OTs in Crisis: A Co-produced Toolkit for Occupational Therapy Practice Across Contexts of Siege, Occupation, Armed Violence, and Humanitarian Emergency

Abstract

Occupational therapy practice in contexts of siege, military occupation, armed violence, and humanitarian emergency, here termed 'crisis OT', is a domain simultaneously ubiquitous in its demand and marginal in its theoretical development. The knowledge base guiding crisis OT has been produced predominantly by researchers and institutions operating at a safe remove from the realities they seek to address, systematically excluding the practitioners whose experience grounds that knowledge. This submission argues that this scarcity is structural and a product of epistemic injustice, the coloniality of knowledge, and the Global South's positioning as a site of data rather than theory generation. Informed by Fricker’s concept of epistemic injustice, Connell’s Southern theory, Haraway’s situated knowledges, Ubuntu philosophy, and occupational justice, this article proposes a theoretical and ethical framework for the co-production of crisis-related occupational therapy knowledge with, rather than about, practitioners situated in contexts of crisis. The OTs in Crisis Toolkit is introduced as a formative, co-produced resource developed with occupational therapists across multiple contexts of siege, military occupation, and humanitarian emergency, governed by principles of contributor protection, equitable attribution, and shared authorship. This perspective calls the occupational therapy profession to account for who is, and is not, in the room where knowledge is made; using crisis as the sharpest illustration of a structural problem that extends across the discipline. It proposes co-production, occupational justice, and ubuntu as the necessary ground for building differently.