Culture and occupational therapy: meeting the challenge of relevance in a global world Culture is fundamentally important to this great profession. The eminent place of culture in occupational therapy is embedded -almost hidden -in its magnifi cent promise; to enable people from all walks of life to engage or participate in activities and processes that have value. This seemingly simple, yet powerful, promise is a complex challenge and has a bearing on the viability of occupational therapy both locally and across social and geographical frontiers. The diversity of humanity represented in both occupational therapists and clients of occupational therapy, and in the dynamic of assessing value to objects and phenomena in human spheres of experience, are essentially conditions and processes relating to culture. The value of occupational therapy to society hinges on how relevant (Iwama, 2003) occupational therapy is to our clients' occupational needs and day to day realities. It forms a basis to the important issue of relevance that may ultimately determine the value of the profession in an increasingly global world.
The essence of the promise of occupational therapy compels us to comprehend culture and its place in the fl ow of this profession in a much more profound way. Until recently it has been much too easy to limit and discourse culture as being synonymous with matters of race and ethnicity, locating it as a static marker of distinction in our clients, and conveniently as a dependent variable in our empirical enquiries. It is hoped that studies which admonished therapists to treat patients categorized along ethnic groupings in a certain special way, or broader health studies which tied treatment outcomes to racial markings, are on their way out. These approaches characteristically tended to situate the 'problems' of culture and relevancy of occupational therapy squarely on the individual therapist and individual client, consequently removing the profession of occupational therapy itself and the contexts of its knowledge, theory and practices from critical scrutiny. In such cases, matters of relevance had much to do with how our clients might be 'cultivated' to meet the cultural norms of occupational therapy and perhaps less with how occupational therapy and its agents might be cultivated to comprehend the needs of our clients' unique worlds of day to day living.