Khazina Hussain and Nadia Khan with OT students following workshop lecture.Whilst some people see travel as a means of escape, Khazina Hussain and Nadia Khan, occupational therapists (OTs) at Bradford District Care NHS Foundation Trust, see it as an opportunity to help others and make a difference to the health and wellbeing of children in Sri Lanka.

With the backing of the Trust and in collaboration with Tropical Health Educational Trust, Jaya Mental Health and the University of Kelaniya the OTs embarked on the trip to tackle health inequalities.

Khazina Hussain & Nadia Khan with university of Kelaniya faculty, consultant Pediatricians, Marjorie Gardner & student & newly qualified OTs.Working on the child and adolescent training project in Sri Lanka and meeting people overseas has been a passion for the dedicated health professionals who relished the opportunity to share learning and help others on the 16-day visit. The aim of the project was to develop child mental health services in Sri Lanka and support the next generation of OTs by championing the sustainability of the Sri Lankan occupational therapy degree level programme, whilst also raising the profile of OTs.

With a population of almost 22 million people and only 176 registered occupational therapists to help people with health issues and disabilities that affect their ability to do day-to-day activities, training a new cohort of OTs has never been more vital. The situation will soon be exacerbated with over 50 OTs set to retire over the next few years.

Due to a shortage of OTs across the country, many families in Sri Lanka travel up to 6 hours for an appointment with an occupational therapist. Once seen they are given an initial assessment and signposted to services and treated by a multi-disciplinary team.

Khazina Hussain and Nadia Khan, occupational therapistsDuring their trip to Sri Lanka, alongside training other healthcare professionals and skill sharing at workshops, Specialist Occupational Therapist and Advanced Sensory Integration Therapist, Khazina Hussain and Specialist Occupational Therapist and Specialist Sensory Integration and Trauma Informed Practitioner, Nadia Khan met with families to educate them, breakdown barriers and encourage people to talk about mental health.  Even though a high proportion of people are affected by mental health in the country, a strong social stigma attached to mental ill health means that people experiencing mental health problems often face discrimination in many aspects of their lives.

Elaborating further Nadia Khan, Specialist Occupational Therapist, said: “In Sri Lanka there is a big stigma around mental health issues and conditions such as autism. Families find it hard to accept the diagnosis. In stark contrast, in the UK it’s the opposite and families are keen to get a diagnosis in order for their child to get support and treatment where needed.”

As a result of Khazina’s and Nadia’s training with families, mental health issues are now discussed more openly.  The parents they have seen have been educated, so myths are dispelled, and they know where they can go to for help for their young people. The training has also been rolled out to healthcare professionals and professionals in the infancy of their careers to help facilitate shared learning.

Nadia Khan, Marjorie Gardner, Khazina Hussain and newly qualified OTs.Khazina Hussain, Specialist Occupational Therapist and Advanced Sensory Integration Therapist added: “During our clinical visits we talked to the next generation of OTs and families about embracing the quirky side of their child, for example a child with autism, and recognising the strengths in their child.”

Citing an example, Nadia said: “We were shown a video by an OT of a little boy that jumped every time he saw a car. His parents were finding it difficult to come to terms with his behavior and really wanted to change it. It wasn’t affecting the child in a functional way at all. It was just one of his rituals as part of his autism that the parents learnt to embrace.”

The project has also created sustainable and durable relationships where all partners involved in the project can learn from each other. Elaborating further Khazina said: “There is an expectation that people from first world countries will go to third world countries and be the teachers and know everything, imparting knowledge. But it’s also what we learn from them. It’s been a really humbling experience.”

Khazina continued: “Within our training we’re equipping people to understand about mental health and also to have conversations with those most vulnerable. We’re helping to break down stigmas. We’re hoping that by equipping families with knowledge, as well as hosting workshops and going to conferences to speak to healthcare professionals we’re beginning to work at different levels to make a difference.”

Nadia added: “Our visit also revalidated for us and for the OTs in Sri Lanka the unique contribution of occupational therapy and the use of meaningful daily activities to help people recover from physical and mental health conditions. It also highlighted that despite living in different parts of world, we can come together as OTs and share the same professional values to make a difference to help people live better lives as part of their treatment plans.”

In unison Khazina and Nadia said: “The project has been made possible by the support of the Trust and the backing of our medical director, Dr David Sims and Catherine Schofield, allied professional lead. Professor Marjorie Gardener, an OT lecturer at the University of Kelaniya, was also instrumental in organising our trip to Sri Lanka. We’d like to thank them and all the partners involved for their ongoing support to make this project a reality.”

Stigma, lack of knowledge and discrimination can trap people in a cycle of illness.  With training and education, children and young people in Sri Lanka have the potential to live fulfilled lives that support their mental and physical health.