fostering resilience. International organizations, NGOs, and humanitarian agencies play a pivotal role in providing resources, funding, and expertise to support trauma recovery efforts in Gaza. Occupational Therapists, through international collaboration and partnerships, leverage the expertise and resources of these organizations to enhance the reach and impact of their interventions. They work in tandem with international supporters to develop sustainable programs that provide ongoing support and healing for women and children affected by trauma.
A vision for healing and resilience
At the heart of every endeavor for healing is a vision—a vision that transcends the challenges of the present and embraces the possibilities of the future. For traumatized women and children in Gaza, this vision encompasses not only the alleviation of immediate distress but also the cultivation of resilience, empowerment, and a sense of purpose. Occupational Therapy embodies this vision by empowering individuals to regain control over their lives. It fosters resilience by nurturing their ability to engage in meaningful daily activities and rebuild their sense of self. It supports empowerment by recognizing the strength and potential within each individual, despite the adversity they have faced. The vision for healing extends beyond the individual to the community and society. It is a vision of communities that are equipped with the knowledge and resources to support one another in times of trauma.(2) It is a vision of societies that prioritize mental health and well-being, where stigma is replaced with empathy and understanding.
Building a sustainable trauma-informed infrastructure
A lasting vision for healing in Gaza involves the creation of a sustainable trauma-informed infrastructure. This infrastructure encompasses accessible mental health services, well-trained professionals, and a supportive community network.(2) Occupational Therapists actively contribute to the development of this infrastructure by training local professionals, collaborating with educational institutions, and advocating for the integration of trauma-informed care into healthcare systems. They recognize that sustainability requires local ownership and capacity building, and they actively engage in these efforts.
A unified call to action
Advocacy, international support, and a vision for healing form a unified call to action for the well-being of traumatized women and children in Gaza. This call transcends geographic boundaries and political complexities, underscoring the shared humanity that binds us all. Occupational Therapy, as a profession dedicated to meaningful occupation and holistic well-being, stands at the forefront of this call, working tirelessly to empower individuals, foster resilience, and nurture healing. In the face of adversity, trauma, and conflict, the vision for healing is a beacon of hope. It is a testament to the resilience of the human spirit and the unwavering commitment to supporting one another in times of greatest need. Together, as a global community, we can turn this vision into a reality, ensuring that traumatized women and children in Gaza find the healing and support they deserve, guided by the principles of interdisciplinary care, cultural competence, and unwavering advocacy.
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2. Diab M, Jamei YA, Kagee A, Veronese G. Integrating a public health and human rights approach into mental health services for Palestinians in the Gaza Strip. The Lancet 2018;391:S27. https://doi.org/10.1016/S0140-6736(18)30393-3.
3. Mason J, Stagnitti K. Occupational therapists’ practice with complex trauma: A profile. Aust Occup Ther J 2022;70:190-201.
4. Abu Mostafa MK, Plastow NA, Savin-Baden M. Participatory Methods to Develop Health Education for PW-SCI: Perspectives on Occupational Justice. Can J Occup Ther 2023;90:55-67. https://doi.org/10.1177/00084174221116250.
5. AlHeresh R, Bryant W, Holm M. Community-based rehabilitation in Jordan: challenges to achieving occupational justice. Disabil Rehabil 2013;35:1848-52. https://doi.org/10.3109/09638288.2012.756944.
FINANCING
There is no funding for this work.
CONFLICT OF INTEREST
The authors declare that there is no conflict of interest.
AUTHORSHIP CONTRIBUTION
Conceptualization: Sabina Khan.
Research: Sabina Khan.
Methodology: Sabina Khan.
Project management: Sabina Khan.
Original writing-drafting: Sabina Khan.
Writing-revising and editing: Sabina Khan.