Learning about OT in the Philippines

Today in my introduction to OT class, our professor talked to us (or rather we did a quick report) on the code of ethics and the standards of practice. She claimed it was kind of a boring topic but honestly the whole thing was just kind of interesting for me (more importantly: the standards of practice). Code of ethics kind of just dictate principles every occupational therapist should follow as it is in the rules and regulations.

Standards of practice is the step by step methodology typically followed in terms of treating someone. It starts with the practicing license (that’s a given), the referral (you need a doctor’s referral as a requirement for starting OT), the screening (wherein the doctor evaluates whether or not you actually need OT), the assessment (the OT is in charge of this one, they evaluate the ADL or Activities of Daily Living. This can take up to two sessions as you try to be as holistic as possible), and then the Intervention Plan.

The intervention is then implemented, the community transitional services are offered (integration with the community), followed by discontinuation, continuation quality index, and then the discharge and management. Pretty simple stuff.

OT is a very westernized medical model. All of the key concepts and methods OTs use are actually all from the westernized world. The short history of OT in the Philippines includes propagating it, brain drain, issues with the law as being confused for PT (people assume that OTs massage people, and no, that is not part of our job) as well as still learning to have a foothold in society and be recognized as a need for people with special needs.

In comparison to psychology, wherein Virgilio Enriquez stood up for Sikolohiyang Pilipino, there is barely a trace of Filipino influence on OT.

Our professor pointed out that since OT is basically a very contextualized therapy and client centered service, it doesn’t really matter whether or not we have our own specialized form of methodology in terms of cultural sensitivity or not, during the intervention phase of the standards of practice, we create an individualized intervention plan for the patient, so it’s more focused on being aware of the cultural context rather than integrating it into therapy.

Maybe it’s because of my psych training, or maybe it’s the Filipino in me that wants recognition, but I do hope that Filipinos are able to provide a contribution to the world of OT soon. Our professor talked about a research paper in the works with regards to the “occupation” of Filipinos but not necessarily as a framework of reference (FOR) since OT is still considerably young as a field here in the Philippines.

In my mind, I had visualized a lot of ideas for studies that could be possible in OT. Here are just some of them.

  1. Learning the social norms when riding a jeep
  2. Learning to adapt to Filipino traditions when you don’t like being so touchy
  3. How to talk to people about sex here in the Philippines (in a public and educating manner)
  4. How to approach indigenous cultures with regards to application of OT
  5. A larger presence of OT in the government system for influential decisions that accommodate people with special needs

There are a lot of improvements to be done for Occupational Therapy in the Philippines. The Philippines isn’t aware of what OT can do for it. There are thousands of kids with neurodevelopmental disorders, adults facing newly acquired disabilities whose functions are limited but can be improved, and an entire population wherein psychosocial well being is not a need but a want that can be ignored until it’s too late.

Therapy isn’t considered affordable or even necessary in the Philippines. People think therapy is expensive. It’s a luxury. Only those with money can actually afford to have therapy. Even though OT is part of the PhilHealth card discount, it only accounts for 10-12 sessions. Two of those sessions are for assessment. What can you do within ten sessions? Especially with kids who have neurodevelopmental issues who need highly intensive therapy for rehabilitation, ten sessions isn’t usually enough.

My professor talked about home plans. These are basically intervention plans patients can do at home. But what if the person is not motivated or if it’s a kid, what if the parents are busy working all day and can’t afford someone to watch over the kid and actually implement the program?

The Philippine population is a very young one, yet the government’s educational plan barely spends 2% of its budget on education. It’s tiring, difficult, and all I see is an uphill climb for occupational therapists.

OTs leave the Philippines often. After fulfilling the two year return service agreement, people often find jobs in other countries due to lack of opportunities here in the Philippines. It’s a tiring process. Brain drain is a real issue and there’s not a lot we can do to stop it.

It’s tiring to look at. The uphill climb has barely started. I feel like I’ve taken on this huge responsibility, something a whole lot bigger than me.

But I remember my internship. I remember the kids whose lives were changed because they went through therapy, they went through early intervention programs. I saw how neurodevelopmental disorders could be circumvented. I may not be here to see the future of that kid who will go on to do great things in the future, but I’ll be happy to know that in the future, I’ll be able to change someone’s life drastically, just because I spent an hour of therapy with them every week, teaching them eye contact, social skills, and ADLs.

It’s tiring to think about but I’m pushing through. This is the path I chose.


My goal is to help people

I’ve recently decided to study again. It’s strange. I’ve diverged from the usual path people walk through and have decided to go through this entirely new one. This would be my second degree after Psychology. I’m not making money. Not yet, anyway.

I’m taking a midyear semester course on Biology, a subject I barely passed back then. I’m commuting to Manila every single day, leaving at 6 in the morning to arrive approximately an hour later. I have to study hard every single night to understand the concepts of Biology.

And this is just the beginning of my journey studying to become an occupational therapist.

I’m pretty sure my brain hasn’t integrated the whole path into its whole being yet. I’m still not defining myself as an occupational therapy major. I still identify with being a psychology major. I look at things from a psychological perspective. I get thrilled at the mention of Freud. I still look back at the terms in psych (corpus callosum, optic chiasma) and I connect it with what I learn in Biology.

It’s a very confusing time. I’m mostly focusing on studying and passing Biology and learning to wake up early in the morning for class. I bring water to class, I’ve had to pith a frog and a toad several times. These are things you wouldn’t have caught me dead doing as a psych major.

There are stereotypes in every college. The Business majors are partygoers, the engineering people are all very gago in their own right, comparative literature majors are the quirky friends who make references to classical and obscure books, and psychology majors often are the ones aiming to go to med school or law school.

It’s so strange. I don’t know what the stereotype for occupational therapy majors are. And my habits have changed so much from back when I was studying psychology.

I feel happy. I feel like I’m working towards a goal bigger than my own. I’m passionate about psychology but I’m also passionate about OT. In psychology, I was amazed at the concepts, studies, and theories everyone was passing around in casual conversation. There were so many things about the human population that could be simplified or become intensely complex that a million page paper would not even cover a quarter of our theories.

But in psychology, I was there for myself. I wanted to take up psychology because it was something that interested me. I loved it because it didn’t bore me. I could pay enough attention in class to get by.

In OT, I’m not here for myself. Or maybe I am. I’m here for the future. I want to help people. I want to be able to give them happiness in what they want to do with their lives. I want to help children have a better foundation in their development years to help them deal with struggles in the future with a healthy coping mechanism.

In the future, I see a vision of people who I’ve helped become their own person. I see them being able to go forward on their own, using their own strength and skill.

They say occupational therapy is all about helping people achieve what matters to them and to be able to move forward even with the disabilities they have right now.

I guess, that’s what I want in life. I want to push people forward to a better future.

It’s stupid. It’s idealistic. But this is my goal.

I’m going to be an occupational therapist. I’m going to help people. And I’m going to help the Philippines.

I’m not afraid of the dark anymore

When I was a kid, I was scared of the dark. My overactive imagination was filled with ladies in white passing by me, dark ghosts that would render me frozen on the spot, or even eyes that would watch my every move.

I was terrified of the dark. I would sleep with the lights on every night. When I closed the lights in the hallway, I’d run to my room, all the while thinking of all the white ladies and bloodied eyes that would watch me. When I got to my bed, I would cover myself with the blanket even though the summer heat managed to bypass our roof and found me in my room instead.

My parents would tell me there are no ghosts, no monsters in the dark. They would waive it over to my imagination. My mom would tell me that I have nothing to worry about. My dad would tell me to turn off the lights, complaining about our raising electricity bill.

My brother would tell me there were no such things as ghosts. None of that really calmed me down or made me less afraid. My nights were still filled with listening for footsteps that weren’t there or whispers that only I could hear.

When I was a child, I was afraid of the dark. I sensed monsters, ghosts, bloody dead creatures crawling out of the woodwork of our home.

It’s been a few years since I was a child. I’ve grown up now.

My nights are no longer filled with me listening for these noises, shutting my eyes tight in fear of seeing something that wasn’t there. Instead, my nights are filled with silence.

Or sometimes, my nights are filled with tears. Sobs muffled into a towel, headphones on its loudest, door closed, and just that overwhelming feeling of being alone.

Lights off.

At the height of my depression, I ate nothing all day. I cried for hours upon hours at night. Only exhaustion brought me to sleep but it didn’t matter if I woke up three or twelve hours later, I would still be tired. I woke up feeling the dread of being actually alive but feeling nothing.

I stayed up all night without meaning to. Things I found enjoyable before were no longer an option. I forced myself to get up for work but I tired easily. Driving was a nuisance, eating was a nuisance. I often slept during lunchtime. Pants that fit me well became too big for me. All my clothes were too big for me.

Before I had depression, I wanted to lose weight. As I stood in the shower, looking and seeing at how much weight I lost, I laughed at the irony. I still wasn’t happy.

When I was a kid, I was afraid of the dark. I was scared of the monsters, bloodied white ladies, things that crawled up to your bed that weren’t alive.

Nowadays, I turn the lights off. I can’t sleep if it’s too bright. I’ve recovered from depression. I don’t cry anymore. I’ve gained back the weight I lost.

I don’t run down the hallway after I turn off the lights anymore. I don’t listen for footsteps that aren’t there, for voices of the dead.

At the height of my depression as I cried all night looking for a reason to live, I dared the monsters of the dark to come get me, to come look at this mess. I dared the white ladies to show themselves. Scare me, please. Go right ahead.

Because I’ve looked at myself and seen a bottomless pit. I’ve had to face my depression, a shade of black so deep I couldn’t look away.

And guess what? None of these monsters came.

I’m not afraid of the dark anymore.

What do you want to write about, Soups?

Whenever I’m about to start a blog post, this is what I always ask myself first. Usually, my mind supplies with the greatest answers of all time.

Here are some of them:

  1. Death
  2. Depression
  3. Rant about an argument that happened either recently/a few years ago
  4. Heck if I know???
  5. Sad thoughts (more controlled thanks to antidepressants)
  6. Random stories from my life

A lot of the stuff I want to write about is basically me just wanting to tell the truth to another person but feeling scared that they might get hurt with what I say. I have wholeheartedly embraced the truth: I’m an asshole. I tend to say things that make other people hate me or make them sad. It’s not that what I’m saying is the truth, it’s just that it ends up being offensive because I am a tactless idiot.

I talk about this because there are a ton of blogs out there that have such amazing content. They’ve obviously done their research. Photographs, lists of places to visit, editing (my posts are an editor’s nightmare: the first draft), or even maybe sponsorships from companies that want to get noticed.

Compared to this pile of shit (okay, I’ll be a bit reasonable, it’s just a half-assed blog from me tbh), other blogs look friggin amazing, okay?

I kind of honestly don’t care. Other people can blog about fashion, design, travel, or photography, I say go forth and do whatever you want to do! I just want to write. Or sometimes maybe share the stuff I’m thinking about. You can’t really help but compare, though.

Sometimes I think, hey, maybe it would be a good idea to actually put some effort into this blog. Trust me, I have tons of drafts. In fact, I take several photos of places I visit just so I could review them here on my blog. Gulugud Baboy and Tagaytay, for instance. I’ve got all the photos and I’ve got the post in my head, I just have to write it.

I’m not really aiming to make money with this, though. I just want to share shit to my one viewer (hi, friend!).

Maybe I should cater and attempt to try *10 restaurants in manila you should try with the barkada* or *5 ways to know you’re headed for a break-up*, it would be a fun exercise to do that sort of stuff. I don’t know. I used to do it before.

I’m not really sure. It’s five in the morning. I haven’t slept at all. The clock is ticking loudly against the tap of my fingers against the keyboard. Random vehicles are roaming outside, I hear the chickens roosting outside. I’m on the floor in the living room, tired as hell but I can’t sleep. I’m actually in a daze right now.

Things are weird. I’m weird. The world is not my oyster. The world is my cave. The further I go in it, the darker and more echo-y it gets.

My eyes are drooping and threatening to retire for the night (morning?). I’m going to bed.