Cultural beliefs towards disability : their influence on rehabilitation

Masasa, Tseleng Leonea (2002-03)

Thesis (MSc) -- University of Stellenbosch, 2002.

Thesis

ENGLISH ABSTRACT: South Africa is a multicultural, multiracial and multilingual nation ("the rainbow nation") with different traditions, values and cultural practices. Due to this diversity there are different belief systems, which give rise to different attitudes and practices towards various health issues such as disability, which in turn, have an impact on the rehabilitation of people with disability. The purpose of this study is to investigate the knowledge, attitudes and cultural beliefs towards disability and to identify the commonalities and differences of three broad cultural groups of South Africa (Blacks, Coloureds and Whites), and to determine their influence on the rehabilitation of disabled people in the Cape Town area. Sixty respondents (20 Blacks, 20 Coloureds and 20 Whites) were interviewed utilizing the knowledge, attitude and belief (KAB) survey in the form of a structured interview. Both probability and non-probability (systematic and purposive) sampling were used. The study was carried out using both quantitative and qualitative methods. The results showed that Whites and Colored generally had a fairly good knowledge of disability and its causes, acquired while they were young, whereas Blacks had a more superficial knowledge of disability, which was only acquired after the birth of a disabled child. The results also revealed that quantitatively all the cultural groups held positive attitudes towards the rehabilitation, education, marriage, childbearing and employment of people with disability. Attitudes towards the stigma attached to being disabled were also encouraging. In contrast, the qualitative data showed disparities between the three cultural groups in attitudes towards rehabilitation, education and marriage. Although rehabilitation is considered an important aspect to disabled people and their families, some Blacks experience problems in transporting their children to centres where rehabilitation services are offered. Socio-economic factors also have a bearing on this. The results revealed a general lack of awareness of disability among school children and teachers in Black and the Coloured schools, which may make it difficult for disabled children to be integrated into mainstream schooling. Marriage and childbearing was regarded as a way of increasing the support base of individuals with disability in the Black group, while the Coloured and White groups viewed marriage as a way of enjoying life and having children a matter of individual choice. Concerning employment and the promotion of people with disability, all three groups believed that disabled people have a right to be employed and earn a salary. In the area of beliefs, the results showed that the Black group blamed disability on witchcraft and that they consult health professionals, folk healers and look to God for healing. Most of the Whites and Coloureds believed that disability is a result of natural causes, human error or the will of God. There is an uneven geographic distribution of information about disability. Cultural beliefs towards disability may delay or hinder early identification of children and intervention. Two main recommendations are made arising from these results. Firstly, health professionals should know and understand the culture, values, beliefs and expectations of their clients and, more importantly, bring services to the recipients in their own familiar environment, culture and community, via the CBR model. Secondly, I recommend that an evaluation of knowledge and attitudes towards disability should be done in schools, where the disability awareness has been raised by some NGOs as compared with those where no intervention has taken place. A survey of this kind should be done in all the provinces of South Africa. The findings from this research thus have very serious implications for the provision of inclusive education and quality rehabilitation services for all the disabled children of South Africa.

AFRIKAANSE OPSOMMING: Suid-Afrika het 'n multi-kulturele, veelrassige en veeltalige bevolking ("die reënboog nasie") met uiteenlopende tradisies, waardes en kulturele praktyke. Hierdie diversiteit gee aanleiding tot verskillende sienswyses en praktyke met betrekking tot gesondheidskwessies soos gestremdheid, wat op gestremde persone 'n impak het. Die doel van hierdie studie was om die kennis, sienswyses en kulturele opvattings rakende gestremdheid by die drie breë kulturele groepe van Suid-Afrika (Swartes, Kleurlinge en Blankes) te ondersoek en te bepaal wat die verskille en ooreenkomste is en hoe dit die uitkoms van rehabilitasie van gestremde persone in die Wes-Kaap raak. Sestig respondente (20 Swartes, 20 Kleurlinge en 20 Blankes )is tydens gestruktureerde onderhoude ondervra. Die "Knowledge, attitude and belief' (KAB) onderhoud is gebruik: Beide 'n waarskynlikheids en nie-waarskynlikheids steekproef en 'n kwantitatiewe en kwalitatiewe ondersoekmetode is vir die studie gebruik Die resultate het getoon dat Blankes sowel as Kleurlinge 'n redelike goeie kennis het van gestremdheid en die oorsake daarvan, wat reeds op 'n jong ouderdom opgedoen word. Daarteenoor het Swartes gewoonlik 'n meer oppervlakkige kennis van gestremdheid, wat eers na die geboorte van 'n gestremde kind verwerf word. Kwantitatief is getoon dat al die kultuurgroepe 'n positiewe houding het teenoor rehabilitasie en onderrig van, huwelik met, hê van kinders en indiensneming van gestremdes. Houding teenoor die stigma gekoppel aan gestremdheid was ook bevredigend. In teenstelling hiermee het die kwalitatiewe data ongelykheid tussen die drie kultuurgroepe getoon in houding teenoor rehabilitasie en onderrig van en huwelik met gestremdes. Swartes beskou rehabilitasie as belangrik vir die gestremde sowel as die familie, maar ervaar probleme met toeganklikheid tot rehabilitasie. Sosio-ekonomiese faktore impakteer hierop. Skoolkinders en onderwysers in Swart en Kleurlingskole toon 'n algemene gebrek aan bewustheid van gestremdheid, wat integrasie in die hoofstroom-onderwys kan bemoeilik. Die Swart groep het huwelik met en hê van kinders beskou as 'n manier om die ondersteuningsnetwerk van die gestremde uit te brei, waarteenoor die Blanke en Kleurling groepe die huwelik beskou as 'n manier vir die gestremde om die lewe te geniet en dat die hê van kinders 'n individu se keuse is. AI drie die groepe glo dat die gestremde die reg het op indiensneming en om 'n salaris te verdien. Sover dit die sienswyses oor gestremdheid betref, blameer die Swart groep die toorkuns daarvoor en besoek hulle die tradisionele geneser sowel as professionele gesondheidswerkers. Hulle verwag genesing van God .. Blankes en Kleurlinge glo dat gestremdheid die gevolg is van natuurlike oorsake, menslike foute of die wil van God. Daar was ongelyke geografiese verspreiding van inligting oor gestremdheid. Kulturele sienswyses oor gestremdeheid mag 'n remmende invloed hê op op vroeë identifikasie en intervensie by kinders. Twee hoof aanbevelings kan op grond van die resultate gemaak word. Eerstens behoort professionele gesondheidswerkers ingelig te wees oor die kultuur, waardes, sienswyses en verwagtinge van hul kliënte, en dit te verstaan. Dienslewering behoort na die ontvangers se eie omgewing, kultuur en gemeenskap via die GBR-model gebring te word. Tweedens beveel ek aan dat 'n evaluering van kennis en sienswyses, rakende gestremdheid, in skole gedoen word. 'n Vergelyking kan getref word tussen die skole waar bewusmaking van gestremdheid reeds deur NRO's gedoen is, teenoor die waar geen intervensie was nie. So 'n ondersoek behoort in al die provinsies van Suid-Afrika uitgevoer te word. Die uitkoms van hierdie studie het dus implikasies vir beide die voorsiening van inklusiewe onderrig en kwaliteit rehabilitasie-dienste vir al die gestremde kinders in Suid-Afrika.

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