Occupational Therapy in Disaster Risk Reduction and Response: A Case Study in the Philippines

SIGNIFICANCE: This study illustrates how occupational therapy could make a difference in the lives of persons, families, and communities directly affected by natural disasters. Using conceptual models based on community development in the Philippines, we developed a framework of intervention that served as a guide for future work on disaster relief and risk reduction. Through a qualitative case approach, the complex phenomena of living through a disaster within participants’ contexts were examined and formed the basis for the development of an intervention framework.

More specifically, in this study, we sought to analyze the development and implementation of an occupation-based community development intervention framework as part of a national effort toward disaster response and relief to Typhoon Bopha, which struck the southern Philippines in December 2012. This study is important and needed because there is limited empirical literature that illustrates occupational therapy interventions for clients affected by natural disasters. Thus, a goal of this study was to gain an in-depth understanding of a complex process linking intervention implementation and real-life effects. The project innovates by integrating concepts and methodologies from community development and public health to address the occupational needs of those directly affected by a natural disaster. Demonstrating the value of occupational therapy in disaster preparedness, risk reduction, and response brings about a multitude of opportunities for occupational therapy practitioners and scholars in promoting practice and influencing national and global policy.

METHOD: The study design follows an explanatory and descriptive qualitative case approach, with the municipality of Cateel and its citizens as the “case.” Because the phenomenon being studied are complex, the principal researcher bound the study by time, place, and activity. Days after Typhoon Bopha struck the southern Philippine city of Cateel, several volunteer occupational therapists were among the first responders. Using a community development model, the volunteers developed a tiered plan that included a rapid needs assessment phase, a planning and implementation phase, and a follow-up phase. During the rapid needs assessment phase, the volunteers engaged in participant observations of various peoples in the community, conducted meetings with local and Non-Governmental Organization (NGO) leaders, and set up play activities for children as a method of occupational assessment. Field notes, journal reflections, interview transcripts, meeting notes, and document artifacts were used as multiple sources of data to enhance the study credibility. The analysis was iterative—initially using categorical aggregation and direct interpretation of the data while linking the data to the research propositions.

RESULTS AND CONCLUSION: The results of the analysis paved the way for the development of an intervention plan and its subsequent implementation. After consultation with community leaders and other NGOs, the occupational therapy team developed a program called Balay Dulaan (Playhouse). Balay Dulaan is a resource center that was designed as both a children’s library and a multipurpose place where children could engage in solo and group play, other social activities, and school-related occupations. In a span of 1 yr, more than 500 children participated in the activities of the center. Feedback from and observations of occupational routines of adult members of the community were positive. As a family-centric society, the adage “it takes a village” holds firm and true in this part of the world. Balay Dulaan provided the anchor to the village that took care of its children and afforded the adult members of the community the time to focus their energies on community building and resuming traditional gender-specific roles: mothers establishing households and fathers establishing livelihoods. This qualitative case study illustrates the process and outcome of establishing an intervention framework that addresses the needs of clients centered on and through occupations. The intervention framework has since been adopted for future disaster relief work. As the study is complex and contextually situated, the results do not readily generalize. However, future scholarship may draw from the lessons offered by this study.