In 2015, Samira Umutoni suffered a stroke when she was 16 years old and she fell into a coma. After one month of unconsciousness, Umutoni found herself unable to walk, sit up or lift anything with her hands. She went through physiotherapy sessions for three years to be able to walk unaided. “They taught me everything like a baby – how to sit, crawl, stand up and then how to walk,” she says. But then, being able to walk independently wasn’t just enough. Umutoni, now aged 23, remembers an occupational therapist telling her: ‘You should be able to help yourself with everyday activities, have a bath, wash your clothes and brush your teeth.’ Inconceivable at first, all of these would be possible only after Umutoni attended occupational therapy sessions. Occupational therapy (OT) is defined as the form of treatment that uses practical activities to help a person with or is at risk of developing an illness, injury, disorder or disability to be able to do everyday activities independently. “Thanks to occupational therapy, I am now able to do about 60 per cent of all the things I did before the illness,” said Samira. “Cooking is my passion. I cook and when I need to remove the saucepan from the stove, I call someone to help me.” She says that a major part of the OT sessions starts with giving someone self-confidence: “They show you even if you have a disability, there’s still something you can do.” Need to mainstream occupational therapy “Our profession needs to be integrated into the health system because we help people who are disabled as a result of accidents, and certain illnesses and need to be able to do everyday activities independently,” says Epiphanie Murebwayire, the chairperson of Rwanda Occupational Therapy Association (RWOTA). A practising occupational therapist at the Rwanda Military Hospital, Murebwayire says that at least 50 people attend therapy sessions every week. There are 42 occupational therapists in Rwanda today, most of them having been trained since 2015 when a dedicated programme was started at the University of Rwanda (UR). “Currently, only King Faisal Hospital and Rwanda Military Hospital have occupational therapists in their structure,” says Murebwayire. “Even the positions of occupational therapists in some other hospitals remain vacant. Therefore, the Ministry of Health should do more to ensure other hospitals have occupational therapists because there are many patients who need our services.” Stressing the needed support for the budding profession, Murebwayire says that even trainers of occupational therapists remain very few in number. OT services not covered by health insurance “Occupational therapy services take long periods of time, which makes them very expensive,” says Gilbert Kubwimana, who runs Love with Actions, an organisation that advocates children with disabilities. “It can take about three months of therapy sessions to train a child who was born with a physical disability to feed himself, or six months to be able to brush his teeth,” said Kubwimana, whose organisation caters for about 70 children. However, because OT services are not mainstreamed, it is hard for the providers to charge them appropriately. “If insurance companies and RSSB can insure the occupational therapy services, we would be able to come to a solution,” says Kareem Kayode Ayodeji, a therapist and the head of UR’s department of occupational therapy.
