Zorangie Hernandez Montano

Hi Zorangie. Please tell us a bit about yourself.

I moved to Wales from the Dominican Republic in 2004 and I’ve worked in the NHS for 20 years. I’m married with two children. I’m now working in stroke services as a qualified OT.

What inspired you to start looking at cultural awareness?

It was while I was working with older adults that I first became interested in cultural awareness within occupational therapy.

There was a Jamaican service user who wanted to take part in a cooking activity, but he wanted to use ingredients that were important to his culture and weren't easy to find in the supermarket.

One of the technicians didn't know what the ingredients were or where to find them, so she asked me because I'm from the Caribbean and was familiar with some of the ingredients.

I was able to help find what he needed, and he was then able to cook the meal he wanted.

That experience stayed with me because it made me think about how, if we had known about his cultural preferences earlier, we could have been more prepared.

How did you take that experience into your studies?

In my first year, we had to create a health promotion resource, so I created a video called ‘The Importance of Understanding Ethnic Cuisine’

For my dissertation, I looked at the initial assessment we do with service users and noticed there wasn't a specific question about culture.

There were questions about values, and if someone happened to mention something about their culture, it might be recorded, but there wasn't anything that specifically prompted the OT to ask about it.

That meant important information could easily be missed.

So what did you change?

I found that OTs were already having conversations about culture with service users, but they weren't always documenting that information.

I worked with colleagues to introduce a new question into the initial assessment:

“Are there any cultural values, traditions, or beliefs that influence how you prefer to carry out your daily routines or activities?”

Before the change, only 13% of assessments included culturally relevant information. After it was introduced, this increased to 47.4%.

Why is it important for OTs to understand culture?

As OTs, we help people engage in activities of daily living, but also in the things that matter to them.

Because the origins of occupational therapy are Western, this is often reflected in how the profession approaches assessment and intervention. This means we need to make a conscious effort to explore service users’ cultural practices from the beginning. Their cultural preferences are a crucial part of how they carry out their daily routines and understanding this helps us support meaningful engagement.

How can asking one question make a difference?

Although it is a single question, it opens the door to explore a person’s routines, traditions and preferences in more depth. Therefore, the intervention plan is shaped by what feel meaningful to them. The intervention is then done in collaboration with the service user, they are the experts in their own lives. As clinicians, we can prepare in advance: whether it’s food preparation, celebrations or personal care, people may have certain rituals or cultural practices they follow. This can also include things like preferred clothing, prayer times, family roles, or how they structure their mornings and evenings.

It's not about just adding a question and thinking that’s the end of it. It needs to be something that becomes part of the way we think about people.

Your work is closely connected to cultural identity and representation. What does Black History Month mean to you?

For me, it is a time to recognise and honour the histories, contributions, and lived experiences of Black communities across the UK, including here in Wales.

It’s also a moment to reflect on equity, representation, and cultural safety, especially in health and social care.

As an OT, it reminds me why culturally responsive practice is essential for truly person‑centred care.

On a personal level, it’s a chance to celebrate identity, heritage, and the communities that have shaped me.

This year’s Black History Month theme is “Honouring Our Communities”. When you consider this theme, who comes to mind?

I think of the everyday contributors, the people whose quiet, consistent work strengthens our communities through care and advocacy.

I think of Black colleagues in health and social care who bring cultural insight, compassion and leadership to their teams.

I also think about the diversity within Black communities. They are not all the same; they include people from African, Caribbean, and Afro‑Latin backgrounds, each contributing in distinct and meaningful ways to life in the UK. Through my work, service users help me understand how cultural identity shapes everyday routines, and their experiences have shaped my understanding of culturally meaningful occupation.

And I think of the wider Black communities in Wales, whose traditions, creativity and presence enrich everyday community life.

Honouring our communities means recognising contributions that truly deserve to be celebrated, while also recognising the strength that comes from cultural identity and shared experience.