CULTURE AND DISABILITY

by Michael Eskay, Samantha Gardner, and Suzgo Nyirenda

Loyola University Chicago, 1998

Introduction

This paper [written for a class on multiculturalism taught at Loyola University Chicago by Fr. W. Krolikowski and Dr. T. Wren in the spring of 1998] was developed on the basis of a critical examination of literature on disability and culture, as it was presented by Benedict Ingstad and Susan Reynolds Whyte (1995) in their book Disability and Culture. The book, a collection of twelve ethnographic essays, was looked upon as an important source for understanding disability in the context of different cultures, as it discussed disability in terms of social processes from a global, multi-cultural perspective. Moreover, disability in this text was presented in the context of routine social interactions between those who were disabled and those who were not.

Specifically, our focus was on how disability was defined, understood and given meaning in a culture; how that understanding affected the recognition of the disabled, and how that recognition determined the extent to which essential services and support were provided to the disabled. This paper was developed on the assumption that the meanings given to personhood and humanity will to a large extent influence the recognition of the disabled. The dominant culture's recognition of the impaired person as 'disabled' will determine the availability and quality of education and other important services received by the impaired that enable them to live a 'normal' life in society.

We fully recognize that there are various kinds of disabilities, broadly categorized as physical, mental or intellectual, and emotional; however, for the purpose of having a focused discussion of culture and disability, we dealt more with those disabilities that were visible, because those were the disabilities that Ingstad and Whyte dealt primarily with.

This paper is organized into three major components. The first component provides an examination of the concept of disability and culture. The second component presents a discussion of the common concepts found across multiple cultures. The third component entails a discussion of the services available to the disabled, both in educational and non-educational settings. A summary and recommendations follow the conclusion of the major components.

Part I. Culture and Disability

Culture

Although Ingstad and Whyte dealt in depth with the issues of disability and culture, they did not adequately and concisely provide a definition of what was meant by the term 'culture'. We will therefore attempt to provide a definition, based on the reviewed literature, before we proceed. The concept 'culture' has many versions in its contemporary use. If used metaphorically, culture may be used to sometimes mean an attitude, sometimes a fashion, sometimes a behavior, and sometimes a way of doing things.

It is common nowadays for a new design of clothing to be marketed in a way which allows the wearer to dress in a trendy style and to express cultural pride. For example, in South Africa in 1994, the popular government attempted to ban the Zulus from carrying spears, shields, and machetes in political rallies. The latter responded that they should be allowed to carry the items because they were 'cultural' weapons. Today, the academic world and the mass media is full of stories with reference to 'youth culture,' 'political culture,' or 'organizational culture.' The term culture has become so trendy that it is used as a substitute for more specific words.

Anthropologists reference culture as a total way of life for a society, its traditions, its habits, or beliefs. In this line, LeVine (1984, p. 67) sees culture as "...a shared organization of ideas that includes the intellectual, moral and aesthetic standards prevalent in a community and meanings of community actions." In a similar conception, Geertz (1973, p. 89), points out that culture

denotes an historically transmitted pattern of meanings embodied in symbols, a system of inherited conceptions expressed in symbolic forms by means of which men communicate, perpetuate, and develop their knowledge about and attitudes toward life.

Based on these two conceptions, we could say that culture denotes an identifiable pattern of behavior exhibited by people in response to diverse phenomena in their environment and the meanings they attach to that encounter. People create meaning from their interactions with their environment, thus developing a philosophy from those meanings about man, nature and life, which acts as a reference point in all matters pertaining to the essence of that society. Because a culture is learned, it varies over time. At the same time, however, culture has certain constant features, including language, which differentiates it from other cultures in other times or places. Thus, the Anglo-Saxon American culture of a hundred years ago may not be similar to the one that is here today; it retains certain constant features that identify it from other cultures in America. A culture is, therefore, defined by its differences and exclusions.

Culture has a normative role in a given society (Goodenough, 1963 p. 259). It consists of standards for deciding what is, standards for deciding what can be, standards for deciding how one should feel, and standards for deciding how to go about daily activities. Meanings that are conveyed in a culture and the tested practices are central in setting these standards. Cultures, therefore, determine what is right or wrong in a given society. In the case of individual members, cultural standards define various matters, including what it means to be a person or human being, the value placed on gender, the value placed on children, and the value placed on the old. In the same vein, culture may also determine whether members are categorized in groups or perceived as individuals.

Societies may be categorized as being either 'mono-cultural,' meaning there is only one culture, and bi-cultural or multicultural, meaning that the society exhibits more than one culture. Large and small-scale societies typically display signs of being both mono and multi-cultural. As an example of a large-scale society, the United States at the macro-level displays a 'mono-culture' in the sense that there is one culture that describes the U.S. In other words there is a macro-culture to which every US citizen subscribes. However, within this macroculture, we find micro-cultures represented by the people of Irish, Greek, African, Polish, Anglo-Saxon, Mexican, and Native American descent. Thus, the U.S. is mono-cultural at one level and multi-cultural at another level.

In small-scale societies, for example, it is common to refer to the Bali of Indonesia, or the NQoni in Tanzania, or the Zulu in South Africa as single cultures. However, on closer examination, even these small-scale societies may be 'multicultural' on the basis of clan values within the society.

Disability

In an attempt to define disability one encounters problems of coming up with a definition that would be applicable to all cultures, and as such the definition is constantly evolving. The World Health Organization, as cited by Ingstad and Whyte, has put forth a definition that has gained international acceptance. The concept 'disability' is usually discussed alongside its related concepts of 'impairment' and 'handicap.' Impairment is defined as 'any loss or abnormality of psychological, physiological, or anatomical structure or function' (Ingstad & Whyte, p. 5). While impairment relates to constituents of the body (the 'organ' level), disability relates to the compound or integrated activities expected of the person (i.e., tasks, skills, behavior). Disability is defined as "any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being" (Ingstad & Whyte, p. 5). A person is considered either disabled or not, depending on the extent to which he or she can function in the given society. The term, therefore, refers to a number of different functional limitations that one can observe in any population, in any society. Handicap relates to the social consequences of deficiencies in organs and activity performance. It is defined as 'a disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfillment of a role that is normal for that individual' (Ingstad & Whyte, pp. 5-6). The meaning of handicap, therefore, focuses on the shortcomings in the environment and in many organized activities in society, which prevent persons with disabilities from participating.

Disability, unlike impairment and handicap, is a learned social role. According to Becker (1963) and Scott (1969), disability, like all other forms of social deviance, can be viewed not as an objective, physical or mental condition, but as a role into which people are placed. People with disabilities are rewarded for behavior that conforms to social expectations associated with the disability role and punished for behavior that departs from these expectations. In this light, as Murphy (1990, p .4) points out, disability is defined by society and is given meaning by a culture. It is therefore clear that there are various perceptions of what disability is as there are a variety of cultures.

Disability and Culture

The cultural understanding of the concept 'disability' is central to the determination of the position or status that the disabled individuals are given in a specific society. Cultural understanding is also shaped by the meanings attached to the concepts of human being or personhood, by the social and economic organization of a given society, or by other internal and external cultural dynamics.

Ingstad and Whyte (p. 8) note that the conceptions of disability are formed by the conceptions of the person in a culture. The 'person' refers to the evaluation of others as opposed to self-evaluation. Large and small scale societies perceive the concept of disability differently. According to Scheer and Groce (1988, pp. 331-32), in small-scale societies close interactions between individual members are the norm, and each individual may have extended and multi-strand relationships with other members of the society. Individuals may interact in the course of economic production, during leisure time, or while participating in the arts or ceremonies. The social identity of the person in these small-scale societies is based on family clan and other characteristics and not on how the individual looks. Natural integration of the disabled into family life and community activities is the norm in many small-scale societies. The disabled, as we will see in the course of this paper, are viewed as unique individuals and not as persons with disabilities.

In large-scale societies, on the other hand, where social relations and contexts are more impersonal, individuals are not directly related to each other in varied contexts. For example, relationships that begin at work often end at work. Based on the concepts of equality and individual rights, there is a general assumption that people are not different: difference is treated as invisible. Large-scale societies' conceptions of disability are, therefore, formed not from within the general society and the social processes, but "in the context of the centralist state that imposes a universal code through legislation" (Ingstad & Whyte, p. 8). Legislation determines the existence and recognition of the disabled by defining what it means to be disabled, establishing criteria, and determining the classification of the disabled. Legislation also determines the establishment of medical and paramedical institutions as well as educational services. In this way, people with infirmities become a marked group; they are given social identity; as citizens who have the same rights as others and should be integrated like ordinary people. Disability, therefore, in Europe and North America exists within and is created by a framework of state, legal, economic, and biomedical institutions. The concepts of personhood are also inevitably shaped by those institutions. This situation is not helped by the mass media, which according to Ferguson et. al. (1992, p.229), tend to portray the disabled negatively. They note, for example, that stories, be they fairy tales or movies, tend to portray the villain as associated with abnormality, whether physical, psychological, or mental. They also note that there are usually very few positive images of the disabled in the media. The positive images displayed are mainly of disabled children and very rarely adults. This tends to give the impression that the disabled are like children.

Part II. Conceptual Concepts Across Cultures

According to Beatrice Wright (1960), "language is not merely an instrument for voicing ideas but that it also plays a role in shaping ideas by guiding the experience of those who use it (p. 7)." As the literature will attest, when different cultures used positive language to describe individuals with impairments, impaired individuals were integrated into the society (Scheer and Groce, 1988). Whereas cultures, who used negative language to describe their impaired individuals had a tendency to disavow the impaired (Boylan, 1991). This section reviews the key concepts that appeared across multiple cultures, as presented in the Ingstad and Whyte essay selection. Specifically, the following concepts will be reviewed: Body, Identity (stigma), Labeling, Liminality, and Personhood.

Body

Bodies, across cultures were universally recognized as having a purpose, a function, and a value, which aided in the survival and the advancement of the given society. The purpose, and inherently the value, placed upon the body was contrived through a number of factors (i.e., industrialization, social status, or gender). Although the body was capable of having multiple purposes and varying degrees of value, it was perceived as functioning as a complete whole, a oneness within itself. The whole body was perceived as being erroneous if one aspect of the body was amiss. The concept of 'spreading' was applicable to various levels of impairments and in various contexts (physical, social, or events) across different cultures. For example, if a woman was incapable of walking, she was also perceived as being incapable of having children. If a blind person could not see, it was sometimes assumed that he could not hear, though of course there was no necessary connection. The ethnographic essays in the Ingstad and Whyte book provided three different functions of the concept of 'body'; a symbol of physical beauty, a store house for the soul, and a medium for action.

When cultures used the body as an instrument or an outward sign of physical beauty, individuals within that society were seen as focusing their time, energy and efforts to conform to that standard. Individuals were thereby categorized and recognized as conforming or not conforming to that image. Therefore, it would be expected that individuals in key positions representing a particular culture would be considered beautiful and able-bodied. In the United States, for example, individuals in key positions were considered beautiful and able-bodied (i.e., politicians, entertainers, and athletes). Understandingly then, individuals who did not conform, either intentionally or unintentionally, to this physical image of beauty were shunned and or rejected by the larger society. The disabled, individually and as a group, contravened all the values of youth, virility, activity, and physical beauty that most Americans cherished. The disabled were seen as subverters of the American ideal (Murphy, 1987, p. 143).

In the Punan Bah culture of Central Borneo, the body played a different role from that of physical beauty, as exemplified in American society. For the Punan Bah, the body performed the function of a store house for the soul. The emphasis and value in the Punan Bah society was placed on the soul(s) of their people as opposed to the body which stored the soul's). Thus when the body was not normal, due to physical impairments such as blindness, deafness, or motor disability (e.g., limping), the individual was still considered human nor were they held responsible for their condition. Unlike American cultures, where the disabled have a tendency to be shunned, in the Punan Bah culture the impaired were embedded in society. They were expected to partake in all social activities, daily household chores, and work activities, to the extent of their ability. For the Punan Bah, the issue was not with the physical but the spirit which has taken hold of the body (Nicolaisen, 1995 p. 46).

For individuals who were not born with impairments, the process of coming to terms with its impact upon the body involved a huge psychological and physical re-adjustment. Conceived as a medium for action, when the body was no longer able to perform the functions or the roles it had in the past, life ceased to exist as the person knew it. What once was a form of selfidentity (roles and responsibilities conducted by the body) now become subservient to the impairment. Research performed by Monks and Frankenberg (1995) in the United Kingdom, recognized the 'body' as functioning in three different and integrated modes; incarnate, corporeal, and somatic. It was impossible to impact one aspect of the body without intruding upon the ability or the function of the other two modes. The incarnate body encompassed a notion of a historical and actively experienced and experiencing body, in the phenomenological sense of being in the world. The corporeal (or loosely, physical) body referred to a bounded biological entity, while the somatic body was one defined by medical technologies and was usually fragmented (Frankenberg, 1990). According to an account of Monks and Frankenberg's research on the three modes, the following is a description which most newly impaired individual was likely to experience: 'the body-its corporeal or physical aspect-was no longer an efficient and reliable instrument. It seemed to set its own agenda and have its own requirements, which competed with and inconvenienced preferred activities. In that the physical body provided means through which the self, as incarnate body, performed its social roles, these too had to be re-negotiated' (1995, p. 111).

Identity (Stigma)

Identities and stigmas across the different cultures were universally imposed upon the disabled by the able-bodied individuals. It appears, based on the ethnographic essays provided by Ingstad and Whyte, that the values held by society would ultimately determine how the impaired person would feel about themselves and their impairment. Unfortunately there was no middle ground, either the impaired person was stigmatized or they were fully accepted into the daily activities of the given society.

According to Murphy (1995), in the United states, regardless of what the physically impaired person may think of themselves, they are given a negative identity by society, and much of their social life is a struggle against this imposed image. If the person was stigmatized, the impairment was considered their primary identity, while previous jobs, roles, or activities were perceived as secondary or of little importance by the able-bodied community. Cultures that stigmatized impaired individuals created an environment which fostered a preoccupation with the disability. As a result of this stigmatization, individuals with impairments were often cast into the same lot and social status as criminals and certain minority groups: they were all outsiders, deviants from social norms. One's identity as a disabled person became paramount in one's own mind, and the impairment an axiom for one's actions, so too is the other's reaction to the handicapped person overwhelmed by the flaw (Murphy, 140). The other person's reaction to the handicapped person feeds into the insecurities of the impaired individual, thus creating a cyclical process of insecurity, stigmatization, and identity dis-association. In the United States, unfortunately, physical impairments carry the stigma that bad things happen only to bad people, physical impairments were looked upon as something that did not happen to respectable people.

The stigmatization of disabilities was also seen in the cultures of Japan and Uganda. In Japan and Uganda, physical disabilities were believed to have an aura of contamination which surrounded the disabled person and become attached to other family members. This stigma of contamination in Uganda caused the disabled person to become an outsider, or outcast, often times having to fend for themselves for survival. The stigma was believed to linger on even after death.

Cultures that avoided the stigmatization of the disabled had different perceptions of the ability and roles of the disabled. The Maasai of Kenya avoided stigmatizing the impaired, regardless of the extent of the disability. According to research conducted by Aud Talle (1995) on the Maasai of Kenya, physically impaired persons were expected and encouraged to marry, become parents, and participate in all communal activities to the best of their abilities. For the Songye of Zaire, deviations in the body (at birth) can induce a higher, lower, or undetermined status in comparison with able-bodied people. Therefore, not all deviation was stigmatizing, and not all persons with disabilities were marginalized because of their disability.

Research conducted by Frank Bruun (1995) on the disabled person in Nicaragua, showed how disabled war veterans were given a positive identity for their heroic efforts in serving in their country's war. Individuals disabled during the war were regarded in a positive light and given preferential treatment in comparison to individuals impaired by other means (i.e., congenital, farming). Although many soldiers experienced a reduction in their old identity by their inability to fulfill their former roles (through work or in social events), the identity given to them by the government often resulted in a new higher status in comparison to their previous status.

Labeling

Disabled people are as diverse as the rest of the population, both in terms of personalities or impairments, and grouping them together under the label 'disability' encouraged a false homogeneity in perceptions of those people (Lewis, 1995, p.3). The process of labeling did two things. Labeling presupposed a certain familiarity with the contents under the label, and it provided a method for categorization.

Research conducted by Scheer and Groce found that the process of labeling was displayed more often in complex societies, as opposed to small-scale societies. In small-scale societies, during the eighteenth and nineteenth centuries, regular face-to-face contact between community members was the process for communicating and interacting. Individuals were related and connected to each other in diffused social roles and contexts. In such situations, a single personal characteristic, such as a physical impairment, did not generalize to define the persons' total social identity. On the other hand, in complex societies, social relationships and contexts was more impersonal and task specific, and individuals were not related to each other in varied contexts. Accordingly, visible physical characteristics were commonly used to classify and socially represent the individual's identity.

The essay collection of Ingstad and Whyte validated the research findings of Scheer and Groce and indicated that the label of 'disability or handicap' was not a universal concept. A proportion of the developing cultures represented had no formal categorization or label of 'disabled or impaired' in which to describe individuals with body parts that were not functioning to their fullest capacity. More commonly disabled people tended to be addressed and discussed in terms of the specific disability they suffered from. For example, a person missing an arm was often talked of and addressed as gacanley or gacamey, meaning 'armless'.

Liminality

Turner, in 1967, coined the phrase 'liminality', to describe the process of changing status that an individual with a newly acquired impairment would experience, where they were at once no longer classified and not yet classified. It was as if they had lost their old status and had not yet acquired a new one. This process of 'going through' is captured in the phrase 'liminality'. However, within the essays provided by Ingstad and Whyte, the term liminality was used across different cultures and with slightly different interpretations. In interesting notation was the difference in perception of the liminality phase between the able-bodied and the disabled. As liminal people, the disabled comforted each other as whole individual, un-separated by social distinctions, and often exhibited a level of comfort not displayed in other relationships between able-bodied individuals. This lack of clarity on identity and social roles often caused able-bodied individuals to resolve their indeterminacy by segregating or avoiding liminal people (Murphy, 1995, p. 155).

In an effort to understand disability as a social deviancy, Murphy (1988), used the framework of the liminality concept. According to Murphy's research, the life histories of people with disabilities were seen as arrested and dramatized in a 'rite of passage' frozen in its liminal stage. Liminality, a concept closely related to rites of passage, had three phases: isolation and instruction of the initiate, ritual emergence, and reincorporation back into society in the new role. It was during the transitional phase from isolation to emergence, that the person was said to be in a liminal stateliterally, at the threshold-a kind of social limbo in which the impaired person was left standing outside the formal social system. Thus for a newly impaired individual their state of being was clouded and indeterminate, falling ambiguously between sickness and wellness, living and dead, participation and exclusion (Murphy, 1995, p. 109).

Monks and Frankenberg's usage in the United Kingdom, on the other hand, referred to liminal phases of expressive quality within the course of disablement or chronic sickness. It provided a framework for comparison which highlighted the procedural nature of sickness and incorporated the personal endeavor as well as social constraint (Monks & Frankenberg, 1995, p. 109). In their research findings on multiple sclerosis (MS), the term liminal was used to describe a period of hospital admission or other seclusion from previous routines. This seclusion from life or the daily routine was often sparked by perceived changes in the physical body of a person with MS (multiple sclerosis).

The concept of liminality varied even more when used in smallscaled societies in comparison to complex societies. For disabled children in the Songye culture, their condition was considered liminal and not their personhood. For the Songye, the issue was not the visible disability, but a solution for solving the disability. Thus a person with a disability was not seen as abnormal, marginal, or deviant, but was seen as having potential with a right to development (Devlieger, 1995, p. 96).

Liminality within the Punan Bah culture, similar to Songye, had nothing to do with disability, but with either kinship or personhood. Failure to marry or have children placed a person in a liminal state, where they were neither child nor fully adult but an in-between person, a child-woman, or child-man (Nicolaisen, 1995, p. 50).

Personhood

Whyte categorized the concept of personhood into three different dimensions or into three different characteristics. Personhood was characterized as something that an individual could deny another person from having, similar to that of individuality, respect, or livelihood (Ingstad & Whyte, 1995, p. 276). In other contexts, personhood was described as having a cultural dimension which was seen as central to the cultural understanding of disability, and was characterized as a phenomenon that was capable of being shaped (Ingstad & Whyte, 1995, p. 285).

As with previous concepts discussed in the context of multiple cultures, the concept of personhood also took on different connotations as represented in the essays collected by Ingstad and Whyte. It is important to note that there was a fine distinction between the connotations of personhood in smallscale societies and large complex societies. In small-scale societies an individuals 'personhood' was directly connected to their social function, their individual ability to contribute to the day-to-day activities within their society. While in complex societies, an individuals 'personhood' was directly linked to the appearance of their physical body and their social interactions.

In the Punan Bah culture, personhood was not determined by an individual's physical or mental conditions, nor were individuals denied personhood if they had physical or mental impairments. However, a distinction was made between non-human and human individuals, and between non-persons and persons. At birth every individual was defined as non-human. Human status was given to individuals only after they had reached the age of at least six months. Once an individual reached the human status they were then designated as a person or non-person. This determination was based on the legitimacy of their birth. The concept of personhood was described as the fulfillment of a socially significant career, of which parenthood was the alpha and the omega (Nicolaisen, 1995, p. 50). An individual was denied the achievement of full personhood if they failed to become married or produce offspring.

Similar to Punan Ban culture, the Hubeer and Somali did not define person or personhood by physical ability. The concept of 'person' was never a given, never completed, but rather represented by an array of continuously shifting influences, which grew with the accumulation of experience and age. The Hubeer notion of personhood appears to have had some very marked implications for their attitudes toward deviance in general and for some types of disabilities in particular. Although personal deviance was to some extent supported by the system rather than condemned by it, that did not place all disability on par. For example, blind and deaf people were accepted by the community, while individuals with other disabilities were less tolerated.

In the United States and the United Kingdom, personhood was closely linked to the physical body. Therefore, individuals with physical impairments were 'denied' personhood by able-bodied individuals. The denial of personhood took the forms of avoidance, auras of contamination, or devaluation. Impaired individuals who internalized this denial of personhood, often participated in selfdevaluation. In accordance with the ills of contamination, the disabled in America were seen as pulling back into themselves by their own sense of loss and inadequacy, an impulse to withdraw that conspired with their devaluation by society to push them further into isolation (Murphy, 1995).

The Impact of Recognition on Disability

In the essays collected by Ingstad and Whyte, in addition to the similar concepts there appeared to be an additional theme consistent across the different cultures. The theme of recognition was identified in both small and large-scale societies in the social interactions depicted between the ablebodied and the disabled. The importance of this theme lies in the identification of its existence and in understanding its potential impact, positively or negatively, upon the disabled.

In the analysis of the recognition theme, we will borrow from the philosophy field and utilize Charles Taylor's work, specifically the thesis of his book Multiculturalism (1994). Again, acknowledging the availability of the abundance of literature on the theme of recognition, the author was chosen for his direct work with multicultural issues. Taylor's thesis, in his book Multiculturalism (1994), was that "our identity is partly shaped by recognition or its absence, often by the misrecognition of others, and so a person or group of people can suffer real damage, real distortion, if the people or society around them mirror back to them a confining or demeaning or contemptible picture of themselves (p. 25)." Taylor's thesis is significant in understanding the social interactions and relationships depicted in the essays provided by Ingstad and Whyte.

Although the concept of recognition existed across the different cultures, there was a distinction between large and small-scale societies in their perception of the disabled. Which raises the question, how is it that societies can recognize the same phenomenon but arrive at different conclusion about the phenomenon's value? One could argue, that the 'perceived' value of a phenomenon, meaning its ability to aid in the development of its society, will determine whether it is perceived positively or negatively. Inherent in this claim, is the argument that once a phenomenon changes its ability to aid society then its 'perceived' value would also change. However, in looking at the plight of ex-convicts, minorities or the disabled, it becomes clear that there are other factors used in determining the value associated with a specific phenomenon. Despite their ability to add value or to further the development of their society, exconvicts, minorities, and the disabled in America are to a certain degree still perceived negatively.

One could also make the argument that the perceptions associated with a specific phenomenon is based on the beliefs, opinions, and attitudes of its society. If this is a valid argument, the question then becomes how are beliefs, opinions, and attitudes created and changed? Are ingrained and societal attitudes, opinions, and beliefs capable of being changed? How long would this change process take? In looking at the attempts of other groups (e.g., women and minorities), to change their identity and the recognition that they were receiving from the dominant society, it becomes a sobering reality that changes may take longer than anticipated or desired.

In looking at the research done on the changes in perceptions towards the disabled, change in recognition was possible. Intimate interactions between the disabled and ablebodied individuals normally led to changes in the way that the later perceived the former. Additional research indicated that close acquaintance can lead to judgment of the disabled person on the basis of personality characteristics rather than on their disability (Sentumbwe, 1995). According to Murphy (1995), the greatest impediment to a person taking full part in their society was not their physical flaws, but rather the myths, fears, and misunderstandings that society attached to them. What made the disabled particularly threatening was the psychological mechanisms of projection and identification by which people imputed their feelings, plans, and motives to others, and, in turn, incorporated those others' feelings as their own (Murphy, 1995, p. 143).

In the essays collected by Ingstad and Whyte, when the able-bodied individuals recognized the disabled individual there was either a positive recognition or a negative recognition. When the able-bodied individuals recognized the disabled negatively they had a tendency to either treat them like children or regard them with utter disgust, disdain, or fear (Murphy, 1988; Monks & Frankenberg, 1995; Scheer & Groce). When the able-bodied recognized the disabled in a positive light, the disabled were treated as an integral part of the culture and society. The disabled were given jobs, or important roles in social functions. Research showed that employment was important for persons with disabilities. It can provide economic security and independence and give them value and status as individuals. It helped with integration and acceptance by the able-bodied and, most importantly, it gives life a purpose (Boylan, 1991).

Thus as long as physical disability is linked with shame, inferiority, disdain, or fear, realistic acceptance of one's position and one's self is precluded in the life of the disabled (Wright, p.14).

Part III. Services Available

In small and large scale societies, there are a number of internal and external factors that militate against adequate services being provided to the disabled. These factors drastically impede or increase the disabled chances of self actualization and social recognition. These factors will be carefully examined and discussed.

Small-Scale Societies

The largest internal factor which militates against small scale societies receiving adequate service is that of funding linked to social perceptions. As indicated earlier, in the essays provided by Ingstad and Whyte, small-scale societies had a tendency of including and expecting the disabled individual to participate in the day to day activities of a particular culture.

This acceptance of the disabled person as being functional, in body, and with limited economic resources being available to the culture, the creation of rehabilitation centers in some smallscale societies has unfortunately been met with resistance. According to Roth (1983), this resistance has resulted in the diversion of aid being utilized for the sole purpose of opening rehabilitation centers. Without the appropriate aid, the disabled will continue to receive inadequate rehabilitation, education, and job training. For these consequential reasons, and many others, she suggests at the conclusion of her research that more human resources (e.g., special education teachers, experts in rehabilitation programs), instead of financial resources, be included in future rehabilitation programs.

Another source of agitation against the creation of rehabilitation centers is the policy maker. Unfortunately, many policy makers, in most small scale societies, do not include the needs of the disabled on their appropriation bill. Exclusion from the appropriation bill, for the disabled, will mean less educational resources and decreased opportunity of being mainstreamed into the dominant society. Unfortunately, the few politicians who do understand the needs of the disabled, carry very little political clout. After becoming frustrated, these mavericks will often turn their attention to international sources for the funding needed to erect rehabilitation centers, where education and other pertinent services can be provided.

Large-Scale Societies

The disabled in large-scale societies, with the help of international organizations, such as World Health Organization (WHO), International Labor Organization (ILO), and other political/social organizations, have been successful in using the political movement to gain recognition and integration into mainstream society. The following large scale societies are noted for their rapid recognition and integration; the United States, England and Wales, New Zealand, Finland, Norway, and Sweden (Mazurek & Winzer, 1994). Within these countries, the disabled enjoy the same rights and privileges availed to their able-body counterparts. As a result of their efforts, a number of public policies and laws was passed, protecting their interest and rights on issues of education and discriminatory practices found in the public and private sector.

With the ideology that all disabled individuals should be recognized as equal citizens, treated with respect, and enjoy the rights and privileges of the able-body, large-scale societies have begun to spread their message, and resources, to small scale societies. With the support from international organizations (World Health Organization (WHO) and International Labor Organization (ILO)), large-scale societies had begun to sponsor rehabilitation programs in small-scale societies through the donation of funding, research, human resources, ideological transfer, equipment, and maintenance. Due to language, culture, and ideology barriers, rehabilitation centers have not been as successful in some smallscale societies in comparison to their large-scale counterparts. It is assumed that these barriers were more theoretical in terms of divergent perceptions of the word 'disability and disabled'. This assumption was based on the research that indicated that those smallscale societies that held similar perceptions of the words 'disability and disabled' as their large-scale counterparts, were able to resurrect successful rehabilitation centers.

The DAM project, although awaiting funding, is an example of a rehabilitation initiative sponsored by a large-scale society, being implemented in a small scale society. DAM, which stands for Disability Awareness Missions, is sponsored by Global Alliance for Africa, a non-governmental organization (NGO) that, like all NGOs, is a non-profit, non-sectarian, and nonpartisan organization registered by the NGO co-ordination bureau. The DAM project is being implemented in the semi-arid region of north west of Kenya. The DAM's target areas of disabilities include: hearing impaired; visually handicapped; mentally handicapped; physically handicapped; and the epileptic. The goal of DAM is to improve community education, health standards, socioeconomic levels, and the moral conditions of the disabled and their community, through the detection, prevention, and development of a sustainable intervention. In addition to the need for funding, other strategies for ensuring that the program will not collapse after the large-scale representative leaves will need to be implemented (Roth, 1983).

Services for the Disabled

There are many gains to be had by implementing services in both large and small societies. While most of the gains are seen in the quality of life for the disabled, research has also shown benefits for the economy through an increased supply of human capital and an increase in productivity by disabled workers.

The disabled report a greater sense of belonging and an increased state of self-actualization when they were made to feel included in society. Society is able to assure this 'feeling of belonging' by providing the appropriate resources (medical attention, employment opportunities, job training, education, and adequate housing), to the disabled and their families (Batemann, 1992). By providing the appropriate resources, job training and education, the disabled were also able to attain financial freedom and experienced lower levels of stress.

On the other hand, failure to provide the appropriate services to the disabled may result in psychological complications or even death (Hardman & Wolf, 1993). Additionally, the disabled and their families may constantly be subjected to public ignominy, resulting in embarrassment for both the disabled and their families.

The impetus for changes found in the educational services provided to the disabled were connected with state and government enforced laws and policies Many political and social activists credit the Civil Rights movement as the catalyst for the renewed interest in the rights of the disabled. The issue at that time was "whether any institution could provide a humane environment that allowed maximum personal freedom and self actualization for any individual (Kaufman & Hallahan,1992, quoted in Mazurek & Winzer, 1994)." These social and political activists believed that people with disabilities should be treated as 'equal citizens' (Ingstad & Whyte, 1994). When the National Commission on Excellence produced its report 'A Nation at Risk,' it paved the way for governmental intervention on education, which also included the disabled. For example, Public Law 94-142, part B of the Education of the Handicapped Act (1975), states that all disabled children in the United States are entitled to a free and appropriate public education. Provisions were also made to include services around employment, medical services, and to public and private accomodations (e.g., hotels, theaters, restaurants, grocery stores).

IV. Conclusion and Recommendations

Ingstad and Whyte provided a comprehensive compilation of essays on the varying aspects of disabilities across different cultures. Three key themes emerged from the cross-cultural essays. First, all cultures were exposed to individuals with impairments, although not all cultures recognized those impairments as disabilities. In some cultures there was no specific word or phrase to accurately describe or explain the concept of 'disabled or disability.' Second, there was a distinction drawn between large and small scale societies on their perceptions and interactions with the disabled in their cultures. Third, there was a discrepancy between the provision of services provided in large and small scaled societies. Research findings, as reported by Mazurek and Winzer (1994), showed that large-scale societies, in comparison to their small-scale counterparts, provided adequate funding for rehabilitation, education, and other services (e.g., medical, housing, and employment).

While the essays provided by Ingstad and Whyte provided varying aspects of different cultures and their interactions with the disabled, there was minimal explanation provided on the services available to integrate the disabled into the mainstream culture. Although, small-scaled societies had a natural tendency to include the disabled into the day to day activities, due to economical reasons, the authors failed to discuss how that culture eliminated the negative perceptions or stigmas typically associated with the severely disabled. A potential research focus for future anthropologists is on the inclusion and integration process found in small-scale societies. Insight gained could prove beneficial to large scale societies who are still grappling with issues of stigma and integration.

Additionally, research should be conducted on the effectiveness of rehabilitation centers in large scale societies. Knowledge gleaned from this research may prove worthy for small scale societies on their attempts to erect successful rehabilitation centers. With respect to education, research should be conducted on the effect of cultural interpretations of disability in various societies on intervention programs done in schools and other learning institutions.

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