It started with a group activity hosted by The Peer Collective’s Fatima Al-Sarakbi Hernandez (student in the OTD program) and Joy Xiao (student in the DPT program) during Granola with Gagliardi in the IPE Building on April 18, 2025. Patrick Lester, coordinator in the Doctor of Physical Therapy program’s Student Affairs office, stopped by to write and fold an affirmation into an origami star and struck up a conversation with Dr. Jane Gagliardi, Associate Dean for Learning Environment and Well-Being. By Monday April 21, Lester had reached out to inform Gagliardi of September 12th’s World Day of Encouragement – and offered to let Le Well partner on a fun, engaging community-building activity.
On Friday, September 12, 2025, Le Well and the DPT Student Affairs Office sponsored Day of Encouragement activities in the IPE Building. Activities included coloring and rock painting (with a goal of starting an encouraging rock garden in the Medical Center Library, where the next rock painting event will take place on World Mental Health Day – October 10, 2025). Participants also were treated to a presentation on the Kawa Model of occupation, offered by its inventor, Dr. Michael Iwama in the Division of Occupational Therapy.
Iwama, who completed PhD studies in Medical Anthropology and International Comparative Sociology, has brought his international experience, scholarship, humility, and insights from working at 7 different universities in 4 countries and acculturating into social and cultural contexts to understand ways of looking at the following questions:
- What makes for a good life?
- What does it mean to be “healthy” – to be well?
Iwama has concluded that there is no one definition of what it means to be well, and our work is culturally bound. Basing his Kawa model in cosmological myths and observations of collectivism vs. individualism, Iwama developed a model of life that helps to contextualize illness, wellness, and interventions we can bring to bear for our patients – and for ourselves in our own lives.
Imagine life is a river. The water condenses at the top of the ice-capped mountains, coalescing until it starts to flow, gently, making its way down the mountain and gaining volume and momentum. The water develops into a stream and continues to gain volume and momentum, eventually becoming a river and turning into a large body of water.
No two rivers are the same, and every river is uniquely and beautifully made.
In the Kawa model, water represents life. As long as there is water, there is life. The shape and volume of the river represent environmental factors. The inner sides and bottom of the river represent the immediate environment, and the outer river sides and bottom represent the ambient environment. Rocks in the river represent problems/challenges, difficulties. Driftwood in the river represent personal factors. The length of the river represents the duration of life; at any moment in time life can be captured as a cross-section of the river, where we might find more or less “flow” of the water as relates to the width and depth of the river, the number and size of rocks, and the location and permanence of the driftwood that is present.
In conceptualizing the person whose life it is as the expert in that life, Kawa gives agency to the patient while providing tools to the healthcare provider in the goal of enabling and maximizing life flow. The view of Kawa is one of great hope, provides an opportunity for gratitude, and encourages individuals to identify opportunities for greater flow in their own lives.
Le Well would like to thank Jashi Abhirajan and Patrick Lester for making the event possible, Jeanine Bandini for her help, and Dr. Michael Iwama for his kindness, compassion, wisdom and humility in presenting. Thanks also to the students, faculty and staff who attended Le Well / DPT Student Affairs’ National Day of Encouragement event!