Other factors that influence attitude towards disability

Traditional cultural views

For many people who hold traditional cultural views, there is shame associated with disability, and commonly an attitude of pity in cultures in this section. As a result people may be hidden from the community either because the family is embarrassed by the impairment/disability, or sometimes to protect the person from ridicule or the abuse they might receive outside the home. This applies to members of all ages including children who would be at school, i.e. they may be kept at home.

Because of stigma and shame, in some communities marriage and job prospects are affected for other members of the family. For this reason the person with disability can be secluded from the community, often resulting in isolation and potentially neglect. Some families may not understand the potential of those with disability and may keep them at home believing that they have no prospects for life, and are unable to learn. Others however may send their family member to rural communities, not necessarily to hide them, but to have them cared for in an environment that has less demands and is more relaxed. Ingstad (cited in Hasnain et al 2008) notes how important it is to look for evidence that is outside popular beliefs about how people deal with disability. The concealment of the disabled is found in Muslim communities as well as in cultures that are not Muslim, so this is often more culturally-based than characteristically Islamic.

Enquire about a family's culture, and their practices around disability. People usually appreciate enquiry if it is genuine and potentially for their benefit.

Whilst some families prefer to keep an impairment concealed, others may go to great lengths to get help. The disability may be treated as an urgent medical need with parents taking children to many health professionals or services, or to faith healers, and in search of traditional remedies. In some cases there may be an unrealistic attitude with no acceptance of the disability as permanent, and where prayer or ritual provides hope of a cure, or a faith healing.

Whether disability is acquired or congenital

Whether the disability is acquired or congenital can influence how it is dealt with, with acquired impairments being more acceptable, especially those acquired during war. An example offered by Hasnain et al (2008) is of a Pakistani family who had a child born with cerebral palsy. The child later developed post-polio paralysis which the family wanted treatment for believing it to be a disease. The father however forbade treatment for the cerebral palsy because this reflected the Will of Allah. He believed however that Allah provides a cure for every disease, so he accepted treatment for the post-polio paralysis.

Gender, beliefs about causes, acculturation

Other influences on attitudes towards disability include: gender (boys often receive better healthcare than girls), beliefs about the causes of disability (whether it is a punishment, curse or blessing), and level of acculturation for migrants and refugees (whether people have an understanding of potential through management and support services). Terminology can be integral to attitude; different ethnicities describe disability differently ('crazy', 'stupid', 'mental' etc), some reduce the description to ill health to avoid stigma, and varying inferences emerge through language.

Educational levels

For many with rural origins or for those who have received minimal education, the physical functionality of the person is given more weight than the label or diagnosis. Others regard intellectual disability or mental illness more negatively than physical disability because of a lack of understanding; intellectual impairments are often confused with mental illness.

Country of origin

Country of origin influences attitude a great deal, with people from developing countries often subscribing to more traditional views than people originating from countries where there is wealth, access to education and western healthcare. This is a generalization however, since within every ethnicity and community there exists enormous diversity. It is worth noting that some Arab countries (Saudi Arabia, Brunei and Qatar in particular) have initiated and funded the development of social foundations to assist people with disability. Not all Muslim countries are in a financial position to fund such enterprises although many Muslims and their governments recognize that they are enjoined by their faith to meet humanitarian responsibilities of assisting their disabled (Hasnain et al, 2008).

Migration

In some instances being Muslim and disabled doubles a person's chance of being discriminated against after re-settlement (in a country where Muslims are a minority). They may be avoided and rejected because of their religion and thereby alienated from their new host culture, or undermined, dismissed or underestimated by their own community. Being a single refugee mother (as many refugees from the Horn of Africa, Iraq, Iran and Afghanistan are), can triple the challenges.

Involve a cultural case worker to assist your client in linking with supports in the community, with others from the same culture who have a disability, and with relevant health and disability resources.