Introduction

Over the years, perceptions towards disability have varied significantly from one community to another. Limited literature in disability history, however, continues to pose a great challenge to students of disability studies in their endeavor to trace the development and formation of perceptions towards persons with disabilities. It is towards this end that this article seeks to present a coherent literature review on cross-cultural factors that influence perceptions towards children and adults with disabilities from a historical perspective. The final section provides a few examples that illustrate positive steps taken by the international community, and several countries, to improve disability perception.

As Roeher (1969) observes, an examination of attitudes towards people with disabilities across culture suggests that societal perceptions and treatment of persons with disabilities are neither homogeneous nor static. Greek and Roman perceptions of disability and illness are reflected in the literature.

Among the Greeks, the sick were considered inferior (Barker 1953), and in his Republic, Plato recommended that the deformed offspring of both the superior and inferior be put away in some "mysterious unknown places" (Goldberg & Lippman 1974). On the other hand, "Early Christian doctrine introduced the view that disease is neither a disgrace nor a punishment for sin but, on the contrary, a means of purification and a way of grace."(Baker et al. 1953)

During the 16th century, however, Christians such as Luther and John Calvin indicated that the mentally retarded and other persons with disabilities were possessed by evil spirits. Thus, these men and other religious leaders of the time often subjected people with disabilities to mental and/or physical pain as a means of exorcising the spirits (Thomas 1957).

In the 19th century, supporters of social Darwinism opposed state aid to the poor and otherwise handicapped. They reasoned that the preservation of the "unfit" would impede the process of natural selection and tamper the selection of the "best" or "fittest" elements necessary for progeny (Hobbs 1973).

Lukoff and Cohen (1972) note that some communities banished or Ill-treated the blind while others accorded them special privileges. In a comparison of the status of persons with disabilities in a number of non-occidental societies, Hanks and Hanks (1948) found wide differences. Persons with disabilities were completely rejected by some cultures, in others they were outcasts, while in some they were treated as economic liabilities and grudgingly kept alive by their families. In other settings, persons with disabilities were tolerated and treated in incidental ways, while in other cultures they were given respected status and allowed to participate to the fullest extent of their capability.

Variations in the treatment of persons with disabilities are manifest in Africa as in other parts of the world (Amoako 1977). Among the Chagga in East Africa, the physically handicapped were perceived as pacifiers of the evil spirits. Hence, care was taken not to harm the physically handicapped. Among the citizens of Benin (formerly Dahomey in West Africa), constables were selected from those with obvious physical handicaps.

In some communities in Benin, children born with anomalies were seen as protected by supernatural forces. As such they were accepted in the community because they were believed to bring good luck (Wright 1960). Nabagwu (1977) observed that among the Ibo of Nigeria, treatment of persons with disabilities varied from pampering to total rejection.

Diversifications in perception of persons with disabilities exist in Ghana as they do in other places in Africa. Among the Ashanti of central Ghana, traditional beliefs precluded men with physical defects, such as amputations from becoming chiefs. This is evident in the practice of destooling a chief if he acquires epilepsy (Rottray 1952; Sarpong 1974). Children with obvious deviations were also rejected. For instance, an infant born with six fingers was killed upon birth (Rattray 1952). Severely retarded children were abandoned on riverbanks or near the sea so that such "animal-like children" could return to what was believed to be their own kind (Danquah 1977).

In contrast, the Ga from Accra region in Ghana, treated the feeble-minded with awe.They believed the retarded were the reincarnation of a deity. Hence, they were always treated with great kindness, gentleness and patience (Field 1937).

The degree to which persons with disabilities are accepted within a society is not directly proportionate to that society's financial resources and/or technical knowhow. Lippman (1972) observed that in many European countries, such as Denmark and Sweden, citizens with disabilities are more accepted than in the United States. He also found that, these countries provided more effective rehabilitation services. The prevalent philosophy in Scandinavian countries is acceptance of social responsibility for all members of the society, without regard to the type or degree of disabling condition.

While throughout the world many changes have taken place in status and treatment of persons with disabilities, the remnants of tradition and past belief influence present-day practices affecting such group (Du Brow, 1965; Wright 1973).

Franzen Bjorn (1990) observed that in some communities in Kenya and Zimbabwe, "a child with a disability is a symbol of a curse befalling the whole family. Such a child is a "shame" to the whole family, hence their rejection by the family or the community. Children who are met by those beliefs and attitudes can hardly develop to their full potential: "They get less attention, less stimulation, less education, less medical care, less upbringing and sometimes less nourishment than other children." Franzen Bjorn (1990), pg 21-26.

Thomas (1957) sees societal perceptions and treatments of persons with disabilities within cross- cultural settings as a kaleidoscope of varying hues that reflect tolerance, hatred, love, fear, awe, reverence and revulsion. The most consistent feature in the treatment of persons with disabilities in most societies is the fact that they are categorized as "deviants rather than inmates by the society." (Lippman 1972 pg. 89).

From a cultural point of view, therefore, there are many specific circumstances that have influenced the living conditions of persons with disabilities, not to mention people's attitudes towards them. History shows that ignorance, neglect, superstition and fear are social factors that have exacerbated isolation of persons with disabilities.

Throughout Africa, persons with disabilities are seen as hopeless and helpless (Desta 1995). The African culture and beliefs have not made matters easier. Abosi and Ozoji (1985) found in their study that Nigerians in particular and of course, Africans in general, attribute causes of disabilities to witchcraft, juju, sex-linked factors, God /supernatural forces.

The desire to avoid whatever is associated with evil has affected people's attitudes towards people with disabilities simply because disability is associated with evil. Most of these negative attitudes are mere misconceptions that stem from lack of proper understanding of disabilities and how they affect functioning. "These misconceptions stem directly from the traditional systems of thought, which reflect magical-religious philosophies that can be safely called superstition" (Abosi, 2002).

In addition to other perceptions, social attitudes towards persons with disabilities are reflected in the family, which teaches by example customs and institutionalized values. For example, Gellman (1959) strongly believes that child-rearing practice tend to predetermine an adult's behavior towards persons with disabilities. This concept is consistent with cross-cultural research conducted by Whiting and Charles (1953), which provides evidence that child- rearing practices influence attitudes towards illness and disability. Their findings show that beliefs about illness are influenced by significant early relationships between children and parents that deal with the child's conformity to adult standards behavior. Their investigations examined the relationship between theories held in a culture to account for illness and the severity of child-rearing practices devised to instruct children to conform to adult standards. Intense social training was found to be related to oral, anal and genital functioning. It was hypothesized that those areas of child development which were most severely disciplined would create high levels of anxiety and would also be incorporated in theories of illness within the society. This hypothesis was supported. Also supported was the hypothesis that societies with the most severe socialization practices would create the highest degree of anxiety and guilt, and therefore would tend to blame the patient as the cause of illness.

It would seem that specific values attached to body parts and their functions would be related to the significance that is given to them within specific cultural settings based on the influences of language, religion and ethnic identity.Wright (1960) observed that knowledge about the self is built up through sensory experience, through the view points of others, and through inference based on these sources. This makes it possible for the body to become invested with significance beyond its concretely appraised function. As a result, body parts may assume such connotations as good and bad, clean and unclean, adequate and inadequate. "The hands for example, may not only be regarded as tools for grasping and manipulating but also contaminated by shame and evil should the child have been traumatized when caught masturbating or in fecal play." (Wright, 1960 pg141)

The impact of sub-culture membership on the individual's response to persons with disabilities is illustrated by studies conducted by Richardson, Goodman, Hastorf and Dornbusch, Richard and Hastorf (1963). Their research shows that adults and children of the same sub-culture (Italian and Jewish) are consistent in their preferential ordering of photographs of children with various physical disabilities.

Gellman (1959) suggests that cues learned in childhood serve as guides for distinguishing and differentiating various types of disabilities in accordance with socially accepted norms. He indicates, for example, that Eskimos perceive a limited number of disabilities, whereas Americans generally use a large number of terms for persons with disabilities. "Society furnishes in addition to roles and languages, a customary attitude towards the handicapped" (Gellman 1959 pg. 4). The meaning of one's own disabled physique to a person with a disability and to others who interact with him or her will depend in general upon the values of the cultural group to which they belong (Barker et al. 1953). The affective attitudes discussed by Wright (ibid) include pity, fear, uneasiness, guilt, genuine, sympathy and respect.

These attributes are distinctly divided into positive and negative categories, and are likely to critically affect the relationship between persons with disabilities and non-disabled people. They form some of the attitudes which can stigmatize persons with disabilities, impose artificial limitations upon them, deny them equal opportunities for development and living, and inequitably demote them to second-class citizens to be pitied (in the sense where pity is seen as devaluation tinged with contempt).

As Wright further observed: "Attitudes and behavior towards physical deviations are tenaciously held and transmitted to the young as much because they are felt to fit with sound and comprehensive beliefs and because of less clear emotional prejudice" (Wright 1960 pg. 256).