Flowing through the Indian

land – Kawa in India

- Kavitha Murthi

What I intend to do in the next 10-

15 minutes?

• Gist about OT in India

• Need for conceptual models

• Use of models in Indian practice

• Culture and conceptual models

• My experience of using Kawa model in

India

Indian healthcare practice (Karthik 2011, Uplekar 2000)

• Privatization of healthcare in India

• OT was first introduced in 1952 by Kamala V Nimkar

• Growing demand helped proliferation of OT within

prominent branches of allied healthcare like mental health,

paediatrics, neurology, cardiology, orthopaedics etc.

Current stance of OT in Indian ethos

• OT is yet to make a national mark in Indian allied health

system (Karthik 2011)

• 57% studies focus on interventional

effectiveness (Shetty 2011)

BUT

• No focus on understanding underpinning

rationale (Shetty 2011, Murthi 2013)

Need for conceptual models in OT practice

• OT built around –’occupation’

• Professional role blurring (Wilding and Whiteford 2007)

• Profession reduced

to a technicality

• OTs termed as ‘gap-fillers’ (Fortune 2000)

Factors involved in the choice and use of theoretical models

• Education

• Perceived utility in work ethos

• Therapists’ perspectives regarding models

Culture

• Unique and personal (Iwama 2006)

• Impact of culture upon disability (AlBusaidy and Borthwick 2012)

Difference between Western and Eastern

(Indian) Values (Iwama 2006, Hammell 2009, Turpin and Iwama 2011)

Western Values

1. Autonomy and independence

2. Mastery over surrounding environment

3. Client – centred practice

4. Occupational engagement

5. Classification of occupation into self-care, productivity and leisure

Eastern Values

1. Interdependence and harmony

2. Stable relation with theenvironment

3. Family and society centred practice.

4. Occupational disengagement

5. Classification of occupation into self-care, productivity and leisure is over simplistic

Influence of culture on conceptual models(Iwama 2005, Hammell 2011)

• Direct transportation of western philosophies can be

catastrophic

• Limited adaptability of conceptual models from one

culture to another

• Creates confusion, disengagement, dissatisfaction,

coercion, alienation

Conclusion (Turpin and Iwama 2011)

• Conceptual models to guide practice

• Uniqueness of the profession maintained

• Realise the dangers in the ‘one size fits all’ technique

• Provide service that is service user centred and

something that they understand, cherish and participate

in

References

• AlBusaidy, N.S.M. and Borthwick, A. 2012. Occupational Therapy in

Oman: The Impact of Cultural Dissonance. Occupational Therapy

International.

• Fortune, T. 2000. Occupational therapists: Is our therapy truly

occupational or are we merely filling gaps? British Journal of

Occupational Therapy, 63, 225–230.

• Hammel, K.W. 2009. Sacred texts: A sceptical exploration of the

assumptions underpinning theories of occupation. Canadian Journal

of Occupational Therapy, 76 (1) February, pp. 6 – 13.

• Hammell, K.W.2011. Resisting theoretical imperialism in the

disciplines of occupational science and occupational therapy. British

Journal of Occupational Therapy, 74(1), pp. 27-33.

• Iwama, M. K. 2005. Situated meaning: an issue of culture, inclusion,

and occupational therapy. In: Kronenberg, F., Algado, S. S. and Pollard,

N. eds. Occupational therapy without borders: learning from the spirit of

survivors. Edinburgh: Elsevier Churchill Livingstone, pp.127-139.

• Iwama, M. K, 2006. The Kawa Model: Culturally relevant Occupational

Therapy. Churchill Livingstone. Edinburgh

• Iwama, M., and Turpin, M.K 2011. Using Occupational Therapy Models

in Practice: a field guide. Churchill Livingstone Elsevier.

• Karthik, M. 2011. Introduction to Occupational therapy and

Occupational Therapy Marketing. New Delhi: Jaypee Brothers Medical

Publishers.

• Murthi, K. 2013. Exploring Indian occupational therapists’ perspectives

regarding use of conceptual models to guide occupational therapy

practice in India. MSC thesis, Queen Margaret University.

• Shetty, R. (2011). State of the Journal: A Five year review of Indian

Journal of Occupational Therapy. Indian Journal of Occupational

Therapy, 43(2), pp. 10 – 15.

• Uplekar, M.W. 2000. Private Health Care. Social Science and

Medicine, [online] 51(6), pp. 897- 904. Available at: http://ac.els-

cdn.com/S0277953600000691/1-s2.0-S0277953600000691-

main.pdf?_tid=4690bba0-b105-11e2-b887-

00000aab0f6c&acdnat=1367264879_14822e91e7a7e8532ba87eb0

5c0d7bec [Accessed October 23 2012].

• Wilding C.and Whiteford G.2008. Language, identity and

representation: occupation and occupational therapy in acute

settings. Australian Occupational Therapy Journal, 55(3), 180-87.