Olya Mangusheva’s road to
occupational therapy started with a
volunteer assignment with an
organization called Mission to
Ukraine based out of Carmel, IN.
She worked as a translator for U.S.
therapists who went on service trips
to Ukraine. Olya started the first
augmentative communication
program in the country in her work
with Mission to Ukraine thanks to the
guidance and help of visiting
professionals from Easter Seals
Crossroads in Indianapolis, IN. A
group of visiting OTs with Mission to Ukraine observed Olya working with children on fine motor development to help them physically access their AAC devices, and suggested she would make a great occupational therapist. Olya took the recommendation to heart and attended University of Indianapolis for her Masters in OT. After graduating, Olya returned to Ukraine where she was the first and only licensed occupational therapists practicing there until recently, as the country just recently acquired their second licensed OT. Due to her work, in collaboration with occupational therapists from three countries, Ukraine Society of Ergotherapists is now an associate member of the WFOT Organization. OTs for Action is honored to have Olya contribute as a guest author to share her experiences with occupational injustice in Ukraine and offer a call to action.

I come from a country where disability continues to have significant social stigma. The kind of stigma that makes mothers hide their children, at best in the comfort of their own home and at worst – hidden in orphanages. I have worked with those children and seen time and again how occupational injustice mercilessly robs them of joy, the joy of doing, sharing, communicating, and being. So what is occupational justice to me? I understand it as violation of the individual’s right to

do what he or she wants in life based on personal distinctive characteristics: ability, looks, social status, ethnicity, etc. The orphanages I’ve worked in are the epitome of occupational injustice where children are tied to their beds, offered little to no sensory stimulation, let alone opportunity to play or explore. This kind of injustice is graphic, nauseating, shocking, and disturbing. But who sees the hidden ‘unfits’? Does the public know what goes on behind the orphanage walls?

At the core of any injustice there is pride, fear, ignorance, selfishness, and lack of compassion. And I believe that any effort for justice must address those very core qualities and behaviors. Hearts need to change. Policies to protect the rights of at-risk populations must be enforced. Economies must budget affordable and professional services. Support networks must embrace the individuals experiencing occupational injustice. Community places must be disability-friendly. Sounds like a utopia, doesn’t it? But who says we must settle for less?

A mother of a child with disability comes to mind. Despite ‘inclusive education’ policy adopted in Ukraine, her son was denied the right to attend public kindergarten based on his cognitive and physical abilities. This happens to many of my clients. Children’s primary occupation is play, preferably social play, and preparation for school or engagement in learning activities. This boy was being denied a chance to participate in activities that not only bring joy and meaning to his life, but also shape his future. Most moms stare this occupational injustice in the face and feel helpless. This mom was fearless and fought till she not only achieved her goal of kindergarten admission, but also a provision of an assistant for her son with special needs.

This story isn’t unique, albeit so powerful. This mother knew she had a voice, and she persisted till it was heard. How do we fight occupational injustice in our communities? As occupational therapists, we have a variety of tools to address this issue. We empower our clients to find meaningful occupations and equip them with the skills required. But must think broader as occupational injustice is the climate our clients live and work in. It is the temperature of attitudes, terrain of accessibility and disability-friendliness, and precipitations of opportunities available to those we support. We must educate our communities to eliminate social stigma and nurture acceptance and compassion. We must enable those who have a voice to make it louder and be the voice for those who are hidden. Wouldn’t it make sense to start at the very beginning: our children’s first interactions with those who are different from us?

In reality, our ‘day jobs’ as occupational therapists rarely allow for much advocacy and social integration opportunities, let alone policy making and systems changes. However, without these changes the seeds we plant daily may not take root because of the climate. So, let us work together to find solutions and grow as professionals and human beings. I look forward to seeing what the future has in store for OTs For Action.

Olya Mangusheva, Occupational Therapist

Zhitomir, Ukraine

https://www.missiontoukraine.org

Interested in providing support as occupational therapy emerges in Ukraine?

Ukraine needs the support of occupational therapy professionals in other countries to lecture, provide curriculum, mentor students, and provide clinical training. Interested individuals please contact Natalie Zaraska: natalie.rehab365 @gmail.com who has been working with WFOT to develop OT in Ukraine.