At a ward in Kenyatta National Hospital, clinical occupational therapist Mikie Baron moves between bedsides and rehabilitation spaces, guiding patients through everyday tasks that have become difficult or impossible.
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For many patients, illness, injury, or childbirth disrupts routines that once felt automatic. Simple actions such as walking, bathing, using their hands, and managing pain suddenly become difficult.
Occupational therapy steps in at that point, using the activity itself as treatment.
“When function is compromised, even the most basic activities become difficult,” Baron explains. “That is why occupational therapists are here. We use practical, evidence-based activities to help patients regain independence.’
One area where occupational therapy can play a critical role is in postpartum recovery, particularly for women who develop complications such as hypertrophic scarring. These scars grow beyond the normal skin level, causing pain, hypersensitivity, and restricted movement, Baron explains.
“We desensitise the affected area because the surrounding skin nerves become very sensitive. We also use compression therapy to help manage pain, reduce sensitivity, and promote healing.”
Swelling, medically known as edema, is another common challenge after childbirth or surgery. According to Baron, occupational therapists follow strict clinical guidelines to reduce swelling and restore mobility, sometimes even using water-based techniques to enable movement.
‘When swelling is reduced, patients can walk, move and engage more easily,’ he says. ‘That is part of rehabilitation, helping the body return to function.’
But occupational therapy is not only about physical recovery. It is also about identity. Baron recalls working with patients whose injuries affected their ability to perform roles that once defined them, parents, workers, caregivers.
‘If someone’s hands are affected, their occupation is compromised,’ he explains. ‘If a patient was managing a home, our thinking is: how do we resettle her back into that role? Or what other skills can we give her so she remains productive?’
This focus on occupation, the meaningful activities that fill daily life, is what sets occupational therapy apart. Baron argues that, contrary to popular belief, occupational therapy is not limited to specific wards or diagnoses.
‘In a nutshell, every patient requires occupational therapy as long as their function has been compromised,’ he says. ‘It does not matter whether you are in a maternity ward, diabetic, or recovering from surgery. If your daily routine is affected, you need occupational therapy.’
One of the most visible, and misunderstood, interventions at KNH is dance therapy. Introduced as a leisure activity after dressing and rest, dance helps patients manage pain, regain movement and reconnect with their bodies in a controlled environment.
‘Dance therapy comes in after patients have rested,’ Baron explains. ‘It helps them relax, reduces pain and allows them to move independently while we closely monitor safety.’
Not every patient participates. Occupational therapists first conduct screening and assessment, ensuring patients are medically stable and capable of engaging without risking injury. For those confined to bed, therapists adapt activities to prevent pressure sores and loss of function.
Beyond physical rehabilitation, occupational therapists also work closely with psychologists and psychiatrists, particularly for patients dealing with trauma, burns or sudden changes in appearance.
One technique used is mirror therapy, which helps patients gradually accept physical changes.
‘Mirror therapy helps patients process what has happened to them,’ Baron says. ‘By exposing them slowly to their reflection, we support psychological healing alongside physical recovery.’
This integrated approach is part of a broader multidisciplinary model at KNH, where occupational therapists collaborate with surgeons, nurses and mental health professionals. During dressing procedures, therapists assist with positioning to prevent contractures, tightening of muscles and tendons that can permanently limit movement.
‘Our job is to prevent disability,’ Baron says. ‘We work with surgeons to fabricate splints, with nurses during wound care, and with psychologists for mental health recovery.’
Despite its impact, occupational therapy remains under-recognised in Kenya’s healthcare system. Baron believes public awareness is still low, and staffing levels are inadequate for the demand.
‘Many people do not know that occupational therapy exists,’ he says. ‘Yet the workload here is heavy, and the need is great. Hospitals need to employ more occupational therapists so patients can receive quality, holistic care.’
That philosophy is reinforced a few corridors away in the occupational therapy unit, where everyday objects, switches, taps, doors and handles, are mounted on boards that resemble ordinary homes. To the untrained eye, they look insignificant. To Silas Wakulwa, the Head of the Occupational Therapy Department at Kenyatta National Hospital, they are treatment tools.
‘This may look like nothing,’ Silas says, gesturing at a small fixture fixed onto a wall. ‘But this is treatment. These are the things that happen in people’s lives.’
The activities are deliberately simulated to mirror life outside the hospital. Patients recovering from stroke, injury or illness often lose the ability to perform basic tasks – turning on lights, opening taps, closing doors. Occupational therapy retrains those movements using controlled environments that resemble home settings.
‘When they come here, we train them to use their hands to operate their life at home,’ Silas explains. ‘These activities look simple, but they are what make daily living possible.’
Beyond simulated home environments is a dedicated hand therapy area, designed to restore dexterity and strength. The hand, he says, is the primary tool through which people perform their occupations.
Those occupations, he explains, fall into three broad categories. The first is activities of daily living, toileting, bathing, feeding, dressing and sleeping. Injury or disease can strip people of these abilities almost overnight.
‘The role of occupational therapy is to make sure you go back to those occupations so you can operate your life daily,’ Wakulwa says.
The department’s work extends beyond physical rehabilitation into cognitive and developmental care. Every day, the unit sees dozens of children with sensory processing disorders, commonly associated with autism spectrum conditions, a number that has risen sharply over the past decade.
‘Ten years ago, we saw maybe three or five children a day,’ Silas says. ‘Now we see about 40 daily.’