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Social Model in Majority World
December 2010
Introduction
Debate surrounding the conception of disability is replete with various perspectives,
contested from grassroots to government level. According to Ingstad and Whyte (1995), to
define someone as disabled in ‘minority world environments’, will manifest in an altered
public persona and a series of distinct social experiences compared with those in the
‘majority world’. Nevertheless, disabled people across the world have united in disability
activism in order to achieve what is loosely defined as ‘disability equality’ (Driedger, 1989).
The majority of disabled people are socially excluded, oppressed and, regardless of the
international variation in the definition of what it means to be disabled, live within societies
which disadvantage and deprive their existence (World Health Organization, 2001).
Whilst this variability of definition raises an issue for the comparability of international data,
figures indicate that the majority of disabled people live within the poorer nations of the
majority world, even though wealthier countries have a higher reportage of impairments
(Coleridge, 1993). This higher instance of reportage is explained by the access to support
services enjoyed by disabled and non-disabled people in the minority world, which results in
both an increased recognition of hereditary conditions and an increased chance of surviving
to old age, at which one stands a far greater chance of acquiring additional impairments. The
socio-economic context of disease plays an equally important role; the reality being that
certain conditions, now rare in the industrialised countries of the minority world, remain
prevalent in majority world environments (Stone, 1999).
The social model of disability emphasises that a disabled person's exclusion from society is
firmly rooted within the physical and social environments of the mainstream and is not a
direct result of the functional limitations possessed by the health condition or impairment
(Oliver, 1983). While not disputing the importance of medical support in the management of
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impairment, Barnes and Mercer (2003) acknowledge that the social model focuses on
political drive and social change as a means through which disabling barrier can be removed.
Considering that this model exists as a framework for achieving disability equality within the
United Kingdom (Prime Minister’s Strategy Unit, 2005), it is reasonable to ask whether the
social model of disability can be applied to the majority world. By reviewing academic
literature on disabling barriers within the majority world, the benefits, if any, of applying the
social model in this context will be analysed. This paper will also assess the criticisms
directed toward the application of the social model, by reviewing case studies which assess a
social model analysis in accordance with particular countries’ (Egypt, China and Iran)
evaluation. This is part of an initiative to globalise disability, and reassess the vision of the
social model through various interpretations which have derived from the core principles of
the social model – the materialist and rights based approach. Examples of both approaches
will be illustrated to reinforce their applicability to such environments. Finally a critical
interpretation of globalisation will be reviewed, in accordance with the effect any initiatives
will have for a social model application.
Understanding the terms: Social Model and Majority World
Oliver (1990) expresses concern over the numerous models which exist to explain the
concept of disability. There exists a very real risk that the application, or not, of specific
models, will come to form the focus of discussion at the expense of the issues surrounding
disabling barriers. Most of these models, including the traditional charity model, are excluded
from this paper in the hope that, by focusing on the social model and its relationship to the
medical and individual model (Oliver, 1983; Oliver, 1990), we can gain a far clearer
appreciation of its potential for the majority world.
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The individual model locates the ‘problem’ of disabling barriers within the individual, and
the functional limitations to arise from being labelled as a disabled person. It is associated
with a belief that disability is a personal tragedy (Oliver, 1990). The medical model of
disability, which derives from the medicalization component of the individual model,
considers the health of a disabled person to be the primary reason for discrimination and
disadvantage. This portrayal concludes that society will view disabled people as abnormal
and dependent upon medical professionals and carers, with cure or rehabilitation, and often
the segregation of the individual within an institution for their own ‘protection’, the only
means by which disabling barriers can be overcome (Swain, Finkelstein, French and Oliver,
1991).
The core values of the social model was first established by Paul Hunt (1966), and later came
to be considered a fundamental principle (Union of the Physically Impaired Against
Segregation, 1976) whereby disability would be considered a product of social conditions,
requiring a holistic assessment of existing barriers, and, potentially, allowing disabled people
to assume a degree of independence. Oliver (1990) summarised the social model by
demonstrating that disability is rooted within society's failure to provide adequate services
and ensure the needs of disabled people are considered which allow for inclusion. In this
context, medical contributions play a key role in establishing a quality-of-life for disabled
individuals, with an increased life expectancy and the capability to manage the health
implications of their impairment far more effectively than the past. Nevertheless, the social
model considers the "impairment" to be the health condition, i.e. diagnosis of Down's
syndrome, and the "disability" to explain the oppression and exclusion, i.e. attitudes,
inaccessible transport, poor employment opportunities (Hurst, 2005). In terms of defining a
social model analysis within a minority world, it is the essential tool for establishing the
dignity, rights and structural changes needed in order to guarantee the removal of disabling
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barriers (Kallen, 2004). The outcome, i.e. actions taken for social change, is the product of
the analysis (Flood, 2005).
With reference to the global classification of disability, we should consider those definitions
outlined by the International Classification of Impairments, Disabilities and Handicaps
(ICIDH). Under this review, ‘impairment’ is defined as a biological health condition,
‘disability’ is defined as the functional limitations of their impairment and ‘handicap’ is the
social consequences of acquiring a disabling impairment (United Nations, 1990).
This
interpretation is associated with the individual model, as defined by Oliver (1990). For those
working toward a universal definition, the International Classification is considered
terminologically problematic in those multiple meanings associated with the terms
‘impairment’ and ‘disability’ (Ingstad and Whyte, 1995). However, the World Health
Organisation has now adopted the International Classification of Functioning, Disability and
Health (World Health Organization, 2010), which mainstreams the experience of disability
and recognises it as a universal experience, acknowledging the social aspects of disability,
and not solely a medical dysfunction.
In reference to the definition of the majority world, we are forced to analyse the term
‘development’.
When, predominantly western, countries use terminology such as
‘developed’ or ‘undeveloped’, it results in the formation of a socio-economically defined
hierarchy (Ranis, Stewart and Ramirez, 2000). In using this restricted characterisation, there
is arguably a hint of imperialism as less developed countries are forced to conform to
Western ideals in order to be considered civilised and thus developed. This is supported by
Anand and Ravallion (2000) who considers the term, ‘development’ as a meaning for
modernising nations to a standard of industrialisation or Westernisation, which originated
with the evolution of capitalism.
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Stone (1999) uses the term ‘majority world’ to refer to Third World countries and those from
the southern hemisphere. At its simplest, the term is used to describe the vast majority of the
inhabited world, where, despite an expanding population, opportunities to attain wealth and
power remain minimal. However, the ‘majority world’ should be largely devoid of the
geographical connotations which correlate global position with monetary wealth, and
recognises areas of deprivation within supposedly developed nations, and limited areas of
wealth in otherwise deprived countries. Instead, focusing on an environment’s framework for
distributing resources and power (Sheldon, 2005).
The term also distinguishes between the idea of ‘progress’ – as defined by western academia
- which the associated promotion of elitism, and that of ‘development’ which refers to those
economic, cultural and social issues extant within a majority world context. The concept of
the ‘minority world’ can refer to rich countries within which power and wealth, not
population, are concentrated, and who become powerful through the manipulation of global
resources for their own benefit (Stone, 1999). The distinction is an interesting one, given that
a majority of disabled people consider themselves marginalised - regardless of their
geographical location (Chambers, 1983). In light of this, the definition should not be divided
on basis of geography, but actually poverty – and the minimal choice, control and
independence people have within an environment (Sheldon, 2010).
This has clear
representation with disabled people (Metts, 2000; Elwan, 1999).
To evaluate whether the social model has relevance, there is merit in reviewing what
academics have recorded when looking at disability within majority world environments.
Disability in a Majority World Context
Globally, disabled people experience poverty, oppression and reduced life chances. With
pressure groups and disabled activists recognising their shared exclusion, certain
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organisations, such as Disabled People's International (DPI), have focused on implementing
equal participation for all disabled people by considering disability to be the limitation within
society (Disabled People's International, 1981). The DPI manifesto, published in 1981, was
composed around the principles of the social model; thus, in most circumstances, countries
with a disability rights movement should be aware of social model thinking – although this is
not always the case (Shakespeare and Watson, 2002).
There are numerous case studies of majority world environments and their relationship to
disability (Japan International Cooperation Agency, 2002; Hagrass, 2005).
The three
reviewed, in this paper, demonstrate recurrent themes associated with oppression of disabled
people. Through analysis it becomes apparent that similar themes continue to be raised within
literature. These include nondisabled attitudes toward the medical or traditional charity
model, the lack of empowerment of disabled people on a national scale, and the continuing
inability of disabled people to access mainstream life (Groce, 1999).
In Egypt, disabled people are usually perceived as objects of charity, observed with pity and
sympathy, with disability considered a personal tragedy (Hagrass, 1998). The perception of
disability in Egypt, particularly in law and social policy (Ahmed, 1997), has been heavily
influenced by the work of two Egyptian scholars, Osman and Abdel Nour. Osman (1969)
refers to disabled people as different from the normal, implying that such people are
‘abnormal’, while Abdel Nour (1973) identified disability to be the responsibility of the
individual, focusing on medical intervention as a potential resolution, and advocating a
personal effort to achieve normality. Both references do not consider cultural, social or
environmental issues in the cause of disability, and ultimately focus on the individualistic
medical perspective.
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The work of Stone (1999) has demonstrated how China considers disability ideology. A
country in a state of transition, it is clear to see the widening gap between the minority and
majority worlds within the borders of China. A country once aligned with communism is now
engaging in quasi-capitalist development, resulting in the dismantling of certain societal
structures and opening up to a clearer distinction of what disability and impairment means to
China (Japan International Cooperation Agency, 2002).
Iran has a disabled population of 3 million, with a majority of nondisabled people focusing
heavily on the impairment implications, rather than the social barriers (Salehpour and
Adibsereshki, 2003). There appears to be an unofficial hierarchy of impairments devised by
the public, with those considered to have learning difficulties occupying the highest level of
severity (Nazari, Raheb, Afroosheh and Panahi, 1998). The social model is essentially nonexistent across much of the country, though attitudes toward inclusion are fairly positive,
albeit in a tokenistic sense. However, ‘inclusion’ refers only to those socio-economic aspects
of society, and the idea of including disabled people within the education system is,
alternatively, considered very negatively (Shariati and Davarmanesh, 1991).
The two major causes of impairment in Egypt are either social or economic, write Teçke,
Oldham and Shorter (1984). Unsanitary living conditions, as a product of poverty, promote
infectious disease, which, in turn, can develop into long-term health conditions. The structure
of Egyptian society, and particularly the practice of endogamous marriage, is an additional
factor in the prevalence of impairment. According to El Banna (1989), 67% of impairments
are caused by a preference for intra-familial marriage, particularly among cousins, which
results in the concentration and propagation of hereditary genetic impairments. Neither
should we forget the physical and psychological impact of war and tribal violence; a factor
increasingly linked with impairments in Egypt (Nosseir, 1990).
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In China, a country where each child represents potential economic capital, impairment can
undermine the capability for economic survival and long-term security welfare (Delman,
Ostergaard and Christiansen, 1990). Chinese families consider individuals to have core sociocultural responsibilities, which confer a status of personhood through their fulfilment. It is
usual for Chinese families to consider disabled people as less productive than nondisabled
people, or as a burden, both for those family members required to act as carers, and
financially, as a product of expensive medical treatment (Stone, 1999). This can result in a
familial investment, both financial and educational, toward a cure, and an intentional focus on
becoming as ‘normal’ as possible (Kleinman, 1980).
Multiple interpretations of ‘disability’, and the propagation of related myths, can have an
adverse effect on disabled people. Indeed, El-Safty (1994) notes how disabled people are
denied education and employment because of the assumption that disability is associated with
incompetence. In the case of Egypt, it is clear that social-model thinking is not widespread,
that the Egyptian government has proved ineffectual in meeting the needs of disabled people
and that existing social policies are inadequate, with the result that disabled people have little
alternative other than to turn to their families and charity for support (Hagrass, 1998).
In China, there has been an increase in disabled foetuses being aborted or disabled children
being abandoned, as negative social attitudes result in an expectation of social isolation
and/or inferior status for disabled individuals (Field, 1996). This means, for those born, the
lack of opportunities for education and social participation are apparent, as the majority of
time is spent seeking a cure. Moreover, the concept of a ‘perfect child’, arguably more
important in China due to the now inaccurate ‘one child policy‘, relates to perfection being
defined as: attractive, intelligent and non-impaired (Dassu and Saich, 1992).
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The support of extended family is required to provide for disabled people, although some
support is commissioned by the religious economic system as well the state in Iran.
Nevertheless, all support systems consider the disabled person as a dependent, with no
opportunity for choice, control or independence (Salehpour and Adibsereshki, 2003). It is
worth mentioning that the Iranian government is apparently keen to adopt new programmes
which might empower disabled people, confer an enhanced social status and offer increased
opportunities for education, employment and social interaction (Caldi, 1999).
There are few systems of support available to disabled Chinese. State welfare continues to be
inadequate, particularly in rural areas, and, where support is utilised, it is implemented as a
short-term programme to coincide with festivals and state celebrations, rather than as a
consistent support entitlement designed to achieve independence and equality (Stone, 1999).
There are hints that China is aiming to rectify this situation, with published policies advising
that disabled people should be considered an asset, rather than a liability (China Disabled
Persons Federation, 1988), though social-model thinking remains largely ignored.
Disability literature has traditionally amalgamated the term with those issues affecting the
elderly and people in poverty, while it remains common to utilise the concept of impairment
and disability as legal punishment (Shirvani, 1997). Public writings also carry a strong
message about the morality of treating disabled people with mercy and sympathy at all times,
similar to the apparent request by disabled Iranians to be treated as dependent and pitied
individuals (Shirvani, 1997). Finally, there has been a link between disabled people and
incompetence, which creates problems of social stigma and focuses on the need for charity in
order to survive (Holzer, Vreed and Weight, 1999).
The case studies demonstrated how the nondisabled public consider disabled people through
a medical lens, with the associated view that the disadvantages and barriers faced by disabled
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people exist as a direct result of their impairment, and therefore their disability. It was also
shown that those disabled people highlighted in the case reviews did not have a sense of
empowerment – underlined by how disability and impairment should be perceived in a social
model context (Union of the Physically Impaired Against Segregation, 1976; Oliver, 1990);
and like similar countries within the minority world; they lack the opportunities to participate
within mainstream society.
Social Model(s) Application
Considering this oppressive and medicalized approach to disability is global, how relevant
can the social model be for those countries occupying a similar position to those highlighted
above? Firstly, the social model of disability was constructed in the minority world
environment, thus it is too simplistic to suggest that it be applied unaltered to any culture,
geographical location or economic environment, particularly considering that any application
risks being considered imperialistic or, at least, misunderstood (O’Toole and McConkey,
1995). It is clear that the social model exists as an international point of debate amongst
policymakers, disabled people's organisations and governments (Albert, 2005). Yet, while
academics discuss the implementation strategy of the model, and provide examples of how
disabled people are attempting to participate equally with their nondisabled counterparts,
questions are raised over the efficacy of the social model with regard to the disability agenda
(Hurst, 1995).
According to Hurst and Albert (2006), one of the main criticisms of the social model in this
application is the ignorance of the reality of impairment for disabled people. The definition of
what causes disability can be understood to negate the importance of what causes the
impairment, so often a result of social or economic factors. Nevertheless, the social model
should not be seen as a rejection of medical intervention, merely as a resistance to the
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perception of disabled people as medical objects. Many of the fundamentally important
community-based rehabilitation centres and medical environments within those countries
discussed will act as a conduit to publicise the concepts of the social model (duToit, 1989).
Werner (1998) has raised concerns over whether the social model overlooks assistive
technology. Access to technology can be empowering for disabled people who would
otherwise be unable to participate within their communities or, indeed, wider society. For
disabled people within the minority world, their intended outcome of the social model is the
struggle for social rights, as the majority have access to personal assistive technology.
Considering that the literature on disability equality is dominated by minority world
inhabitants, largely educated in the West (Seddon, Lang and Danes, 2001), there is a risk that
the struggle for social justice will be wrongly imposed as the main priority for disabled
people who live in the majority world.
The final point is the cultural context in which the social model has developed. The social
model, first and foremost, is a product of the majority world, where there exists an emphasis
on human and individual rights. This individualism can differ greatly from the family-centric
circumstances prevalent across much of the majority world (Malik, 2002), however, the
social model has been argued to be culturally adaptive (Coleridge, 1993). Ultimately, the
intended outcome of the social model is either an idiosyncratic situational analysis, or the
(implementation of that) action required for social change with reference to human rights
(Kallen, 2004).
While these highlighted issues affect the validity of the social model, they do so,
predominantly, in relation to those practical difficulties which result from its implementation.
Ultimately, there must be some assurance over the ‘theoretical identification’ of the social
model. In this context, the purpose of the social model also comes under scrutiny. Finkelstein
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(2001) embraces the concept of rights, but refuses to consider its use as a rights model, while
others (e.g. Horsler, 2003; Priestley, 1998) have argued that the social model can be
interpreted differently to identify the cause of disability. Through its various interpretations,
the social model has been identified as either a materialistic or rights-based model (Sheldon,
2005).
The materialistic model considers the concept of disability as a product of the Industrial
Revolution, wherein the value of disabled people as responsible community members
decreased in line with the introduction of a labour market which created competition within,
and amongst, those communities which had no provision to support the participation of
disabled people within this new socio-economic climate (Russell, 2002). Supporters of this
view, such as Gleeson (1997), consider the capitalist system as the root cause of disability; as
a system adopted by the majority of globalised nations, it is only with the radical
transformation of society, and a rejection of capitalist ideals, that the social oppression of
disabled people can be prevented. Yet, the rejection of global capitalism as a means of
negating the oppression of disability is hardly realistic (Charlton, 1998), and translates only
as a naïve retort for societal change from a marginalised group oppressed by the prevalence
of a ‘standardised approach to normality’ (Gleeson, 1997; Barton and Oliver, 1997).
The approach itself is too often marginalised, in favour of, the traditional belief system,
which considers discriminatory beliefs and prejudice behaviour as the cause of disability –
the rights-based social model (Horsler, 2003). Whilst this model recognises those arguments
forwarded by proponents of the materialist model, the rights-based interpretation considers
cultural representation, societal terminology and the pervasiveness of social stigma to be the
root-cause of disability (Shakespeare, 1994).
In this incarnation of the model, social change
for disabled people is achieved by analysing and understanding belief-based, abusive or
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oppressive experiences, from across a broad spectrum of majority world contexts (Pfeiffer,
2003).
Two aspects of this type of model are problematic. Firstly, considering disability to be a
cause of traditional beliefs results in the overall concept of disability being separated out on
the basis of culture, rather than it being considered as a ‘universal’ struggle. Ingstad (1999)
provides minority world examples wherein cases of abuse towards disabled people are
viewed, inaccurately, as exceptional, whilst in the majority world, cases of abuse or genocide
are depicted as the cultural norm. This can pave way for western audiences and academics to
impose their priorities for achieving equality, rather than allowing disabled people to
implement their own structure for achievement in their respective cultural contexts (O’Toole
and McConkey, 1995; King and Anthony, 1972).
Secondly, concern is raised over the notion of ‘rights’; allegedly a natural principle, provided
to all, regardless of cultural background or social status (Armstrong and Barton, 1999). The
rights-based social model offers practical solutions that seek change through equal
opportunities and equal rights agendas in compliance with existing systems (Sheldon, 2005).
Unfortunately, this model focuses only on the apparent short-term practicalities of removing
the disabling barriers to society, which will improve the quality of life for many disabled
people – albeit mainly in minority world environments – but not reduce the global problem of
disability (Gleeson, 1997).
Any analysis of the majority world relevance of the social model requires further evaluation
of its focus on ‘rights’. Many support the idea that disability should be embedded within a
human rights agenda (Quinn and Degener, 2002; Armstrong and Barton, 1999), but there is
an inherent assumption that rights to social, cultural and political entitlement are universal
(UK Department for International Development, 2000). While it is immoral to oppose the
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provision of human or civil rights to all, we must be realistic and consider the proposal in its
current context. The current proposal for the universal entitlement is founded upon three core
principles: participation - to ensure people realise their rights; inclusion - building societies
based on values of equality; and fulfilling obligations - structuring policies to protect and
promote human rights (UK Department for International Development, 2000). Given that the
perceptions of non-disabled people are still very much embedded within the charity or
medical model, campaigning for rights will always be seen as the preference by empowered
disabled people (Drewett, 1999); as the rights agenda moves towards a socio-economic and
political framework (Young and Quibell, 2000).
With reference to concerns over academic imperialism (O’Toole and McConkey, 1995; King
and Anthony, 1972), we must remember that ‘rights’ exist as a product of Western liberal
individualism (Sheldon, 2005). In the United Kingdom, disabled rights have evolved thanks
to the action of individuals standing against collective force (Robertson, 1997). This, of
course, has implications for their application to a majority world context, where social norms
are to be found in familial and communal ideologies, rather than in the realms of
individualism (Lang, 1998).
There has been significant commitment toward the promotion of rights at the international
level. Disabled people are regularly referenced in mainstream international guidelines,
however, the onus should be on the individual governed state to impose these guidelines,
regardless of any action undertaken by these international organisations to campaign for,
advise on, or publicise such rights issues (Sheldon, 2005). There exist multiple reasons why
states fail to adequately implement these international guidelines (Barnes and Mercer, 2003),
though it is clear that the limited resource availability of majority world groups is a
significant contributory factor. The United Nations Convention on the Rights of People with
Disabilities in 2006 (United Nations, 2006) marked a change in attitude toward disabled
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people; ensuring that disabled people were recognised as having rights and the capability to
make life-affecting decisions. Considered to be a human rights instrument, it was signed by
147 countries and ratified by 96; though it has clearly failed in its aim of achieving global
disability equality. Tomlinson and Abdi (2003) note several additional conventions which
have failed in their implementation following ratification, and which suggest that inadequate
policies exist as a product of, or are, at least, blamed on, resource deficiency.
While the work of disabled rights activists is undoubtedly valuable (Dunne and Wheeler,
1999), if the main focus for disability equality is on the notion of rights, then we must
question exactly what current international agencies and grassroots organisations are doing in
the name of the social model.
The introduction of Disability Adjusted Life Years, commissioned by the World Bank, has
not helped. As Russell (2002) notes, the program measured health through a series of cost
benefits in order to analyse the burden of impairment upon society. This type of initiative can
only serve to damage any attempt to implement social model thinking. Even at the level of
the United Nations, it is only recently that disabled people have featured in international
human rights documents (United Nations, 2006). Before the 2006 convention, disabled
people had featured only once in an official human rights declaration, in 1948, where they
were categorised as ‘others’ (United Nations, 1990).
It was noted above that support services and aid agencies would perform a vital role in the
implementation of the social model in a majority world contexts (Dutoit, 1989). Ironically,
many support programs under the control of minority world activists have been perceived as
barriers to the promotion of the social model (Flood, 2005). Projects intended to promote
disability equality too often portray disabled individuals as passive and dependent, or as
recipients of charity. Malinga (2002), alternatively, recognises that the lives of disabled
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people will only improve if they themselves are included, by the development agencies,
within the planning process.
While social model thinking is evident in the majority world, it is too often exploited by
development agencies that use social model terminology to cultivate a positive self-image,
even where disabled people continue to be negatively affected (Malinga, 2002). One potential
adverse effect is a fundamental misinterpretation of the model itself, wherein agencies
attempting to mainstream disability issues consider the model only as a tool to bring
disability into the public domain, thereby skewing the focus toward promoting the prevention
and rehabilitation of impairments rather than the equal opportunities for disabled people
(Nkeli, 1998).
Luckily, some majority world environments have understood the core values of the social
model and have applied it using a top-down approach. For example, the ruling political party
in Uganda has ensured that disabled people will have an opportunity to represent themselves
within government (Twimyuke, 2001). Here, the disabled community elect disabled people
into office in order to influence national policy and improve living standards; an approach
which has recently realised significant success in education legislation. A similar approach is
evident in South Africa (Office of the Deputy President, 1997), where disability issues are
subject to review by disabled staff within the President’s office – a system which has also
seen 10% of all departmental budgets ring fenced for improving disability equality. While
these examples demonstrate the potential effect of social model thinking at the highest
national level, it has not yet eliminated exclusion and oppression within these countries.
Nevertheless, it is a considerable achievement that social model principles have been knitted
into governmental structure. While extremely positive, the lack of uptake by other nations
means that these developments remain fragile, and potentially, reversible (Twimyuke, 2001).
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The approach taken by Uganda and South Africa to the removal of disabling barriers echoes
the empowering slogan "nothing about us without us"; a statement intended to demonstrate
that disabled opinion was the expert opinion in the context of disability issues (Malinga,
2002). While this ethos is not specifically of the social model, it is, nevertheless,
fundamentally similar, and, there are plenty of examples at grassroots level where the social
model has been used as a tool for social action and, ultimately, change (Flood, 2005).
When Disabled People's international (1981) publicised the message of full participation and
equality with equal rights and responsibilities within society, one grassroots organisation in
South Africa, the Self-Help Association of Paraplegics (SHAP), recognised the importance of
self-empowerment. The association aimed to achieve dignity and control by employing only
disabled people to carry out significant work for large mainstream industries (Nkeli, 1998).
The program evolved to tackle those barriers associated with transport, education and leisure,
and also to provide an advocacy service. Their work ethos echoed those principles established
by the Union of the Physically Impaired Against Segregation (1976) in which the social
implications of impairment, not the limitations of the health condition, formed the focus.
This organisation, which could be considered a centre for independent living, is a prime
example of the social model in action (Fletcher and Hurst, 1995). Although, recognising the
bilateralism of the social model, with its materialist and rights-based forms, we might assume
that their motives sit within a human rights agenda, though economic stability and selfsufficiency must play their part (Nkeli, 1998). During its early development, the group was
approached by white, privileged disabled activists to promote issues of human rights, and yet
the organisation was not interested, instead it retained its focus on the rejection of charity and
notions of dependency by promoting the importance of disabled participation within society.
This philosophy has encouraged Disabled People's Organisations across the globe to
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prioritise economic stability in order to achieve equality for disabled people (Hurst and
Albert, 2006).
The social model is not only enforced by collectives of empowered disabled people. In
Cambodia, for instance, disabled children are achieving inclusion by promoting the principles
of the social model within mainstream education.
Lansdown (2001) explains that deaf
children, previously offered no support and excluded from mainstream learning as a result,
managed to implement a teaching programme which included the use of sign language, and
allowed disabled children to participate alongside non-disabled peers, thanks to their strong
focus on achieving this goal and pressure from several disabled people’s organisations
(Cambodian Disabled People's Organisation). A secondary benefit of this action was the
creation of disabled role models and the removal of negative societal perceptions of disabled
people (Lansdown, 2001).
Other programs have focused on human rights from a social model perspective in order to
achieve disability equality. One example with a particular relevance to the globalisation of
the social model is the Reduction of Poverty Program in India (Andhra pradesh rural poverty
reduction program,). This program aims to install disabled individuals in leadership roles, in
the hope that this will have a positive effect on non-disabled perceptions. This example has
ultimately been considered a success, as beliefs in targeted areas are now overwhelmingly
respectful (Werner, 2002). Even the World Bank group have stated that more countries
should adopt the rights-based approach for achieving disability equality, (World Bank group,
2003).
Before drawing any conclusion as to the relevance of the social model to the majority world,
it is worthwhile reviewing attitudes toward the globalisation of disability equality. This topic
continues to dominate debate as organisations, such as the World Bank group or the
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International Monetary Fund, continue to provide financial support to organisations which
share their approach to achieving disability equality. Neufeld (1995) identified five
components which impact the positive reception of globalisation; they include the national
economic framework, international relationships, the structure of state production, the
concept of human identity and the presence, or absence, of democratic process.
Nuefeld’s framework provides a useful model through which we can approach the potential
impact of the social model at a global scale, and any associated affect on disability equality.
Steinstra (2002), for instance, has expressed concern over the potentially negative impact of
state-structured production, and its role in the continued marginalisation of disabled people
within a globalised economic workforce. This is apparent in today's society as government
services are being reduced; resulting in the closure or privatisation of care systems and
educational institutions.
McPherson (2001) believes economic globalisation will ultimately reinforce a position of
possessive individualism, where each individual will possess an ability to protect their own
capabilities without accountability or social debt. However, globalisation will remove the
notion of independence from a disability perspective, and reinstate the idea of disabled people
as dependent individuals (Steinstra, 2002). These issues raise a question mark over any
realistic hope of achieving global disability equality; and while the social model continues to
act as a useful tool for social change, the root causes of oppression remain intact.
Conclusion
Disability equality is a unifying ambition for those involved in the struggle against
oppression. But, whilst the aim is clearly outlined, the route to it is paved with multiple, and
sometimes contradictory, ideas (Driedger, 1989). Globally, disabled people experience
poverty, discrimination and reduced life chances compared to their nondisabled peers. Their
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health condition, i.e. impairment, is perceived as the cause of their oppression, thus the
objective for many is ‘cure or care’ (Oliver, 1990). Conceptualising disability in this way
(the medical and individual models) offers no hope of dismantling barriers, but promotes
segregation and the notion of dependency. The social model evolved as a product of this,
around a core argument which recognises that it is the inability of society to meet their needs
which results in the non-participation of disabled individuals (Oliver, 1990).
Equal
participation requires a radical shift in attitude, service provision and mainstream
opportunity.
But the key question behind this paper is whether a model formed around a liberal western
perspective can be globally relevant, or, indeed, globally implementable? Given that poverty
exists as a central theme in both the study of disability and of the majority world (Metts,
2000; Elwan, 1999), the question is influenced by whether we categorise the majority world
like Stone (1999), who argues it as a geographical location where opportunities for wealth
and power exist at a minimum, or, like Sheldon (2010), as an environment where systems
inherently favour the distribution of power and resources to the wealthy.
Similarly, understanding the relevance of the social model in a majority world context is
highly dependent on the interpretation of the model itself.
While some believe it to be a
toolkit for social change (Flood, 2005), others consider it as an evolved human rights model,
specifically targeting disability (Hurst and Albert, 2006). This latter interpretation is
problematic, since, to adopt the model as either a human or a civil rights issue, ignores the
institutional causes of oppression (Gleeson, 1997).
For true structural change, disabled people must align themselves with other marginalised
groups to promote the idea of a materialist social model (Charlton, 1998) which promotes
radical economic transformation in line with social model principles. Continuing to treat only
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the symptoms of oppression, through attempted attitudinal shifts, will continue to allow only
minimal participation (Gleeson, 1997).
Whilst the disability rights movement have done valuable work, a majority of disabled people
remain socially segregated, pitied and poor (Barnes and Mercer, 2003). The social model, in
certain forms, retains the potential for structural change, but the current focus on attitudinal
change and the promotion of rights means that it has yet to be effectively implemented to this
end (Drewett, 1999).
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