From Improvisation to Advocacy: Justice-Oriented Occupational Therapy Practice in the Rohingya Refugee Camps in Bangladesh

Forced displacement can restrict participation and intensify occupational injustice, particularly for people with disabilities. This phenomenological qualitative study explored how occupational therapy practitioners (OTPs) enact participatory occupational justice in the Rohingya refugee camps in Cox’s Bazar, Bangladesh, using the Participatory Occupational Justice Framework (POJF). Face-to-face semi-structured interviews with five OTPs working under varied organizational designations were analyzed using inductive reflexive thematic analysis. Six themes were generated: Occupational Therapy Grounded in Contextual Realities; Empowering through Capacity and Knowledge Development; Facilitating Inclusive and Just Environments; Fostering Belonging and Social Support; Promoting Sustainable and Dignified Livelihoods; and Addressing Barriers to Justice-Oriented Practice. OTPs operationalized POJF processes through context-responsive assessment and adaptation, capacity building, accessibility-focused environmental modification and assistive technology adaptation, culturally meaningful group occupations, and livelihood facilitation via multisectoral coordination. Stigma, interpreter-mediated communication challenges, resource scarcity, environmental disruption, and institutional misrecognition constrained sustained justice-oriented practice, indicating the need for intersectoral systems support.