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Report of the Second International Congress of the World Federation of Occupational Therapists Copenhagen, Denmark, August 1958 M. THELMA CARDWELL O.T. It has been an honour and a very great privilege to attend the Second Congress of the World Federation of Occupational Therapists from the 11th to the 16th of August, 1958. I would like to take this opportunity to express my sincere appreciation to the Canadian Association of Occupational Therapy for this very gratifying and rewarding experience. The setting for the congress was Denmark's capital, Copenhagen—a city of friendliness for the Danes are a friendly people ; and a city with an infectious gaiety, brimming over from the worldfamous amusement park, The Tivoli. We will always remember the Town Hall Square where the two Bronze Age trumpeters soundlessly blow their lurs in welcome; the sun glimmering on the copper roofs and spires, in particular the Stock Exchange dragons, changing them from green to gold; the Stroget, lined with fine shops and thronged with pedestrians and bicycles. It appears as though the whole population of Copenhagen is on bicycles, rushing through the streets, to the complete amazement of the visitor. We will remember, too, that the surging humanity of the Stroget seemed to belong to another world as we strolled along the peaceful walk by the sea, Langelinie, where the Little Mermaid, created by Hans Christian Andersen for the delight of children the world over, sits

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on a smooth boulder at the entrance to the harbour. It was amid this friendliness, gaiety, novelty and history that the second congress convened in the University of Copenhagen, Anatomic Institute. The double row of national standards of the ten member countries formed a very impressive and colourful entrance to the institute which provided excellent lecture theatres, discussion rooms and exhibit space. An unpredicted large registration necessitated the use of closed circuit television to carry the proceedings into an additional auditorium which the Danish therapists hospitably and unselfishly used. The second congress has been a significant step towards the fulfilment of the hopes and goals of the World Federation. It is encouraging when we realize that it is only seven years since the Preparatory Commission met in Liverpool and in that short period we have experienced two memorable congresses. The growth of the Federation in that time is evidenced in the necessity of closing régistration several days prior to the congress when the membership reached seven hundred. These seven hundred represented thirty-three widely scattered nations and were meeting for a week with a common interest and a common purpose—Occupational Therapy as a Link in Rehabilitation. It was a proud moment for the Feder-

Presented at the Annual Convention of the Canadian Association of Occupational Therapy, London, Ontario, October, 1958.

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ation when Her Royal Highness, Princess Margaretha of Denmark entered the auditorium for the opening ceremonies. We will remember with pride her kind patronage of the congress and her gracious presence among us. We were proud too, to have, on this occasion, the presence of Countess Bernadotte of Sweden and the inspiring and informative addresses of welcome from Dr. Johs. Frandsen, Director-General of the Danish Health Service and President of the Congress, and from Mr. Julius Bomholt, Minister of Social Affairs. It was a privilege to have Dr. R. M. Malan, representative of the Secretariat of the European Regional Office for Occupational Health, World Health Organization present at our meetings during the whole week of the congress and at many of the social functions. The interest in the congress at this level was encouraging and is indicative of the growing recognition of the Federation in the health and welfare programme of the world. An interesting innovation for many of us at the opening ceremonies was the music provided by a Danish string quartet. During the afternoon session the members of the congress received reports of recent developments in occupational therapy in each of the ten member countries —Australia, Canada, Denmark, Great Britain, India, Israel, New Zealand, South Africa, Sweden, and the United States of America—and in the three countries whose memberships were pending at that time, Norway, West Germany and the Netherlands. It was encouraging to hear of the continued progress in occupational therapy during the

past four years—the increase in literature, the development of new services, the improvement in educational programmes, the increase in the number of schools, the increasing emphasis on research and the representation on health organizations at both national and international levels. The circling of the globe was completed at this session so aptly listed as Occupational Therapy 'Round the World with the greetings brought by members from those countries which are not yet members of the Federation but which had representation at the congress. The focal point of the congress was the presentation by international authorities of scientific papers which reflected the knowledge and observations, the progress and philosophy of rehabilitation in many countries. The thirty-two papers covered many areas in the all-embracing subject of rehabilitation under the broad headings of Physical Disabilities, Rehabilitation of Children, Psychiatry, Neurology and Geriatrics. At the final lecture session a panel composed of a physician, a psychologist, a nurse, an occupational therapist, a physical therapist and a social worker discussed "How to Establish the Ideal Team Work in Hospital and Institution". It is not possible to give details of this important material in a report nor is it necessary as the papers will be published in full in the Proceedings of the Congress which will be distributed free to all 1958 members of the World Federation and will be available to other members of the, Canadian Association through the national office at a nominal charge. The Proceedings which will be available

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shortly will bear witness to the detail with which the subject Rehabilitation was discussed and the wide range of interest provided by the congress. During the papers we heard many factors which are not new concepts but which are sufficiently important that emphasis was placed on them again and again, not only in the formal presentation but very frequently in the discussion groups as well. Has this emphasis an additional, deeper implication worthy of thought? Is it that we are allowing these familiar concepts to remain only as theory and not carrying them through in practice? Team Work—how frequently we hear this term—how frequently it appears in our professional writings. The continued re-emphasis would appear to indicate that, for some reason, the team is not functioning as effectively as it should. The services of the various disciplines are being provided in the hospitals and in the clinics but are the members of the disciplines working as a team or are they continuing to work independently? Are they planning together a programme for the patient, each being encouraged to contribute fully of his experience in the planning, or are the services being ordered and then carried out in isolation, ignorant of the total plan for the patient and ignorant of the function and contribution of the other services? Is each member making the contribution that he should and is his contribution of the newer trends interpreted so that it is acceptable to the other members of the team? Are the contributions then being co-ordinated and

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used to the best advantage? We know that the patient is an essential member of the team. Is each member motivating the patient and gaining his co-operation so that he is an effective member of that team? We all know the answers to these questions which give the true concept of the rehabilitation team but if it is to function efficiently and effectively in providing the best services for the patient then we must further examine the team to assure that we are giving more than mere lip-service to the concept. The importance of the psychological aspect of treatment in all disability fields was emphasized by many of the speakers from the medical profession. This is not new to us but the emphasis was stimulating and timely for I believe that, in Canada, we have recently had the tendency to minimize the importance of the contribution of occupational therapy in this aspect in an attempt to emphasize the contribution in other areas. While this could result in neglect to interpret its true meaning, I am inclined to believe that the almost apologetic attitude towards it, at times, implies a lack of true conviction of its importance. 'We must heed the warning to keep a true perspective and a balanced interpretation in all areas. Research is another area in which we are challenged. We are all aware of research which is taking place but unfortunately it is in isolated instances. We heard frequently at the congress that we must not only know WHAT we are doing but WHY we are doing it. If occupational therapy is to continue to progress, and if there is to be

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that the problem confronting a member of our profession in another country is a problem which we share. We also realized that the ideas exchanged and clarified while discovering a solution to a problem improves our own professional capacity. The scientific exhibits and demonstrations provided further factual information on methods of treatment and gave striking evidence of the progress being I do not intend the fore-going thoughts made in rehabilitation of the handicapped as criticism of our profession for the in many countries. The exhibits which thought-provoking material was not pre- were extremely well assembled represented in that way in any instance at the sented a great deal of time and work in congress, and we certainly heard through- those countries responsible for their proout of progress in occupational therapy; duction. They were a real contribution of instances of ideal team-work, re- to the congress. search, etc.; but rather it is my intention A daily schedule of films of profesto give you an idea of the thinking stim- sional interest was available for viewing, ulated by the congress and which is so showing aspects of treatment in various valuable in preventing a profession from disability areas in South Africa, United remaining, self-satisfied, on a plateau. States of America, The Netherlands, Germany, Denmark, Canada, Scotland, A very important contribution of the India, England and Israel. The response formal presentations was the stimulus to requests for films and slides discloses which they provided for informal discusthe interest in this means of recording, sions. The "give-and-take" discussions interpreting, educating and publicizing. which result during a meeting of so many Unfortunately, due to the limited time people are perhaps the greatest value and for showing, only fifteen of the many significance of an international meeting. Three mornings during the congress excellent submissions could be used. formal discussions were arranged on var- Canada was very proud to contribute the ious topics—Training, Rehabilitation of film "Teamwork in Action" by the Children, Cerebral Palsy, Rehabilitation Workmen's Compensation Board of Onof Psychiatric Patients, Old Age Prob- tario which had been chosen from among lems, Sheltered Workshops, The Pay- forty-seven films from seventeen counment for Occupational Therapy, and tries for the International RehabilitaResearch. The discussions provided the tion Film Award at the 1957 Congress real opportunity for international under- of the International Society for the Welstanding and help in solving each others fare of Cripples. The Danish therapists arranged for problems. We realized more thoroughly

steady advancement we must investigate and analyze our methods and procedures; there must be follow-up data and the application of accepted findings; we must develop new techniques. There was the suggestion that we, as occupational therapists, must stop being afraid of the term "Research" and that we must start presenting scientifically proved information in order to make what we are doing valid.

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one complete day of the congress to be devoted to separate study visits to hospitals and rehabilitation centres. This was a means of sharing with us the many aspects of treatment used and the facilities available for rehabilitation in Denmark. Again, as in the whole congress programme there was a wide area of interest provided with thirteen visits to choose from. The sight-seeing tours arranged in conjunction with the hospital visits added to the enjoyment of the trips. For those members who felt that they needed a rest from professional endeavour at this time there were six sightseeing tours arranged in and around Copenhagen. Although the study course, arranged by Great Britain on behalf of the World Federation, was not part of the congress proper, I would like to mention it at this time as it was arranged immediately prior to the congress for the privilege of those members who wished to participate. A group of therapists in London planned the course for July 30th to August 5th and in spite of a small registration due to problems and changes in the initial plans which caused a delay in the publicity, the participants reported a varied programme of hospital visits followed by discussions which provided a very stimulating and successful course. The final session of the congress on Saturday afternoon was the General Meeting, at which time the SecretaryTreasurer presented a report of the activities of the Federation over the past four year period and a report of the Council meetings held in Copenhagen prior to the congress.

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The Council, which is the policy-making body and directs the affairs of the Federation, meets every two years. The 1958 meeting convened on August 7th, 8th and 9th, with additional meetings during the week of the congress. This was the largest meeting of the Council thus far with full representation of one delegate and two alternates from Australia, Canada, Denmark, Great Britain, Israel, New Zealand, South Africa, Sweden and the United States of America; one from India; and one observer from each of Norway and West Germany—a total of thirty delegates from a possible thirty-two which is an impressive record. I would like to sincerely thank Miss LeVesconte and Mrs. Smith for the encouragement and the assistance which they so generously and graciously gave me during the meetings and for the contribution which they made to the Council. I am not including a report of the Council meetings in this report of the congress as the official summary of the minutes will be published in the Canadian Journal. I urge you all to read the minutes, when they appear, very carefully and give some thought to the discussion which has gone into each of the decisions so that you, as a member of your profession, are familiar with the activities of your international organization. An important part of the congress was the social functions which afforded an opportunity to partake of Danish entertaining, to see Copenhagen's beautiful buildings and a further opportunity to make and renew friendships. The social

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side was introduced with a reception at the National Museum given by the Association of Danish Occupational Therapists when the sombre music of the ancient lurs heralded the arrival of Princess Margaretha. The lur is a prehistoric, very long twisted trumpet which, I understand, is brought out of the museum on certain highly exceptional and solemn occasions. The Mayor of Copenhagen welcomed the members at a civic reception in the Town Hall which is a beautiful building, richly decorated with sculpture and paintings. The Ministry of Education gave a reception at the New Carlsberg Glyptotek Museum —a sculpture gallery founded by Carlsberg Brewery and housing large collections of both ancient and modern sculpture. The appropriate liquid refreshment was donated by the founders of the museum for the occasion. Wednesday was the banquet, the social highlight of the congress. The Danish national custom of banqueting was a delightful change to what is routine to us. There is no head table as such but the honoured guests are seated at a table in the centre of the room with the other guests—and there are no after-dinner speeches! The beautiful decorations of the banquet tables were enhanced by the colourful and elaborate national dresses worn by members from various districts in Denmark, Norway, Sweden, Greenland, Iceland, Switzerland, Nigeria, Ghana, India, etc.

We soon learned not to have dinner before going to an evening reception.

A report of the congress would not be complete without expressing sincere thanks to the committee of Danish therapists who made the congress possible. A congress of the size and the calibre of the one in Copenhagen does not just happen —it takes years of planning, the enlisting of help from families, from friends and from organizations. We know that each therapist on the committee must have given very generously of her ability and of her personal time to achieve the very high degree of organization and the attention to detail which was so apparent throughout the congress. In carrying a task of such proportions through to the very successful climax they have made a great contribution to the World Federation and to our profession. What has been the significance of the congress—to the members—to the patient —and to our profession? It is very difficult to convey the stimulation and rich experience of an international meeting. To those who attended it has been a meaningful and productive experience. We have gained new knowledge. We have had an opportunity to reaffirm our ideals and to set new ideals. We have had the impetus of meeting and enjoying a closer relationship with our colleagues around the world which makes it possible to more easily share our knowledge and our skills. We have broadened concepts Denmark is famous for the original- of health and welfare services and a new ity and the novelty of the "Smorrebrod" and refreshing sense of belonging to a or open sandwich. To the visitor it is world community. I think, too, that an magnificent but the variety and abund- international meeting gives the particiance is, at first, somewhat overwhelming. pant a greater tolerance of another's op-

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inion and a certain humility. Sir William Osler, philosophizing on the virtues of international travel and meetings, once said: `[We] can find at home laboratories and hospitals as well equipped as any in the world, but [we] may find abroad more than [we] knew [we] sought—widened sympathies, heightened ideals and something perhaps of a Weltcultur which will remain through life as the best protection against the vice of nationalism". To the patient the congress cannot help but mean better and more effective rehabilitation. Seven hundred people met for a week sharing their knowledge and their philosophies—they were combining their resources for the welfare of their patients. They would return to hospitals and to clinics with new knowledge, renewed e ff orts, and with the inspiration and challenge of the meeting to provide the best service possible for each patient. To the profession, the congress has been concrete evidence of our growth. In 1954, 425 members registered for the congress in Edinburgh; in Copenhagen, the registration was closed at 700. This membership represented an increase from twenty to thirty-three in the number of countries present. In this same period there has been an increase from fifty-two to sixty-two schools of occupational therapy and an increase from ten to twelve member organizations of the World Federation. Perhaps there is a tendency for us in Canada to take our membership in the Federation for granted. But we were made to realize the significance of a membership when delegates from non-member countries rose, one after another, during

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the Monday afternoon session and, in bringing greetings to the congress, expressed very sincere hope of membership in the Federation by the next congress. To each of these countries the World Federation is a very strong incentive to establish occupational therapy in their country on a sound basis. To these people the Federation is something tangible —a reality toward which they are striving. Those of us who were present at this very moving experience could not help but realize how important our membership is. It is through our membership in the World Federation and through its affiliation with other international organizations that we have the privilege of contributing to the health and welfare of all countries ; and it is equally through our membership that we are gaining further strength for the development of occupational therapy in our own country. The congress has given further recognition to the Federation and thus to our profession in the health field of the world at both the national and international levels. It has also given us an awareness of the magnitude of the area in which an international organization has responsibilities. The strength and effectiveness of the international organization in carrying out the responsibilities is dependent on strong national organizations which in turn are dependent on therapists who have a true conviction about their work, what they individually have to contribute, and what their individual responsibilities must be. We are still too close to the congress in time to assess the full significance of it but we do know that the congress was a truly dynamic and memorable event.