Different countries and organizations have their own definition towards the term disability and hence, it is hard to find an exact definition for disability. For example, the World Health Organization (1980) defines disability in terms of impairment. It refers it as disturbances in body structures or processes which leads to loss in function or abnormality in no matter psychological or physiological area. In Taiwan, according to disability means having injuries or incompletion in any body structures or functions. In mainland China, according to, disabled people refer to someone with psychological, physical or bodily abnormalities. Lastly, in Hong Kong, according to Employees’ Compensation Ordinance (2013), disability can be referred to three conditions and is relatively equaled to 100% loss of earning capacity. These three conditions are physical impairment, serious defect in mental processing and severe loss of hearing ability. Despite the fact that there are different definitions towards disability, these four definitions are quite similar with one another. They all refer disability as bodily or mental impairments which cause problems and difficulties in daily activities. This kind of definition is named as biomedical model. According to a survey done by Hong Kong Monthly Digest of Statistics (The Census and Statistics Department ,2009), among eight selected types of disability which are identified using this model, restriction in body movement, seeing difficulty, hearing difficulty and mental illness are of the largest proportions, with a prevalence rate of 2.7, 1.8, 1.3 and 1.3 respectively. This indicates that people with these physical impairments are the most common in Hong Kong.
Apart from biomedical model, the society also defines disability using the sociological model. This model emphasizes more on public issues and social forces instead of individual physical variations and troubles. It sees restrictions or lack of ability faced by the disabled as social responses to bodies that fail to meet social expectations or assumptions about the body reflected in the social or physical environment. When compared to sociological model, biomedical model mainly focuses on injury, illness or congenital conditions solely within the individual mind. (Weitz, 2006)
Difficulties generated form the own self
After understanding what disability is, we would than discuss the difficulties faced by disabled people in the society.
Disabled people face many problems in most of their daily activities.
Difficulties generated from the society
Apart from individual difficulties, there are also difficulties generated from the society and it is mainly discrimination:
Discrimination can be understood in this way: because there is something that someone is different from the normal ones, they are some deviance towards the normal ones, deviance means difference, therefore the normal ones may consider they are something abnormal and want them to be separated from their lives to show that they are two different groups and the thing that they can do so is to discriminate them. Therefore, discrimination exists.
In this part, we are going to discuss the discrimination exists in the society towards the impaired people and the discrimination can be understood from two ways, one is the hardware discrimination, which means something solid, like the inadequate resources support or the not fine policies of the society. Another way is software, which are mainly the comments from the public.
Now we may take a chance to discover these topics in different aspects:
Aspect 1: Education (Hardware)
According to the data provided by the report conducted by the Census and Statistics Department (C&SD, 2009), it shows that the education levels of the impaired people mostly reach primary school of education level. The figure is about 36.3% among the population of the impaired people. Only few of them can reach tertiary education (Only 6.4%). Remember that these data does not include the one from mental handicapped. They are mainly the one with other health problems, like sight or speech difficulties. Frankly speaking, they do not have lots of big problems with their understanding towards knowledge but why they cannot reach a higher level of education? One of the causes may due to the inadequate support from the society.
In Hong Kong, there is actually policy, integrated education, which may help the impaired student. Integrated education means that the schools from the main stream may provide some special arrangement for those impaired students. However, it is a policy that is not fine enough and actually cannot provide help for the impaired students. For example, according to the figure shown in the study conducted by Equal Opportunities Commission (EOP, 2012), we can see that over 40% teachers are not familiar with this policy and most of them actually disagree that they are well-trained. It shows that 60% of principals, 49% of teachers and 44% of professionals disagree that their teaching stuff receives sufficient training over integrated education. Moreover, due to their own insufficiency because of the inadequate training and resources, almost 30-50% of them are not willing to provide help for the impaired students.
Aspect 1: Education (Software)
Now we may take a further look on the other stakeholders’ comments towards this policy integrated education. According to the same study conducted by Equal Opportunities Commission (EOP, 2012), it shows that most of the parents actually do not support the policy because they think that providing help to the impaired students, their children are deprived at the same time. Thus, we can see that the policy is actually not fine enough to provide help and it is not being supported by most of the relevant stakeholders. The society wants to help but at the same time they do not provide enough efforts to provide help and this is actually a lope hole.
Now we may also see the comments collected by Equal Opportunities Commission (EOP, 2010) from the general public towards their preference on allowing the impaired students to receive education from the main stream schools. We can see that almost 40% of them object this suggestion. They disagree that the impaired students should have the right to enter the general schools.
Therefore, we can conclude that there is actually a kind of resources and interpersonal discrimination exists on the impaired students and the resources and interpersonal discrimination are actually generated from the non-impaired general public.
Aspect 2: Employment field (Hardware)
According to the videos CA Wall-less World produced by Radio Television Hong Kong, it shows that the impaired people are hard to seek job opportunities and they are being discriminated from the working environment. They really face great difficulties in workplace.
We may take a look of the job types of the impaired people. According to the survey conducted by Equal Opportunities Commission (EOP, 1997), it shows that most of them (about 37% among the total impaired people population) mainly get the job of lower level, just like elementary. Moreover, we can see that their salaries are really low, just a few thousand (32% impaired people receive the salaries between the range of $1999-$5999) and these are all due to their problem of impairment.
Furthermore, we can also see the level of satisfactory of the impaired people towards the job prospects and training (ibid). We can see that their satisfactory is quite low. Only 29% of the impaired people are satisfied with their job prospects and only 25% satisfied with their training provided during work. We can know that the job prospects of the impaired people and the training for them are not enough and the reason behind is same as before that they are being discriminated due to their own health problem. They are not believed to be resourceful. We can actually see how they are being treated in the employment field.
Aspect 2: Employment field (Software)
We can further conclude that the impaired people are really being discriminated while taking a look into the research taken by the Equal Opportunities Commission on the topic of the views of the general public towards the impaired people. Over 50% of the respondents of the study conducted by Equal Opportunities Commission (EOP, 2010) believe that the impaired people are not suitable for the competitive working environment in Hong Kong and they are expected to do something simple and with repetition. They are not accepted by most of the general public (ibid). Moreover, according to Zola (1985), we can see that the impaired people are believed that they are incompetent and they cannot be trusted. Therefore, we can know the reason why they can only get a lower level job, as well as salaries and with curious future of their career.
As mentioned earlier before, there are two different models to understand disability – the biomedical and sociological model. In addition, many determinants will also contribute to our understanding of disability. We will first take a look at social model.
Understanding disability: sociological model
Social model think that anyone who has impairment can act as a normal person but they don’t have that chance. The main reasons of disability are social barriers and discrimination.
Social barriers limited their opportunities. There are many social barriers in Hong Kong. For example, the blind people are hardly to take bus because they don’t know which bus is coming. Also, in some less developed areas in Hong Kong such as Hong Hom, there are not lifts and slope on the bridge, and hence wheel chair users are not abled to use the bridges. Because of the design of the society is mainly for normal people, people with impairment cannot use the services or equipments in the society. It brings them a lot of inconvenience. They need others’ help. Others may think that they are useless in the society and label them as weakness. They are being excluded from the society and becoming disability.
Discrimination in workplace also limits impaired people’s opportunities. Many employers think that impaired people’s productivity is lower than that of normal people. They are not willing to employ the impaired people. Therefore people with impairment have less chance to contribute to the society. In social model, they are being disabled because the society do not accept them and provide chances to them. Social model believes that people with impairment can take care of themselves and work normally in the society if the society can be redesigned and adapted to suit the disabled people. The abnormality is about the society but not the impaired people. We can see that social model focuses on social exclusion and discrimination when analyzing disability.
Understanding disability: biomedical model
In the biomedical model, the concept of normal and abnormal is used to understand disability and it is significant. Unlike social model, biomedical model thinks that the abnormality is about the impaired patients and they are the abnormal part of the society. As a result, it will tend to exclude and separate them as unusual group. The main focus of biomedical model is on the impairment. According to WHO(1980), disability is “any restriction or lack of ability to perform an activity in the manner or within the range considered normal for human being.” Biomedical model of illness is actually implied in it in this definition. Biomedical model thinks that any abnormalities of the body will cause illness. So impairment being seen as an abnormality is an evidence of that biomedical model of disability is based on medical model of illness. Also, biomedical model thinks that disability is caused by impairment. Being impaired and disability is their own tragedy. Therefore, coping with impairment is how this model solves disability. The impaired people have to change themselves to adapt to the society.
Understanding disability: other determinations
There are a lot of factors that contribute to the understanding of disability. First of all, media contributes a lot to our understanding. In TV shows, movie or even news report, they often shape the people with disability as weakness and they need help For example, in 1 Litre of Tears, the actress got a rare disease (Spinocerebellar Atrophy) and had difficulties in movement. She was shaped as a very weak, sad and unlucky person. Unfortunately, we are easily affected by media as we receive information from it every day; even when we are small, still do not have any concept about disability. Therefore, it is common for to public to think that disabled people are weaker than the general. Also, in movie or TV shows, they usually use biomedical model to understand disability. Biomedical model’s definition of disability is being promoted in this way and that is why the biomedical model is dominant in our society.
Secondly, culture will affect how we understand disability as well. Let me use an example to explain how culture affects the understanding under biomedical and social model. In China, foot-binding is an old tradition. Many ladies suffer from foot-binding because the society sees it as beauty. If foot-binding are put under the biomedical model, it really causes body impairment. They can’t walk fast, not to mention doing sport. So it should be classified as disability. In the west, there is no doubt that foot-binding is being considered as disability. However, in China, people do not think it is impairment because every woman does it. So it becomes normal. Also, a foot-bound woman may be discriminated in West Country, therefore decreasing their opportunities to perform as normal. This causes the disability under social model. In contrast, foot-binding person will not be discriminated in China and defined as disability.
Lastly, resources is one of the factors that affect the understanding of disability. Short sight will be used as an example to demonstrate this point. In Hong Kong, short sight is common, but it is not a big deal. Wearing glasses or having laser surgery can help us if we have money. So it is not being defined as impairment, much less disability. However, in some poor countries, people do not have that money to cure their or their children’s short sight. Not seeing well may become impairment in these areas.
Problems of biomedical model
A number of problems are associated with biomedical model. First of all, only impairment is mentioned but not disability, researches and interventions are mostly based on impairment rather than social change. Impairment is being defined as difficulty in functioning or body dysfunction. It is thought to be a personal tragedy and purely objective, while the actual experience and interpretations of the people concerned are being ignored.
Secondly, one’s body is firstly implied in the biomedical model, then the whole person, which both physical and psychological aspects are being considered. But at the same time, civil and human rights are being undermined in the model.
Thirdly, it is assumed that all people who suffered from impairment are actually fear of being impaired and emphasis on medical intervention, and the attitudes and actions of the impaired is thought to be the main reason that disabled us rather than any social factors. Problems like abortion, euthanasia and cure are thought to be quality of life issues rather than issues related to impairment.
Problems of sociological model
As for social model, there are also many problems concerning the model. Firstly, most of the researches are made largely by people with no direct experience of impairment, which not all people, both the impaired and the disabled ones, are being included. Even though the problem is being noticed, these researches are being presented authoritative in this model.
Secondly, although mainstream interventions are presented to be benefitting the disabled people, they are still made for the application for a non-disabled society.
Thirdly, the disabled individuals are not able to be included and represented fully in the social model, which bodily discomfort and pain experienced by the people with disabilities are not being acknowledged.
Fourthly, social model does not attempt to deal with the personal restrictions of impairment but the social barriers of disability, like the social support given to the disabled. However, the removal of social barriers may not necessarily mean the removal of restricted opportunities. This showed that the limitations to an individual’s health and energy levels or their experience of pain still constraint their participation in activities even though more facilities are built to help them. An example would be the difficulty for a wheelchair user to move around in a house that is crowded with people during parties.
Fifthly, it’s assumed that the disabled has a tendency to deny the experience of their own bodies, claiming that all the restrictions are entirely socially created. It is admitted that environment barriers and social attitudes are being the only important parts of experience of disability, which an ideal social model is believed that an adequate social theory of disability must contain a theory of impairment. Little actions are being taken into account as to clarify the nature of the social barriers faced by people with serious psychiatric disorders.
Last but not least, the perceptions of the significance of their mental health problems are not being addressed. For example, the problem of depression suffered by a man who lost his leg during an accident is being ignored. These associated problems may lead to life threatening results.
Renewed social model and suggested improvements
As a result, a renewed social model is needed. Suggested by Crow (1996), the renewed social model should be operated on two levels, which a more complete understanding of disability and impairment as social concepts is allowed. It tends to encapsulate the total experience of both disability and impairment. When disability comes to an end, it is believed that no socially created barriers to transport, housing and education are being made, while impairment is no longer a pretext for excluding people from the society, indicating that impaired people would be able to participate in and contribute to the society on a par with others. A dialogue between disabled people and medical sociologists may enrich and improve the model.
In conclusion, a number of improvements are being suggested. Firstly, policy change should be made. For example, legislation on civil rights should be made as to protect the disabled people from being discriminate. Secondly, the resources available, including both researches and interventions on impairment and disability, should be increased by the government for future use. At the same time, more physical facilities like lift and different machines should be built in order to help the impaired people with daily matters. Thirdly is about education. The public should be taught the acceptance of individuality with a wide range of attribute. All these suggestions can enable the individuals to enjoy full citizenship, respecting their rights and duties.
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