By Dr. Ashley Subbiah
The global conversation around disability and accessibility is changing rapidly.
Artificial intelligence can now describe images, summarise documents and assist with navigation. Smart glasses can identify objects and provide environmental information. Refreshable braille displays connect seamlessly to smartphones and computers. Mainstream mobile devices increasingly include accessibility features that were once available only through specialised assistive technologies.
These developments are transforming opportunities for blind and partially sighted persons worldwide.
Yet amid the excitement surrounding technological innovation, an important question remains: who ensures that people have the skills to use these tools safely, effectively and meaningfully?
The answer lies in a profession that remains one of the most critical, yet often overlooked, components of visual impairment rehabilitation: Orientation and Mobility (O&M).
South Africa’s Orientation and Mobility profession recently reached a significant milestone with the formal recognition and registration of O&M Practitioners through the Health Professions Council of South Africa (HPCSA). Following more than a decade of advocacy by the Orientation and Mobility sector, formal recognition of Orientation and Mobility Practitioners was achieved when the Minister of Health promulgated the relevant regulations on 13 December 2024. The HPCSA subsequently operationalised the registration process through the establishment of the Orientation and Mobility Register in March 2025, enabling practitioners to register under a recognised professional framework. The profession now has a recognised regulatory framework that establishes professional standards, qualification requirements and accountability mechanisms.
This achievement is more than an administrative development.
It represents formal recognition that Orientation and Mobility is a specialised rehabilitation profession that plays a vital role in enabling independence, safety and participation for blind and partially sighted persons.
For practitioners who have spent decades delivering services in schools, communities, rehabilitation centres and non-profit organisations, HPCSA recognition provides long-overdue professional acknowledgement and creates a pathway towards greater standardisation of services nationally.
However, professional recognition alone will not solve South Africa’s accessibility challenges.
For many South Africans living with visual impairment, access to Orientation and Mobility services remains extremely limited.
The reality is that thousands of children and adults continue to live without access to structured mobility training. Many individuals never receive a formal O&M assessment. Others may wait months or years before accessing services, particularly in rural and under-resourced communities.
Recent reports have highlighted that many visually impaired learners continue to navigate schools and communities without adequate mobility support, despite the central role O&M plays in educational participation, safety and independence. Challenges include insufficient funding, limited practitioner numbers, inadequate service structures and the absence of dedicated posts in many settings.
These challenges are not unique to service users.
A recent South African study conducted by Dr. Michelle Botha (Stellenbosch University), published in the British Journal of Visual Impairment, examining the experiences of O&M practitioners found that professionals face complex socio-economic, emotional and systemic pressures. Practitioners often work within under-resourced environments while supporting individuals with diverse and multifaceted rehabilitation needs. The study further highlighted concerns regarding the historical marginalisation of the profession within the broader rehabilitation sector.
In many respects, South Africa faces a dual challenge: increasing access to services while simultaneously strengthening and supporting the workforce required to deliver those services.
In an era dominated by artificial intelligence and digital innovation, there is a growing misconception that technology can replace rehabilitation services.
It cannot.
A smartphone navigation application cannot teach a person spatial concept.
A wearable AI device cannot replace the judgement developed through structured mobility training.
Smart glasses cannot teach protective techniques, route planning or safe road-crossing skills.
Technology can enhance mobility, but it cannot create mobility competence.
The long cane remains one of the most successful assistive technologies ever developed. It remains affordable, durable, battery-free and universally recognised. More importantly, it provides real-time environmental feedback that no digital system can fully replicate.
The most successful rehabilitation outcomes occur when traditional mobility skills and modern technology work together.
A person who understands orientation concepts, environmental awareness and independent travel techniques will derive significantly greater benefit from AI-powered navigation tools than someone who has never received foundational O&M instruction.
Technology enhances confidence; it does not create it.
Globally, rehabilitation thinking is evolving.
Historically, success was often measured by whether a person could travel independently from one place to another.
Today, success is increasingly defined by participation.
Can a student independently access learning materials?
Can a university learner participate in online education?
Can an employee effectively manage digital systems, emails and workplace technologies?
Can a parent independently manage household responsibilities?
Can a community member fully participate in civic and social life?
These are participation questions.
Increasingly, the answers involve a combination of rehabilitation, assistive technology and environmental accessibility.
A blind university student may use a white cane, smartphone navigation, screen reader software, optical character recognition, artificial intelligence tools and a refreshable braille display within a single day.
A professional may rely on multiple integrated technologies to access information, communicate effectively and perform complex workplace functions.
The goal is no longer simply movement.
The goal is meaningful participation in society.
This shift is also changing the role of Occupational Therapists within visual impairment rehabilitation.
Occupational Therapy has traditionally focused on enabling participation in meaningful activities and occupations. As assistive technologies become increasingly sophisticated, Occupational Therapists are playing a growing role in assessing technology needs, facilitating adoption and supporting integration into daily living, education and employment.
The relationship between Occupational Therapy and Orientation and Mobility is therefore becoming increasingly important.
O&M practitioners help individuals move safely and confidently through their environments.
Occupational Therapists help ensure those individuals can participate effectively once they arrive.
Together, these professions form complementary pillars of independence.
The future of rehabilitation depends not on professional silos, but on collaboration.
Across South Africa, much of the country’s specialised visual impairment rehabilitation infrastructure continues to be delivered by the non-profit sector.
Organisations serving blind and partially sighted persons often provide Orientation and Mobility training, braille instruction, assistive technology support, employment preparation and independent living services.
Yet many of these organisations are operating under significant financial pressure.
Economic constraints, increasing demand for services, rising operational costs and reductions in donor funding are forcing many NPOs to do more with fewer resources.
At the same time, public sector rehabilitation services face their own challenges, including resource limitations, workforce shortages and competing healthcare priorities.
The consequence is a widening gap between need and available services.
Without sustained investment in rehabilitation services, workforce development and assistive technology access, South Africa risks leaving many blind and partially sighted citizens behind.
While the challenges are substantial, the future is also filled with opportunity.
Artificial intelligence is arguably the most significant development in assistive technology since the introduction of screen readers.
AI systems are moving beyond simple information access toward information interpretation.
They can describe photographs, explain diagrams, summarise documents, assist with productivity and support independent decision-making.
Research increasingly points to the role of intelligent assistive technologies in improving autonomy, social participation and quality of life for visually impaired persons. However, technology adoption remains dependent on training, accessibility and the ability of users to integrate these tools meaningfully into daily life.
The challenge for rehabilitation professionals is therefore not whether AI should be used.
The challenge is ensuring that people develop the skills necessary to use AI critically, responsibly and effectively.
The future of accessibility in South Africa will not be determined solely by technological innovation.
It will be determined by policy decisions, investment choices and collaborative partnerships.
South Africa requires a renewed and coordinated commitment to strengthening visual impairment rehabilitation services. This includes greater investment in Orientation and Mobility services, the expansion of practitioner training programmes to address workforce shortages, and the establishment of sustainable funding models that enable rehabilitation non-profit organisations to continue delivering essential services. There is also a pressing need for dedicated Orientation and Mobility posts within education, health and rehabilitation sectors to ensure that services are available where they are most needed. At the same time, access to assistive technology must be expanded so that blind and partially sighted individuals can fully participate in education, employment and community life. Achieving these goals will require stronger collaboration between the healthcare, education and disability sectors, as well as increased public awareness of the value and importance of visual impairment rehabilitation. Most importantly, South Africa must recognise that independent mobility and full participation are fundamental rights that underpin dignity, equality and inclusion, rather than optional services available only to those fortunate enough to access them.
The recent recognition of O&M practitioners by the HPCSA represents a major step forward.
The next step is ensuring that every blind and partially sighted South African can access the professional services, assistive technologies and rehabilitation support necessary to live independently and participate fully in society.
Because while technology continues to evolve, one truth remains unchanged:
Independence is not created by devices alone.
It emerges when rehabilitation, technology, opportunity and human support come together.
* Dr. Ashley Subbiah is the Head of Business Development at Sensory Logix and Sensory Solutions – he leads solutions-driven initiatives focused on expanding access to assistive technology across education, government, corporate, and community sectors in Southern Africa. His work centres on strategic partnerships, accessibility innovation, Braille literacy, digital inclusion, and the development of scalable assistive technology ecosystems that promote independence and inclusion for persons with disabilities. *