The political construction of occupational therapy in South Africa: critical analysis of a curriculum as discourse
Van der Merwe, Tania Rauch
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Does the occupational therapy curriculum strengthen the reproductive machineries of the departments, and by extension the universities in which they are located? Are the patterns of inclusion and exclusion a function of curriculum? This is the key interest of the study, especially since developments post-1994 in South Africa indicate that transformation in higher education has been painfully slow. This is particularly so in the profession of occupational therapy and its academic departments, both in terms of prevailing surface patterns of homogeny and implicit exclusionary practices. At the particular historically Afrikaans-medium University which is the focus of this study, 95% of students are white and female, a pattern that is mirrored in the demographic representation of lecturing staff, in spite of regulatory imperatives and multiple institutional efforts to recruit student applicants and staff from diverse backgrounds. Though white South Africans nationally constitute 8,9% of the country’s population, about 60% of all occupational therapy graduates are white and female, a pattern this study is probing at the level of curriculum. The core values of the occupational therapy profession include a commitment to occupational justice and, at least in theory, a highly reflexive-responsive attitude when judging the paradigms shifts occurring over less than a century. Nevertheless, there is increasing evidence that the profession is grappling with its Eurocentric origins and their taken-for-granted, embedded norms. The profession is confronted by perceived patterns of (un)just exclusion/inclusion against a backdrop of calls for the decolonization of curricula. These enduring, semi-permanent patterns, with their racialized outcomes in the South African context, call for a deeper analysis of the role of curricula in the continuous underrepresentation of black students, particularly male students, in the profession. My study is anchored in a post-structuralist critical theory paradigm. I draw upon a Foucauldian discourse analysis (FDA) approach which includes an archaeology-analysis and a genealogyanalysis. I treat curriculum as both the discourse and the interface between the conditions of possibility, that is, the rules of formation for how knowledge comes into being and how it is reproduced through the technologies (rationalizations) of power and self. Data sources for the archaeology-analysis included commemorative documents of universities on the origin of their programmes; historical international, national and institutional regulatory documents; and the South African Journal of Occupational Therapy archive from 1953-1994, with specific focus on the Vona du Toit memorial lectures. In the genealogy analysis, the lens of ‘layers of curriculum’ is employed: the formal, the informal, the hidden and the negated curriculum. This approach was chosen to show how some patterns discontinue while others persist through rationalizations of power and inventions of the self as a legitimate bearer of knowledge. The study consists of two in-depth analyses, the methods of which emerged through a prolonged critical engagement with the existing literature. An archaeological excavation was carried out on the construction of the rules of formation of knowledge – specifically as it came about in South Africa in the historical context of post-/neo-colonialism and apartheid. In this instance, the reproduction of these rules is situated within the specific current occupational therapy curriculum at a historically Afrikaans-medium university. The genealogy-analysis is innovative, since it not only problematizes the (student as) object that emerges from the rules of formation but also extends its enquiry to the rest of the constituents of the rules of formation of knowledge: enunciative modalities, concepts, and strategies. Within the archaeology-analysis, eight main themes and eight subthemes were excavated. Examples of the main themes, as part of the formation of the object, include ‘the occupational therapist as a white female’ and ‘white exceptionalism’. With the formation of enunciative modalities, the role of regulatory bodies and their historical origin, together with contextually situated subject positions, the bedrock of a Victorian familial trinity emerged: the ‘medical doctor as father’, the ‘occupational therapist as mother’, and the ‘patient as child’. Concerning the formation of rules for concepts, the findings include the political ambiguity of the profession prior to the country’s democratic election, together with a rich ‘know-how’ basis that affirms its pragmatic roots. In terms of the formation of rules of strategies, the themes of holism and the need for recognition of the profession’s ‘uniqueness’ unfold in this part of the inquiry. In the genealogy, the critical analysis shows how the historical norms of geo-politically bounded white demographics, seen as a dominant epistemological marker, are reproduced through rationalizations and notions inter alia of exceptionalism and meritocracy, as well as the ideological imperatives of docility as virtue. In terms of the repetition of enunciative modalities, the reproduction of the taken-for-granted discourse of hierarchy based on paternalism is illustrated in student discourses, for example on the constitution of the student association. With regard to the reproduction of concepts, the reification of the negation of political clarification, pertaining for example to decolonization, is highlighted by showing the rationalization of monocultural epistemologies, with epistemic silence that may lead to epistemic injustice. Turning to the formation of strategies, the tension between the philosophical underpinnings of holism and the limits of occupational therapy practice and core aspects of curriculum are pointed out. The study shows that by viewing curriculum-as-discourse, the historical markers for the reproduction and reification of unjust patterns of inclusion and exclusion can be archaeologically excavated. By framing curriculum-as-discourse, one is able genealogically to identify the modes of rationalization that maintain such patterns. In this way, a curriculum may be reconceptualised so that it is built on epistemic freedom, making it contextually relevant to socially just education and practice. A thorough, non-authoritarian self-reflexivity about the contextual, historical origins of (a profession’s) ways of thinking, speaking and doing, together with the ability to ideate new narratives, are important aspects in achieving self-determinacy and liberating the profession and its knowledge from its colonial and apartheid past. Perhaps, in such a way, we can create an orthogonal disruption that can go some way towards generating something new, not merely (re)producing another pathway heading for the same destination.