Short History of OTASA

How it all began

In January 1942, during World War II, two pioneering Occupational Therapists sailed from Britain for South Africa to establish the first training course at the University of the Witwatersrand, as well as the first OT Department at the Johannesburg General Hospital, then situated on Hospital Hill. On the way their ship was torpedoed, and they lost literally everything: clothes, books, lecture notes and equipment. They were marooned in Freetown for many months and did not arrive in Johannesburg until late 1942. Nevertheless, the course started as planned in 1943 with six students and Occupational Therapy made its debut in South Africa.

In 1945 the second OT Department was established at Groote Schuur Hospital in Cape Town, under Elizabeth Turner. By this time were three additional OT’s in the country, brought out under the auspices of the Red Cross. They provided occupational therapy services to the large number of injured service men recuperating in military hospitals in South Africa.

In 1945 these five Occupational Therapists met in Johannesburg to form an organization that could speak for all the OT’s in South Africa. They realised that employing bodies were more likely to listen to an organised group than to individual approaches. Thus, the SAAOT (South African Association of Occupational Therapists) was inaugurated with five full members. First, second- and third-year students attended this inaugural meeting. From the beginning of the Association, the constitution stipulated that no occupational therapist could be excluded from membership on account of race.

From a modest beginning the Association and the profession grew year by year. In 1952 SAAOT was one of the founder members of the World Federation of Occupational Therapy (WFOT), with Vona du Toit, from South Africa, elected as the first Vice-President of WFOT.

In addition to the education programme offered at the University of the Witwatersrand, further programmes were established at Pretoria in 1955, Stellenbosch in 1961, University of Cape Town in 1972, University of the Free State in 1976, MEDUNSA in 1976, University of Durban-Westville in 1977 and University of the Western Cape in 1980. In the 1976 it become compulsory for occupational therapists to register with the South African Medical and Dental Council as an auxiliary profession contributing to medical and rehabilitative health.

The Association recognised the need for trained occupational therapy auxiliary workers (i.e. OTA’s). In-service training at various hospitals was encouraged and facilitated. Later, training was moved to Technikons and particularly Tshwane University of Technology (TUT) trained many OTA’s. This training was stopped when the Occupational Therapy Professional Board required that the training be extended from a 120 to 240 credit course. Regulatory difficulties hindered the registration of these courses within the South African National Qualifications Framework (NQF), although all OTAs were given the opportunity to upgrade their qualification to an occupational therapy technician (OTT) by passing a professional board examination process.

In the seventies and eighties, the profession expanded and together, resulting in more occupational therapists working in private practice. Throughout this time service development was constrained by the laws of the apartheid regime. The majority of occupational therapists were opposed to those regulations, as they affected equitable health care and delivery of occupational therapy services to all that needed it. At Groote Schuur Hospital all races were treated but cared for in separate wards. However, due to an acute shortage of space, all races were treated in the same area at the same time in occupational therapy. A similar situation existed at Conradie Hospital, the only specialised spinal unit, and all patients were treated together.

In 1986 a motion was put to the WFOT Council by Denmark that South Africa, who was a founder member of WFOT, be asked to withdraw their membership until apartheid was abolished. This motion was not approved and an alternative motion was approved for a delegation to come to South Africa to investigate the training, service delivery, the role of SAAOT and its members in health service delivery; and what assistance could be provided to enable fair and equitable occupational therapy services to the persons served and to address racial inequities within the profession. This lead to a statement of intent which was developed by SAAOT in 1987, which had two major objectives: to take on an advocacy role for change and to promote an integrated and equitable occupational therapy service for all South Africans; and engage with all with all occupational therapy practitioners of all cultural and racial groups to equalise conditions of service. This was circulated widely and published in the SAJOT 1986, issue 2, volume 6.

By the 1990’s socio-political pressures for change increased and occupational therapists and other health professionals protested about the inequitable, deteriorating segregated health services. Members were growing increasingly dissatisfied with the slow pace of change and were demanding progressive reform. This led to a national strategic planning session and at the 1996 Council meeting, with Ruth Watson as President, a motion was passed to accelerate a transformation process for the association and the profession. In 1997 OTASA made a submission to the Truth and Reconciliation Commission.

In March 1997 a general meeting of all Occupational Therapy staff, whether members of the Association or not, was called in Cape Town and a small committee was elected to develop a proposal for reform. This committee was named the Transformation Committee and given the task of steering the transformation process, which included collecting information and suggestions from all regions where meetings and workshops were held. In December 1997 a General Forum was held in Cape Town with representatives from all occupational therapy constituents. A new constitution was drafted, and a name change suggested: SAAOT to Occupational Therapy Association of SA (OTASA). The word change from occupational therapists to occupational therapy emphasised that membership was open to all occupational therapy personnel as well as to auxiliaries, so that all people involved in the delivery of occupational therapy services had a say in the running of the Association. At the national Annual General Meeting in June 1998 the new constitution and the change of name were ratified and so the SAAOT became OTASA.

Having transformed its membership by broadening its membership base, the Association reviewed how its various committees functioned. Plans were made to improve the efficiency of the organisation and specially to improve the marketing of the profession and recruiting of new members. Greater numbers meant a stronger voice for occupational therapy in the country.

At a time when professional unity was a clear goal, the split of SAISI from OTASA created a sense of disunity within the profession. Further divisions within the profession came in the form of competing professional groupings such as INSTOPP and the National OT forum, each with a defined but legitimate agenda but sometimes conflicting voice. This to a large extent has influenced the membership and the focus of OTASA work believed to be important.

Another major development in 1997 was the establishment of a permanent office for OTASA in Pretoria with a paid office manager and assistant treasurer to deal with the everyday running of the business of the Association. This contributed to a marked improvement in the smooth and efficient running of the organisation and took care of all queries from members. The establishment of the OT office centralised many operational functions which had previously been the responsibilities of the branches.

From 1998-2001 OTASA undertook many activities aimed at cultural transition to the goals and aspirations of OTASA and a new logo, representing the diverse nature of OT, its practitioners and there persons served, was accepted. Much work at this time was associated with the socio-political changes in the country and with policy changes implemented by the ANC government such as the National Rehabilitation policy.

The next decade was characterised by a challenging period of transformation. Major reforms to the constitution were made in 2004 and 2006. A clear mission and vision coincided with a restructuring of OTASA to coincide with the transformation in the country and ensuring OTASA followed democratic processes in all that it did. The first OTASA web page was developed at this time. OTASA also contributed to the formation of OT Africa Regional Group (OTARG), a regional group of WFOT at a meeting in Durban.

The association’s history for the next 6 years was characterised by considerable changes in the management systems, structures and leadership strategies to manage the changing and diverse needs and expectations of the OTASA membership in the complex world of practice. In spite of very hard work by some, the impact was limited due to loss of collective identity and unified action.

In 2010 there was a change in the almost the entire national executive. This was due pressures from within the membership indicating concerns with direction of OTASA relative to professional developments and changes related to service delivery imperatives.

The critical issues at this time was firstly the divide between occupational therapists in private practice and those working in the public sector especially with the plans for universal health coverage with a national health insurance funding being discussed. Secondly the need to diversify and expand the membership so that OTASA was able to be the voice of the profession. Steps were taken to create a space for collective discussion and cooperation with the groups within the profession. Positions on the National EXCO were created for INSTOPP, SAISI and the National OT forum to open lines of communication and collaboration on key issues.

The winning of the bid for the WFOT at this time was exciting and challenging. It created a strong emphasis on rebranding to showcase our profession in South Africa as well as repositioning of OTASA with emphasis on embracing of the diversity of our country as well as that within the profession.

This re-emphasised the transformatory nature of the work that needed to be done in representing all within the profession, being tolerant and accepting of divergent views and providing quality professional services that are occupational and evidence based. This started a critical review of the OTASA mission, vision and values under the guidance of transformation experts to facilitate a consultative conversation within the structures of the Association first and then to the membership and all occupational therapy personnel who were not members through the national listening dialogues (NLDs). The analysis of these conversations led to the development of the OTASA strategic plan 2022. The experience of the WFOT congress and the rich discussion resulted in the refining of the strategic plan not so much in the goals but in the activities and the processes to achieve the plan.

A simultaneous process focussed on occupational therapy students and the professional pipeline focussing on student leadership was facilitated by Fatimah Hendriks. This process has led to formation of OTASA students (OTASAS) a formal constituency within OTASA. Free membership was granted to all students to encourage participation in this structure. The first Executive Committee of this group has been elected and branches are being launched at all universities.

Key developments in this period have been:

The purchasing of property as a home for OTASA in Pretoria, but with innovations to enable a virtual office so that work of OTASA can be directed for across the country and electronic meeting held to reduce meeting costs.

In 2018 OTASA appointed a full time COO to manage the growing demands on OTASA to be at the coal face to manage the strategic positioning of the profession in this time of health market change and professional uncertainty with the introduction of the universal health coverage funded by the NHI. The COO has been tasked with corporate governance within the NPO status of OTASA as well as the creation of some sense of unity so that we think and act as one profession with one voice in this critical time of change.

The acceptance of the strategic plan has led to the reorganisation of the National EXCO and the alignment of their responsibilities to the plan for implementation purposes. The portfolios indicate our commitment to the many aspects of NHI preparation, marketing and advocacy and development of all occupational therapy colleagues with a special concern for the need of the OTA/OTTs. All standing committees have been organised into this portfolio structure to align with the goals, activities and deliverables in the plan. Council has had an opportunity to engage with the strategic plan and committees and branches have committed to activities. Roadshows in the branches are planned to take the strategic plan to the members.

Compiled by Joan Davy, Historian of the Association (March 2003).

Updated by Prof Pat de Witt and Elvin Williams (October 2019).

The detailed history of The Occupational Therapy Association is recorded in the coffee table book entitled: OTASA: a remarkable story edited by Rosemary Crouch, the OTASA Historian.

This book was published in 2017 as a commemorative document to coincide with the WFOT Congress that was hosted by OTASA in Cape Town.