Social Determinants of Disabilitybased Disadvantage:
Fostering Capabilities in Solomon
Islands
Research team:
Dr Alexandra Gartrell, Professor Lenore Manderson, Dr Megan
Jennaway
Judy Fangalasuu, Simon Dolaiano and Savina Nonegbatu
S
Implementing rights-based approaches
Socio-cultural attitudes to disability in Solomon Islands:
Identifying culturally appropriate solutions to disadvantage
Disability, culture, social circumstances and
rights
Tension between constitutional rights and
traditional beliefs
S
“All citizens are entitled to same
rights, privileges and benefits”
(Article 61).
S
Greatest barriers:
“Traditional and religious belief
systems, negative attitudes and a
lack of understanding about
impairments” (Stubbs et al 2005,
Miller 2007).
Disability as a development and rights issue
S
CRPD signed in 2008
S
National Disability Policy
2005-2010
S
Aims to develop appropriate
legal and social protection
S
Low government priority
S
Lack of recurrent budget
S
National Coordinating Council
for Disability never been
established.
Social and political invisibility of disability
Solomon Islands
S
552, 267 people settled in more
than 5000 villages, across 350
inhabited islands
S
22.7% live below national
poverty line (ADB 2010)
S
85% live in rural areas and
practice subsistence agriculture
S
Rapid economic growth (9% in
2011)
S
High population growth (2.3%)
S
Low per capita income ($1782)
Cultural attitudes toward disability:
“Something for the parents to worry about”.
S
Sign of ancestor curse, kastom
or black magic
S
Violation of taboo
S
Exclusion explained by inability
to contribute to household
economy, not by cultural beliefs
Methodology
•
Ethnographic approach
•
3 rural field sites
•
Double/triple disadvantage of
rural areas
•
Field site selection
Fieldwork
•
Pilot
•
3 blocks of fieldwork
•
October 2011 – June 2012
•
Recruitment: CBR worker and
Co-Researcher social networks
Participants
• 50 people with disability
• 13 in Takwa
• 16 in Malu’u
• 21 in Isabel
• 28 women
• 22 men
• 38 key informants
Age distribution
•
24% of interviewees were
between 21 and 30 years
of age
•
64% of interviewees were
under the age of 40
•
18% of interviewees were
between 61 and 70 years
of age
Impairments
S
Mobility
21
S
Multiple disorders
12
S
Sensory
10
S
Psychological
4
S
Nervous system disorders 3
North Malaita: Takwa and Malu’u
S Coastal communities characterised
by swidden agriculture inland,
fishing and gardening
S Takwa residents more connected to
the water and fishing
S Predominant economic activity in
Malu’u is gardening, suggesting a
more recent migration from the
mountainous inland (Hogbin 1939);
Isabel
•
The island of Santa Isabel lies
directly to the north of Malaita
•
Forested, mountainous island
with very little flat land.
•
Traditional patterns of
subsistence: fishing and some
gardening along the coast and
swidden cultivation inland.
•
Strong population drift away
from the centre and towards
the coast
Starting with families
S
Assumption of extended family
systems in non-Western societies,
particularly subsistence economies
S
Embedded in government, donor, aid
and development agency thinking and
debate in regard to disability
S
Communal, inter-dependent, coresident, cooperative
S
Extended family as foundation of
social cohesion in Pacific
Patrilineal and matrilineal systems of descent
S
Patrilineal system: out marriage of
daughters into wife-taking clans,
along with the introduction of wives
from wife-yielding clans
S
Settlement patterns based on
several co-resident patrilocal clans
or extended family
S
Affect on family-based forms of
support available to people with
disabilities
Bilateral basis of community affiliation
S
Customary social practices
subordinate to economic
pragmatism
S
Secondary inheritance rights
(traced through
mothers/fathers) strategically
deployed to access coast land
Key findings 1: Limited support for people with
disabilities and their households
S
Majority of PWDs live with one
or more family members
S
Support of one or at most two of
these.
S
One case of PWD living alone.
S
People with disabilities and their
households have very little
support from extended family
members, irrespective of
matrilineal or patrilineal context.
Key findings 1
S In principle relatives available to help with care for a
person with disability
S No specific cultural mechanism to ensure this
actually occurs outside of the neighbourhood
S Few extended family members provide support from
a distance in all three field sites
S No specific family visits for purpose of respite or
other disability related support
Overtaxed carers
S
The burden of care for a family
member with a disability devolves to
only one or two highly overtaxed
household members and/or
immediate family members living
adjacent (‘the local family circle’),
S
Carers are effectively taken out of
household economic production.
S
Siblings taken out of school
Emily and her family
S
30 year old woman developed
epilepsy after birth of second
child
S
6 children under 12 years
S
Little family support despite
living amongst husband’s kin
S
No help from her natal family –
isolated and excluded
S
Husband sole support
Social determinants of household wellbeing
S
Structures of social hierarchy
determine social conditions in
which people grow, live, work and
age (Marmot 2007).
S
Differences in wellbeing reflect
inherent structural features of
society (land ownership and descent
systems, gendered power relations,
rural-urban inequities)
S
Social determinants approach used
to understand compound and
multiple disadvantages
Determinant 1: Social gradient
S Poor rural economic prospects for
salaried employment and cash
income
S Greater material hardship (food
insecurity, poor housing, lack of
access to safe water and
sanitation), violence
S Health and education (4.3% and
5.2% of GDP)
S Accumulate over life course
S Structural determinants
Determinant 2: Secure economic foundation
S
Security of land ownership,
economic wellbeing, and the
associated material and social
assurance and confidence
S
Angela: family live on Crown
land surround by patrilineal
estate
S
Material and social resources to
support her inclusion
S
Cash income
S
Status within the Church
Living as outsiders
S
40% of cases
S
Secondary and tertiary claims
S
Carrie: patrilineal land to which
she has secondary rights to
occupy and garden
S
Primary gardener, carer and
income earner
S
Active in community
S
Presence of other determinants
Determinant 3: Inclusive early life
S Weak land claims, poor
economic status – energy for
care traded-off against
livelihood activities
S Labour poor households
children and people with
disabilities vulnerable to
neglect and shame
S Christian and Justine:
secondary claim to land
Determinant 4 – Contribution to the household
economy
S
Absence of government and
community support
S
Self-worth, efficacy and wellbeing
enhanced with contribution and living
situations are better
S
Education, vocational training key but
poor access: poverty, attitudes,
physical access
S
Dependency and long term
vulnerability
S
Ofata and Eddie
Determinant 5: Stigma and social exclusion
S
Even with contribution and as primary support for family,
stigma persists
S
Denial of socially expected status, denied decision-making
and norms of reciprocity
S
Joseph – denied use of resources – canoes and knifes
S
James – contributions never reciporcated
Determinant 6 - Gender
S
Gendered power relations in both patrilineal and matrilineal
systems, undermine women’s security and wellbeing
S
Dependency, vulnerability and no choices
S
Women choosing not to marry
S
Emily – triple burden
S
Frances: patrlineal systems doubly disadvantage women
Determinant 7: Social support and accumulated
disadvantage
S
Social capital and presence of
carers key to wellbeing of
elderly with disabilities
S
Care for the elderly is expected
Key finding 2: Presence of several social
determinants most likely to foster inclusive
environments
S
Families with positive presence
of several social determinants
have greater material, social
and emotional resources
S
Meaningful lives typified with
inclusion and dignity
S
If absent, compound
disadvantages which amplify
across the life course
Key findings 3: Disability overly determines
choice
S
Opportunities are withheld or
granted exceptionally
S
A minority develop their
capabilities and fulfil their
aspirations.
S
Life choices and possibilities
are shaped by negative cultural
attitudes and socio-economic
determinants
Poverty of opportunity and achievement
S
Equality of possibility depends
upon individual and household
engagement with local
institutions to build capabilities
and functioning in daily
activities that they value.
S
Demonstrated agency and
initiate is likely to be supported
by others within and beyond the
immediate household and by
government and church-based
institutions.
Current sources of village-based support
S Extremely limited
S Government and NGO reach to village level poor
S CBR worker – an irregular visitor but in some cases key
to providing adapted devices
S Mothers Union (Anglican) and Dorcas (STA) – irregular
visits by village women to PWD and the elderly (ranging
from monthly to every couple of months, to annual visits)
S food, soap, clothing and sometimes cash (a few
dollars)provided
Local social institutions
S
Specific and targeted
assistance, delivered under the
guidance of people with
disabilities is required
S
Inclusive processes are critical
S
Local social institutions such
the Church and schools are key
to the provision of such
assistance
Opportunistic
linkages
•
CBR worker linking in with
Agricultural Extension officers
and other Ministry of Health
village visits
•
Particularly in areas where boat
access is required
•
Train staff in disability
awareness
Building on existing social infrastructure
S
Awareness raising and training
by people with disabilities
(PWDSI)
S
Church
S
School
S
Health Centre
Micro-enterprise
development run by
and for people with
disabilities
•
Social determinant amenable to
change
•
Core group of PWD, all trained at
Bethesta, travelling around
villages in Isabel doing awareness
raising
•
Built training centre where PWD
will consult with other PWD,
design and build locally
appropriate devices