Somalia

It's difficult to generalise in much detail about Somalis as the culture, although unified by Islamic (and for some, Christian) beliefs, is highly heterogeneous due to the many tribal affiliations. There are some pervasive traditional beliefs.

Attitude to disability

Religious beliefs shape much of the attitudes and practices around disability with Somali Muslims in particular believing that fortitude and forbearance are essential. For this reason they are sometimes unwilling to seek support or rehabilitative services in countries of re-settlement as this might constitute a weakness which is believed to be punishable. Somalis are particularly family-oriented and care is seen as responsibility of the family alone. This reason might also account for the fact that the stress that can develop in families who are burdened with disability, is often not declared by Somalis.

In Somali culture there is a tendency to see people as either healthy or unhealthy and disability often fits into the unhealthy category with little discrimination between illness/sickness/disability (Roeher, 2004). Some impairments that are considered taboo (speech and intellectual impairments and mental health issues) may remain concealed within the family.

Research on Somali communities in a number of countries of re-settlement reveals that the new communities are often fragmented and poorly organised. This in conjunction with the lack of familiarity with the social environment of the adopted country, or the new healthcare services and agencies, often results in Somalis remaining invisible and not coming forward to access services. Many Somalis also fear, or do not trust governmental agencies because of experiences with government in their country of origin.

Beliefs about causes

Apart from religious beliefs and the role of God in physical and mental disability, there are strong beliefs in evil and ancestral spirits. Evil eye, jinn and witchcraft are often attributions for impairment. Eating liver at a certain young age, or walking past rubbish dumps where evil is prevalent, is believed by some to cause disability.

Intellectual disabilities and mental health issues are often confused and highly stigmatised. Disability caused by war trauma is more acceptable.

Implications for practice

Treatment, rehabilitative plans or support will need to fit in with religious or traditional beliefs for Somali clients. Healthcare providers need to find explanations that can accommodate traditional beliefs as well as provide biomedical explanations.

Confidentiality (although important for all CALD families) is particularly important for Somalis.