The advent of global disability studies has changed the entire shape of the discipline, and if you have not truly engaged with the inequalities and differences embedded in the international landscape of disability, then The Global Politics of Impairment and Disability (which was originally published as a special issue of Third World Quarterly) may be a useful entrée into the challenges posed by such a wider conceptualization of the field. The advent of various global responses to disability and impairment, such as the UN Convention on the Rights of Persons with Disabilities, the World Disability Report, and other institutionalized responses from mainstream (largely conservative) institutions, has been part of the reason why a global perspective is now more common. More important, in terms of a critical engagement with (and theorization about) disabled people’s experiences around the world, is the increased sense of the inequities embedded in western-dominated theories being uncritically applied to the different social, cultural, economic and political contexts of the Global South. So unlike most traditional disability studies texts, which are either based in North America or Europe, this book includes global overviews as well as case studies from Africa and Asia.
The ‘Global South’ is becoming an increasingly common way to discuss the experiences of poorer countries – avoiding the implied hierarchy of the ‘First World and the Third World.’ This topic – the Global South – is the focus of the first chapter in this book, by the eminent Australian scholar Raewyn Connell. Oddly enough, Connell seems to use the western terminology of ‘impairment’ and ‘disabled people’ without any recognition of their cultural specificity – even while briefly noting that the impairment/disability binary must be replaced by a more inclusive concept of ‘social embodiment’ (2). Nevertheless, she makes a strong argument that impairment must be understood in the material context of colonialism, capitalism and patriarchy. Furthermore, she suggests that because the export of the medical model was a part of colonization, there is a need to rethink its relation to the experiences of indigenous as well as disabled people. Her original theoretical contribution is to suggest scholars focus on ‘the ontoformativity of social process’ (3). Disabled people’s bodies and lived experiences can help us rethink inequality. They not only demonstrate oppression but also resistance which can inform broader studies of inequality, particularly injustice directed towards the lived (and social) body. Equally importantly, disabled bodies help develop new forms of knowledge – there is much to learn from disabled people about the global and social nature of inequality. Furthermore, discussions of impairment and disability need to be global, and must be analyzed in terms of their relationships to capitalism, patriarchy and colonialism – an important argument which is continued throughout the book.
Helen Meekosha and Karen Soldatic continue the theme of the northern domination of conceptualizations of disability by critically examining the UN Convention on the Rights of Persons with Disabilities and suggesting that it has been dominated by northern discourses of human rights. The lives of many people in the Global South are positioned outside these conceptualizations of human rights, so Meekosha and Soldatic call for a re-examination of the social dynamics associated with the politics of impairment. They are concerned that by concentrating on a discourse of ‘human rights,’ many of the problems experienced by disabled people are getting worse rather than better. The discourse of ‘universal human rights,’ implemented through the nation-state, has actually been used to justify human rights violations, wars, and Eurocentric and racist metaphors of non-western states. Furthermore, the hegemony of ‘human rights legislation’ as a way to address the concerns of disabled people has been ‘diversionary’ (21) because it has prevented alternative discourses and alliances that might involve redressing global imbalances in wealth, power and poverty. They endorse Connell’s conceptualization of the ‘ontoformative’ as a way of ‘understanding social dynamics in bodies as a form of global social embodiment’ (22), particularly by focusing on the political processes that occur in bodies.
Case studies from Africa countries demonstrate the practical value of this global approach to disability. Discussing Sierra Leone, Maria Berghs outlines the practical benefits of including diverse global experiences of embodiment in wider understandings of embodiment. Berghs highlights the particular effects of the civil war in Sierra Leone, with regard to camp life, poverty and medical care in the post-conflict period. Like Connell, and Meekosha and Soldatic, she recognizes that analyses must include the social factors such as war (including amputees and the war-wounded) as well as the ‘everyday structural violence of poverty’ (33) in both local and global spaces. Alternative conceptualizations of ‘big man’ masculinity in a ‘patrimonial system’ (47) also demonstrate differences from a western focus on independent living, citizenship and housing.
Inclusion of deaf experiences is another highlight of the book. Another African case study by Goedele Am De Clerck emphasizes the importance of the indigenous knowledge of the deaf community. This impressive study uses participatory and community-based research to demonstrate the value of focusing on non-western forms of deaf knowledge and identity. Similarly, a chapter on the educational experiences of deaf children in Uganda by Susie Miles, Lorraine Wapling and Julia Beart demonstrates the importance of community involvement in asserting the right to education, supported by government funding. Their discussion of 14 units attached to schools in Bushenyi, Uganda focuses on a parent-led, community-based educational inclusion initiative which could not have succeeded if ideas and policies from the Global North had been attempted. The importance of culturally specific, community-led initiatives is also a theme in a study of refugee camps in various countries by Manha Mirza. Even in these awful conditions, mobilizations around issues of disability rights and inclusion have occurred – both with, and without, external support. Indigenous, grassroots efforts are crucial, Mirza concludes.
Another fascinating African case study integrates issues of chronic illness into the study of impairment and disability. Ruth Evans and Agnes Atim explore the contested nature of care, disability and HIV in Tanzania. They rely on two main sources of information: Evans’ qualitative study of 20 women with HIV and the 22 children who care for them and Atim's professional experience as a leader of a national network of women living with HIV. They particularly highlight concerns about embodiment and chronic illness, the ways in which diagnoses are revealed to women, the gendered dynamics of being mothers and wives with HIV (particularly as they affect relationships with children and families), and the issues of access to resources – including treatment. Finally, a discussion of new alliances between HIV and disability organizations around the issue of adequate care provision has important implications for the policies and practices of disability organizations everywhere.
An Asian study by Julie A. King and Mark J. King uses ethnography to explore the experience of men living with spinal cord injury in northeast Thailand, specifically the Khon Kaen province. They use the concept of ‘three bodies’ to describe these experiences: ‘one’s own lived experience of a body, the body as a social symbol, and the body politic’ (110). They state that the concept of three bodies has rarely been used in low or middle-income nations. One particular strength of their ethnography is their detailed discussion of changes in identity (as played out in families, in communities and in relation to the government), as well as phenomenological discussions of individual bodies. They emphasize changes in family dynamics and health-seeking behavior, as well as powerful effects of blame attribution and being constructed as a burden.
Disappointingly, for any book on disability, the language is often inaccessible. This is not only the case with Connell’s concept of ‘the ontoformativity of social process’ but also for another Asian study, by Fiona Kumari Campbell. Her examination of Sri Lanka has important implications about the normalizing assumptions behind policies of the United Nations and the World Health Organization, but it also uses language such as ‘the functioning of geodisability knowledge’ which engages in ‘codifying hegemonic ways of seeing, citing and situating disability’ that ‘colonise different cultural approaches to disability’ (87). Like Berghs, Campbell emphasizes the effects of war (and landmines), but also natural disasters, ageing populations and high-risk work. However, the effects of war cause many of the impairments in Sri Lanka, including depression (resulting in a very high suicide rate) as well as cognitive and visual impairments.
As suggested in the introduction to this review, this is an important book for the field, which is compelled to adopt a more global perspective that recognizes the unique specificities of the politics of disability in the Global South. There is a broader implication too – those authors who focus on the Global North should, to use activist parlance, ‘check their privilege’ before making universalist assumptions.
University of Toledo
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© 2015, Mark Sherry
http://dx.doi.org/10.1080/09687599.2015.1045355