Elizabeth Andare, MScOT, OTR/L: OT working in War-Torn & Humanitarian Contexts
In this episode, we will learn from Elizabeth Andare, MScOT, OTR/L. Lizzie is an occupational therapist and researcher from Kenya whose work explores the intersection of decolonial practice, disability, and forced displacement in the Global South and is passionate about social and occupational justice in underrepresented communities. Her work spans refugee camps in Kenya, grassroots rehabilitation in Palestine, and neurodivergent learners in the Maldives. Grounded in an occupational and intersectional lens, she centers lived experience, co-production, and occupational justice—particularly in underrepresented and under-resourced contexts. Lizzie’s practice moves fluidly between direct therapy, community engagement, policy advocacy, and research, with a commitment to disrupting systemic inequities and amplifying marginalized voices. She is the voice behind @OTintheMargins, where she shares field notes and reflections from the edges of occupational therapy practice.
Q & A with Lizzie:
Please tell us a little about yourself and a few favorite occupations.
I’m Lizzie Andare, an occupational therapist by profession, originally from Kenya and currently practicing in the Maldives. I am a born-again Christian so my identity is found in Christ. My professional work sits at the intersection of clinical practice, research and advocacy: I work directly with children with disabilities and families/community they are situated in, study the systems that exclude them, and try to push for change where policy and practice fall short. Outside work, the occupations that sustain me are creative, spiritual and physical. I swim and run because movement clears my head; I pray and worship to stay grounded; and I do pottery and painting to keep me connected to tactile, slow processes that mirror therapeutic work. I’m also a plant mom to eleven plants, and tending to them reminds me that care, patience and environment all shape growth. These hobbies are not extras to me but part of how I replenish my capacity to be present with other people’s difficult stories.
What motivated you to contribute to this podcast series?
I was drawn to The Uncommon OT because it intentionally highlights practices that don’t fit tidy boxes. The kinds of work that students rarely hear about in classrooms but are vital to the future of our profession. For me, talking here is an opportunity to document and share blueprints for practice that are context-responsive and justice-oriented. If a student hears one thing from my story and understands that OT can be about systemic change as much as one-to-one therapy, that’s a win. I also see the podcast as an important pedagogical tool: it helps normalize messy, cross-cultural practice and gives emerging clinicians permission to work differently. To center community knowledge, to co-produce solutions, and to see occupational therapy as a field that must reckon with power and place.
Please describe the UncommonOT work that you do and the setting in which you work, the population you serve and the needs that you address.
My practice is split across contexts that look very different on paper but share similar margins. I worked with refugees in Dadaab refugee camp in Kenya, documenting how people with disabilities experience profound occupational disruption in a context shaped by displacement, under-resourced systems, and humanitarian aid that’s often symbolic rather than functional. I also volunteer with a grassroots Palestinian effort to rebuild OT practice in a clinic and an OT training institute in Gaza and the West Bank (for safety reasons I cannot disclose the much details of this work). Here I support capacity building, program design and mentorship in an all-volunteer space. Full-time, I work in a pediatric clinic in the Maldives supporting neurodivergent children (children with ADHD, autism and sensory processing needs). On the surface it looks like a typical clinical job, but it’s uncommon because the clinic is privately run by businesswomen who do not always understand or value OT beyond its clinical output. That requires me to navigate business priorities, advocate for capacity building of parents and teachers, and argue for systems-level changes that the managers may not initially see as core to a clinic’s remit. Across these settings I address both individual needs (communication, sensory strategies, participation) and structural needs (school inclusion, teacher training, policy advocacy). I try to co-produce interventions with families and communities, and to translate lived experience into evidence for more equitable programs. So research is also something I am doing on the side of all this and I am currently in the process of publishing my first article at the Disability and Society Journal.
What inspired you or drew you to this type of OT work?
I stumbled into refugee work almost by accident, and it became the axis around which other opportunities formed. Working in Dadaab exposed me to how occupation is disrupted not only by impairment but by systems, by terrain, aid design, or social stigma. That experience made me ask different questions and seek different answers, so I pursued a Master’s where problem-based learning let me combine practice and research. Volunteering in Gaza and supervising community initiatives grew from the same impulse: to make OT meaningful where it’s most needed. What keeps me here is a deep commitment to occupational justice. Once you’ve seen how policy, space and history shape everyday life, it’s impossible to go back to a purely technical understanding of therapy. I work because I want to help reenact our profession's vision of occupational justice that centers agency, dignity and participation especially for people who are routinely made invisible.
How did you get there? Can you describe your path?
My path has felt improvised and serendipitous. I applied for a position in Dadaab while I was finishing my undergraduate studies; a leap into a context I knew little about. A pivotal moment in my trajectory, oddly, involved my Dad, a taxi driver: while driving a passenger who turned out to be a former supervisor and current co-author, he mentioned me, and that led to encouragement to apply for a Master’s program. I was accepted, and the timing was powerful; I began the MSc while employed in the refugee camp, and the thesis became a practice-informed inquiry on occupational disruption among disabled Somali refugees. While collecting ethnographic data last year, a traumatic event where an armed terrorist group raided my residence forcing me to cut fieldwork short. Unlike my participants, I had the privilege to leave; that guilt and the psychological toll lingered. My Dad again stepped in, sending my CV to an opening in the Maldives so I could rest and regroup. What was meant as a pause turned into a second chapter of practice in a new setting, where different challenges surfaced; occupational alienation in schools, the need to advocate to non-health managers, and the responsibility to keep amplifying the refugee narratives that shaped my earlier work. Along the way I volunteered in Gaza, joined networks, and kept researching with an effort of always trying to link scholarship and practice.
Please describe a typical day or OT session at your uncommon setting? What OT skills do you utilize?
I kind of don't have a typical day :) My work changes constantly depending on the needs of the people and communities I’m with. But if I were to map out how I spend my time, it might look something like this: Before 8:30 a.m., my day starts with quiet time with the Lord. Then, I swim as part of my workout. I revisit my fieldnotes from the week and prepare what I want to share on my IG account or LinkedIn page. I often research about systems, the policies, histories, and structures that shape people’s everyday lives as I take my breakfast. Sometimes I reach out to policy makers to request a conversation. I also use this time to edit my article that’s in progress for publication. From 8:30 to 5:30, I’m in direct practice, providing therapy to neurodivergent kids. Some days, I spend time with the managers, educating them about OT roles and advocating for the broader scope of our work. Other days, I’m having those deep, reflective conversations with my colleagues about inclusion and systemic change. After work, I slow down. I cook, tend to my 11 plants, call my family back in Kenya, and often end the day with Bible Study sessions with my brother. My work is grounded in cross-cultural, context-responsive approaches that center lived experience, co-production, and occupational justice particularly in underrepresented settings. I work through both an occupational and an intersectional lens, because the barriers I see are rarely just about the individual; they’re shaped by systems, structures, and histories. So, the skills I utilize kind of help me see an injustice, name it and address it. Working with neurodivergent learners and disabled refugees has honed different OT skills that include; Occupational Justice Literacy, where I recognize when barriers to participation are rooted in systemic inequity rather than personal deficit; Critical Reflection, where I examine my own assumptions, biases, and positionality/privileges; Advocacy Competence, communicating clearly to stakeholders across practice, policy, and community spaces; Ethical Relation skills, identifying other professionals, sects who are addressing similar issues and initiating interests to join in; I also rely on critical relational skills when building trust across cultural and linguistic differences, and letting people define what ‘meaningful occupation’ looks like for them and lastly I utilize Systems Thinking skills to connect individual stories to broader social, cultural, and policy contexts.
Can you talk about some recent highs (successes) and lows (challenges) of your current role?
A recent high was completing my MSc and co-producing the thesis with participants. That process affirmed that research can be ethical, participatory and useful. The feedback and new connections from presenting regionally were energizing; I secured mentorship and invitations to contribute to peer review in Global South scholarship, which felt like recognition that this work matters. I also won the Inga-Britt Lindström Grant Award in Sweden (https://www.arbetsterapeuterna.se/foerbundet/occupational-therapy-in-sweden/the-swedish-association-of-occupational-therapists/inga-britt-lindstroem-grant-award/) for the work I did with disabled refugees in Dadaab refugee camp The lows are equally stark. Clinically, nothing has been more painful than realizing children I support are being excluded from schools that claim to be inclusive. Watching families receive dismissal letters or reduced hours and seeing the community accept this as ‘normal’ felt like a betrayal of what our profession aims for. It’s both heartbreaking and mobilizing: heartbreaking because of the immediate harm to children, mobilizing because it clarifies where advocacy and systems work must focus.
How do you continue to learn in order to stay on top of things within your role?
I invest in continuous learning through conferences; local, regional and international. I have attended the 1st OT Europe Congress in Poland, the 13th OT Africa Regional Group. Presenting and listening at these congresses helped me connect practice questions with broader research and policy debates. Because refugee and humanitarian OT are emergent, context-specific fields, I rely heavily on co-producing knowledge with communities: participatory action, fieldnotes, and iterative evaluation. I also read widely across disciplines public health, education, disability studies and maintain mentorship relationships that challenge my assumptions. Finally, I try to reflect critically: every intervention is an experiment, and I treat my practice as an ongoing inquiry.
Can you share a little bit about salary and compensation in this setting? How do OT or the services you provide get funded?
Compensation varies dramatically by context. In Dadaab, roles employed by humanitarian NGOs or UN partners typically offer remuneration aligned with experience and include allowances, partly reflecting the security and logistical demands of camp work. In the Maldives, my position is salaried with favorable benefits; a tax-free salary in addition to food and accommodation allowances which is more safe and secure than many NGO posts. Funding for OT services is mixed. In camps, services are usually funded through NGO contracts, UN agencies, and donor grants; in private clinics, funding comes from client fees or private sponsors; volunteer initiatives like the work in Gaza depend on small grants, donations, and professional volunteer time. Many of the most meaningful pieces of work (capacity building, advocacy, community organizing) are underfunded and rely on voluntary labor and creative partnerships.
Any career advice for our followers and listeners on how to get started on this path?
Follow your tears, they are your true North. I mean that literally: pay attention to the things that make your heart tender, those are often signposts to purpose. Practically, get grounded in clinical skills first, then seek out interdisciplinary experiences: volunteer in community settings, learn qualitative research, and apprentice with more experienced colleagues. Build networks regionally and internationally, and take small risks; a short placement, a research project, a volunteer stint can reshape your trajectory. Finally, cultivate humility and reflexivity: cross-cultural, justice-focused work always asks you to examine your power and to co-produce solutions rather than assume you have answers.
What’s a common myth or misconception about your job/role you’d like to call out or demystify?
A persistent myth is that occupational therapy is apolitical. In truth, if you are in the game of social and occupational justice you are in the game of politics. Access to occupation is shaped by policy, by infrastructure, by funding which are all political forces. To do justice-oriented OT is to embrace advocacy as part of the role: to name exclusion, to design responsive systems, and to insist that occupational participation is a right, not a privilege. That doesn’t make us activists in a partisan sense; it makes us ethical practitioners who acknowledge the politics of everyday life.
How do we find you, follow you, be in touch with you, and promote your unique work?
You can find and follow me on LinkedIn under Lizzie Andare and on Instagram at @OTintheMargins. You can promote my work by engaging with the content I share. Comment, share, and bring these conversations into your own networks. And if you want to collaborate, learn more, or connect directly, you can always reach me at elizabethandare254@gmail.com.
Please list any resources you would like me to include with your Show Notes (courses, articles, assessments, tools, etc.)
Healing work: Intersections for decoloniality
Antiracist occupational therapy: Unsettling the status quo
Connect with me- OTintheMargins
As always, I welcome any feedback & ideas from all of you, or if you are interested in being a guest on future episodes, please do not hesitate to contact Patricia Motus at transitionsot@gmail.com or DM via Instagram @transitionsot
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