Occupational Therapy in the Caribbean

There are only seven occupational therapists in Jamaica. But they’re a committed group.

Special Focus: International Affairs

This article consists of an interview with Fleur Minott Nembhard, the new president of the Association of Caribbean Occupational Therapists (ACOT). Minott Nembhard worked in Miami with adults with orthopedic and neurological diagnoses before moving back to Jamaica, her home country, where she has worked in adult rehabilitation for over 25 years.

Alma R. Abdel-Moty: Please provide us with a brief history of ACOT.

Fleur Minott Nembhard: The Association of Caribbean Occupational Therapists (ACOT) was formed in March 1991 as a result of the efforts of Jane Water, Sonia Watson-Brown, and Karla Brockie.
At the initial meeting in Antigua, there were nine occupational therapists, including myself, from Antigua, Barbados, Jamaica, and Trinidad and Tobago who met to discuss regional and professional concerns.

The first scientific meeting took place in 1992 in Jamaica. It was attended by 18 occupational therapists from the Caribbean and the United States. Our organization has grown.

Our last scientific conference was held in October 2015 in Trinidad and Tobago. It was attended by 54 occupational therapists from the Caribbean, Canada, United Kingdom and the United States.

Abdel-Moty: Please elaborate on the last scientific conference.

Minott Nembhard: The theme of ACOT’s 12th biennial scientific conference was Moving Forward in Health and Education.

The three-day event started with a cocktail reception hosted by Their Excellences President Anthony Thomas Aquinas Carmona and First Lady Reema Harrysingh-Carmona, where invited guests had the opportunity to meet the president and his wife, [and] network with local healthcare providers to discuss the need for increasing occupational therapists in the local healthcare system.

The scientific conference consisted of oral presentations, workshops, and posters in the areas of pediatrics, education, mental health, physical dysfunction and geriatrics.

In 2017, the 13th Biennial Scientific Conference is scheduled to be held in Jamaica.

Abdel-Moty: As the new president of ACOT, what are two of your major goals?

Minott Nembhard: Two of my goals are to increase awareness that ACOT exists and to increase ACOT’s relevance. In order to accomplish these goals, we plan to reach out to other Caribbean territories and encourage occupational therapists to join ACOT.
We must work together as a profession in order to advocate for occupational therapy services in the healthcare systems, and educate politicians and the general public about occupational therapy. We need a louder voice in order to improve the delivery of our services and act as better advocates for clients. In the Caribbean, each island is completely independent, [and] has its own government, laws, politics, rules and regulations. So, we must unify.

Abdel-Moty: Who can join ACOT?

Minott Nembhard: ACOT has different categories regarding membership. Full members are occupational therapists who are resident in the Caribbean, are members of their national association (where one exists) and meet the legal requirements of the island where they work. Full members have the right to vote.
Honorary members are individuals who have rendered outstanding service to ACOT or who have made notable contribution to the health or welfare of humanity. Associate members are either occupational therapy students or occupational therapists who work [or] reside outside the Caribbean. Associate members do not have voting rights but can attend the scientific conferences.

Abdel-Moty: Describe occupational therapy education in the Caribbean.

Minott Nembhard: There has been a need to establish occupational therapy education programs in the Caribbean. At the present time we have one occupational therapy program in the Caribbean in Haiti, with a second one scheduled to open at the University of the Southern Caribbean (USC) in Trinidad. Graduates of the USC program will earn an MS in OT, with classes starting in September 2016.
The Faculté des Sciences Réhabilitation de Léogâne of the Episcopal University of Haiti has an occupational therapy program at the bachelor level which commenced in September 2015.

Abdel-Moty: You are a practicing OT in Jamaica. How many occupational therapists are in Jamaica and where do they work?

Minott Nembhard: We do not have enough occupational therapists in Jamaica. There are only seven of us and Jamaica has a population of 2.75 million. There are no OTs at the rehabilitation hospital, at the children’s hospital or in any of the public hospitals or schools.
The last occupational therapist funded by the government to earn a degree in occupational therapy was over 30 years ago! Presently there is only one occupational therapist in Jamaica who works in the area of psychiatry in the government sector. The other six work in private practice.

Abdel-Moty: How is the reimbursement system in Jamaica?

Minott Nembhard: Healthcare in Jamaica is free to all citizens and legal residents at government hospitals and clinics. There are two major health insurance providers. Because the majority of the services are provided through independent practitioners, reimbursement is primarily through private pay.
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The Occupational Therapy Association of Jamaica (OTAJ), a small but vibrant organization, has been advocating for and was recently granted providership status for practicing occupational therapists with the larger of the two companies.

Abdel-Moty: What is the biggest challenge that OT is facing in Jamaica today?

Minott Nembhard: I consider that there is inadequate support of the profession from the government. There is no opportunity for training, no opportunity to fix the gap to attract OTs, and there are few government posts (jobs). There are, however, many NGOs, schools who need the services of occupational therapists. Occupational therapists are regulated and licensed to practice by the Council of Professions Allied to Medicine.
As a country we have limited financial and personnel resources. Potential clients cannot access our services because they don’t know that we exist [and] what we do, and cannot afford to pay privately.

We now have a Disabilities Act in Jamaica, which should see even more demand for occupational therapy services. I’m not sure if such legislation exists across the region. ACOT could be an advocating voice to encourage and support similar legislation in the countries where it is not present.

Abdel-Moty: Explain the impact that social networking has made on ACOT.

Minott Nembhard: The internet and social [media] has positively impacted ACOT. Because the Caribbean encompasses a large territory, the physical distance between territories can be challenging. There are parts of the Caribbean where the presence of OT is very small, and in some, non-existent.
Technology has helped us to communicate. On a regular basis we use e-mail, Skype, [and] Whatsapp to share and disseminate information. We are in the process of updating our website. We plan to have a quarterly electronic newsletter that will include country reports, job openings, continuing education offerings, and networking opportunities. It will be delivered to ACOT members.

Abdel-Moty: How do you envision the future of OT in the Caribbean?

Minott Nembhard: I am hopeful that with two training programs in the region, the awareness and visibility of our profession will increase. ACOT will continue to support local occupational therapy associations, will facilitate professional development by offering continuing education, and be the interface between regional governments to expand the scope of the profession. I look forward to having more colleagues working in the Caribbean region so that the potential recipients are no longer underserved but have easy access to our services.

Abdel-Moty: Where can people find further information about ACOT?

Minott Nembhard: Visit www.caribbeanot.com or e-mail acotmembership@gmail.com

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