Te-na- koutou, Te-na- koutou, Te-na- koutou, katoa.
I arrived in New Zealand in 1987 as a new immigrant fresh from the United Kingdom. My first position was not far from here, in Masterton where I was part of a newly established Mental Health Service. As the sole OT for this community team I regularly visited Pahiatua, Ekatahuna, and Greytown and frequently became lost on home visits to clients who lived on rural properties with impossible addresses like RD 23. Nothing in my previous life in England had prepared me for this cultural change. I had left Bristol with a population of about half a million to live in Masterton with at that time 18,000 people. I quickly realised that the differences between my past and my future life were sometimes subtle and sometimes not so subtle. In fact making that move over 20 years ago has been a significant influence to my life both personally and professionally.
Learning to live in New Zealand resulted in developing an awareness of cultural differences between people. I had not expected New Zealand to be different from the UK. The road rules and cars, most of the television programmes, the churches, the food, and the music being played on the radio were all familiar. What was most apparent to me though was that people were different; the values, sense of humour, the way they lived, the things they did and the national Kiwi pride. At first all this was rather strange to me, but over 14 years it has shaped my culture.
Culture is dynamic (Watson, 2006), it is ever changing; individuals and communities change over time as a result of different influences. Although some aspects of our culture will stay with us throughout our lives and be passed on to the next generation, we are not culturally stagnant. Watson, (2006) suggests that 'In the modern world [cultural identity] is increasingly complicated and influenced by globalisation. Most people therefore can no longer be regarded as being wholly embedded in a single group or culture, and the idea of many-sided identities has become popular.' (pg 152)
Similarly, professional cultures evolve and are ascribed to the process of socialisation, during training and education and continue through professional practice (Hall, 2005). The culture of occupational therapy reflects the original values of the profession as our inheritance which, over the course of time, has adapted to changes in technologies and social structures that influence the way we live. It is through these cultural changes that the profession endeavours to meet the changing needs of clients, and of the societies in which we work.
This paper focuses on the possible future of the occupational therapy profession as we strive to adapt and respond to demands of the future world. It is a reflection on the cultural changes observed in the profession and the predicted changes that will come. By using the metaphor of steps to envisage our journeys into the future it is proposed that alternative responses to the diverse cultural and occupational needs of people will evolve.
Occupational therapy in a changing world
According to some scientists the world and consequently the well-being of its inhabitants, may be in serious trouble due to a number of factors; Global warming, rising oil prices, water and food scarcity, the growing and aging population, pandemics such as HIV, obesity and diabetes, labour skills shortage, human rights issues such as slave labour and child trafficking and natural disasters such as those seen recently in Myanmar and China. These global issues will influence our futures in unforeseen ways. It seems that many of these issues will directly affect us as individuals and professionals as they will affect the communities that we serve. The demands of the future are as yet unknown so how can we as individuals and as a profession move forward, when we do not see the steps.
At the latest World Federation of Occupational Therapists Congress held in Sydney, Sohail Inayatullah (2006) said of the occupational therapy profession:
In the past few years of professionalisation what has been
pushed away has been the social justice self, the politics
of a globalising and inequitable world. …