Re-orienting occupational therapy: Embracing generative disruption and revisiting a posture that acknowledges human dignity

Abstract

Background: Amidst the Covid-19 lockdown that commenced in March 2020, while the profession and service-users were coming to terms with its vast implications, the Occupational Therapy Association of South Africa initiated a Webinar series that stimulated provocative discussions and difficult dialogues. The authors of this paper deliver a commentary, critically engaging with the challenges of cogently articulating the contribution of occupational therapy services across various sectors of service delivery during the first wave of the Covid-19 pandemic in South Africa. The challenges of on the one hand, negotiating the abrupt cessation of rehabilitation services, especially in the public sector and, on the other, advancing the reasoning for accessible, community-based services, are considered.

Aim: The commentary draws from presentations at and reflections on the webinar hosted on 24 June 2020 titled 'Ethical and Moral Challenges for Occupational Therapy'. In this paper, the competing ethical and moral issues arising from being urged to adopt different ways of thinking and doing occupational therapy during the Covid-19 lockdown are outlined.

Proposition: It is suggested that experiences emerging from this pandemic are urging the profession to rethink its positionality in the health sector. Two main considerations deserve attention: The first is rethinking how we use occupational therapy knowledge to act from and in relation to local contexts, viewing people who are marginalised as knowledge and action partners through generative disruption. The second is to revisit what it entails to foster a posture that acknowledges human dignity.

Conclusion: Generative disruption includes a continuous and unabashed critical reflection of and on the limits of our practice and knowledge at hand. It means that we need to include service users and community partners in taking necessary steps to render services in local contexts most needed in recalibration toward social and occupational justice. In our knowledge-making partnerships, it is also imperative to revisit the posture of acknowledging human dignity.