Beliefs about causes of disability

Attributions for causes of disability are heavily influenced by culture and place of origin. They vary across cultures, within cultures and even within families; these can span religious and cultural beliefs, or incorporate current biomedical explanations, and they can also change over time. Religious and biomedical beliefs are not mutually exclusive; multiple beliefs can be held in unique and sophisticated ways, even though the explanations appear contradictory. Religious beliefs are often a good coping strategy for families, and sometimes religious beliefs are held when there are no medical explanations.

Example: Kuwaiti mothers in a research programme all expressed strong religious beliefs and said that these provided a strategy that allowed them to cope with their challenges. They all saw the disability as divine intervention with a reason, and accepted this. "If Allah wants her to be like this permanently, then I can't do anything to change it. Thanks to him anyway." (Raman et al 2010).

A study conducted with Pakistani families (Croot et al 2008) found that spouses sometimes differed in their beliefs about why their child had a disability. This can cause dissent in the family about management. Below are the most common beliefs about causes, for the cultures in this section.

• Punishment
  Disability can be seen as a punishment from God. The punishment may be because of wrong doings by the parents or the member in question, or for the wrongs of past family members.
• Test
  Disability can be seen as a test from God, providing the opportunity to overcome challenge and bad fortune.
• Gift or Chosen Parents
  Some regard disability as a gift from God, or attestation of privilege because only those with special qualities are equipped to deal with the challenges of a disability.
• Curse (Evil Eye)
  Disability is sometimes attributed to a curse. Many people believe in the evil eye where a curse can be bestowed on someone by a malevolent or envious gaze. The curse may be unintentional or not. It is prevalent in many countries (both Muslim and non-Muslim) - Middle East (including Christian Assyrians), the Mediterranean, West, East and North Africa, Central America, some countries in Europe, as well as some regions of Tibet and Himalayas. Talismans are used to ward off the eye in many cultures although staunch Muslims regard the use of talismans as superstitious and see Allah as the only one to protect against it. Common talismans are the hamsa hand with an eye in the centre, or a bead or glass disc with a black centre surrounded by white and then by blue concentric circles.
  Image by FocalPoint. Wikipedia. (2011). Blue eyes. Retrieved from http://en.wikipedia.org/wiki/File:Blue_eyes.JPG
• Curse (Jinn)
  Jinn/djinn are spirits in some folklore and in Islam (referred to in the Koran) that can bestow curses. Although jinn can be good or evil, good jinn are seldom encountered as they cannot be seen, but the effects of bad jinn are evident, e.g. as in disability. An individual or family may be cursed because of wrong doings, and often the attribution is to wrongful relations within the family in the past.
• Catching a disability
  Some believe disability is contagious and can be 'caught'.
• Blame
  Some people believe that certain actions (these vary across different cultures) during pregnancy can cause disability. These actions are usually attributed to the mother.
• Biomedical
  Many people have biomedical explanations for disability as well as religious or cultural.

Muslim responses to any of these scenarios differ enormously, ranging from despair and hopelessness to religious strength and devotion. It is important for health practitioners to be aware of the potential range of different responses within Islam.

Ask clients about their explanation for disability. If they offer one, explore other beliefs. Whilst accepting a biomedical explanation, other beliefs may interfere with rehabilitation or support goals.