Rebuilding lives through occupational therapy in Gaza

In Gaza, Palestine, relentless cycles of violence have left many people with physical injuries and disabilities, including amputated limbs. In a region with high rates of poverty and a stifling blockade, Gazans with disabilities often struggle to regain their mobility and return to work.

In MSF hospitals and clinics across Gaza, occupational therapists such as Yousef Alwikhery help injured patients on their long road to recovery. With only one training programme for occupational therapists in the Gaza Strip, their skills are much in demand. Yousef shares his experiences of working with patients with the ultimate aim of helping them achieve happy and productive lives.

“My name is Yousef Alwikhery and I am an MSF occupational therapist at Al-Awda hospital in the northern Gaza Strip. Occupational therapy is not a widely known or understood field of practice in Gaza’s medical system, but I think the profession’s approach to reintegrating patients back into ‘normal’ life is really essential in Gaza.

Many of my patients have sustained injuries in one of the many recent escalations of violence. Practicing occupational therapy here can involve helping patients relearn to dress themselves after having a limb amputated, or regaining their motor skills so they can re-enter the workforce.

Occupational therapy takes a creative, innovative approach to helping patients reintegrate. My work is made more challenging by the fact that we have the blockade to contend with, which makes it extremely difficult to leave to get more training or to acquire necessary equipment. For example, I often make and fit splints and other devices for my patients.

Some may help alleviate pain, others may help a patient with an amputated limb grasp household items like a toothbrush or a broom. Typically, occupational therapists will use a water bath device that heats plastic sheets before shaping them into assistive devices. It took over a year to import one into Gaza; while waiting for it to arrive, I used a hairdryer and a water boiler.

As occupational therapists, we really become a part of our patients’ psychosocial support system – an aspect of our work which is not widely known about. Here at Al-Awda hospital, I work with patients from their arrival in the inpatient ward, through to our outpatient clinic, all the way to their discharge. We spend a great deal of time with our patients and their families, helping them adjust to their new reality.

One of our major responsibilities is to come up with strategies for patients to regain their independence – which is particularly important for their mental wellbeing. Being unable to take a bath or go to the toilet independently can have severe psychological consequences. We help patients learn to do these tasks independently.

You can't imagine how happy patients are when you save them the embarrassment of having to ask a family member to help them to the toilet. This part of my work – when we increase a patient’s independence – has brought some of the best and happiest moments of my life.

One of my patients was a 32-year-old man called Ahmad*. Ahmad’s right hand had been amputated after he was injured during the escalation of violence in Gaza in May 2021. The amputation of his dominant hand had impacted his ability to find employment as a hairdresser and damaged his ability to conduct everyday activities such as eating, dressing and bathing. This had a very negative impact on his psychological condition.

We worked together for six months, gradually improving his ability to do daily activities independently, which helped improve his mental health and outlook. He also took on a leadership role with the other patients he met in and on the way to the hospital, building up a network of friends and encouraging them to regularly attend their treatment sessions. His lively personality and positive approach to life were inspiring to me: despite his relatively young age and poor economic situation, Ahmad could still be optimistic and laugh and joke with his friends.

Although occupational therapy is not very visible or well understood in Gaza, I can see from my work what a positive impact we can have – both here and in other places around the world. For me, it’s not just a profession. I feel passionate about occupational therapy, since I believe it plays a significant role in helping people resume their normal life and participate in the life of their community.”

*Name changed to protect identity.