Defining the Terms as Heuristic Notions of Negative Meaning and Oppression

In the cross-cultural study of other groups deemed "vulnerable" to oppression, such as women, ethnic/racial minorities, sexual minorities, the working class, and the elderly, subtle constructionist analyses have emerged in a variety of local contexts that have shown the complex constitution of social personhood and subjectivity and the asymmetrical relations of power that can sometimes result in their subordination in certain socio-cultural contexts (see, e.g., Bourdieu, 1984; Kondo, 1990; Weston, 1991; Willis, 1977). Yet, in past anthropological work on impairment-disability there has been minimal analysis of relations of power. In fact, many anthropologists currently studying impairment-disability subscribe to a radical relativistic approach and a weak view of oppression that can sometimes diminish the significance of certain problematic cultural responses to people with bodily and behavioral differences. And while it is important to note some of the positive cultural responses to bodily and behavioral differences and to provide a holistic picture of a society's understanding and response to these kind of differences, recognizing and critiquing social exclusions and oppressive social relations against impaired people is also paramount.

An example of the downplaying of a problematic cultural response to differences is provided by Nicolaisen (1995), who notes the fact that among the Punan Bah, people who are significantly physically or mentally impaired, infertile, lame, blind, deaf-mutes, and have harelips are hampered in getting married and begetting children. Yet, Nicolaisen rationalizes restrictions of this sort with the argument that these kind of issues are dealt with as "social and moral problems, not of the individual but of the family" (p. 52). Yet, logically, without the individual's impairment, there is no problem. He then asserts that through certain adoptive practices few Punan Bah are left without children and none is denied full personhood. Yet, his article presents a bleak appraisal of the chances of people with these kinds of bodily and mental impairments ever achieving marriage, certainly a valued institution, and he never even mentions whether they do or do not enjoy an erotic sexual life. This is not to say that impaired people are never fully incorporated into the social fabric and into meaningful roles in different societies, just that up to this point in the anthropology of impairment-disability, a critical gaze has been woefully absent.

This lack of critical focus is compounded with the terminological imprecision that plagues the field. Disability often becomes the default term even when bodily/behavioral difference or impairment or another ethnophysiological or ethnopsychological term would be more precise. Even when citing disability's Western medical and economic origins, scholars lapse into using it uncritically throughout an article. In 1999, Kasnitz and Shuttleworth offered what they called a pragmatic working understanding of disability-related terminology. The key is to consider the anthropology of impairment within any model of disability (see Hughes & Paterson, 1997, 1999, on the sociology of impairment). The following conceptual schema builds on this previous attempt.

Adapting from Douglas (1966), anomaly is a bodily and/or behavioral difference that falls in between cultural categories and is potentially threatening to social order. Cultures imbue anomalies with meanings and structure responses to its occurrence. Sociocultural groups may see persons whom they perceive to exhibit these anomalous differences as transgressing cultural values and threatening cultural cohesiveness, as in Douglas's model. In this case anomaly is socially construed as an impairment. Or, the group may resolve the perceived anomaly and imbue the bearer with a socially integrated role or status that is not negatively valued and does not constitute impairment. Sociocultural group members apply various indices to anomaly to determine its meaning and whether it constitutes impairment. For example, the American view of impairment is oriented toward indices of perceived functional limitations. Elsewhere, other salient ethnophysio-logical or ethnopsychological indices, such as balance between hot/cold, wet/dry, play a key role in identifying an anomaly as a sociocultural impairment (see, e.g., Burck, 1999). In this schema a particular society with its cultural meaning system defines and situates any functional limitation or other physical/psychological statuses (see also Marshall, 1996) as impairments, just as it also constructs health and illness.

There are at least three possible responses to impairment. The person so affected may be socially integrated into a society because of prevailing cosmology and other value-orientations that center on group cohesion. A society may respond by disabling/excluding to varying degrees the persons so affected thereby constructing disability. Or, a society may reserve a transpersonal or sacred role for the persons so affected. Obviously, this schema is for analytical purposes only and that in actuality a society may combine the above kinds of perceptions/meanings/responses to certain anomalous bodily and behavioral differences depending on the contexts of everyday life.

The above view attempts to disengage as much as possible the terms impairment and disability from their original biomedical meanings with the intent of transforming them into heuristic notions for sociocultural research on oppression against people with bodily and behavioral differences. Impairment in this understanding is thus a negative sociocultural meaning stemming from the perception-constitution of a particular physical and behavioral anomaly in terms of physical/psychological function or other ethnophysiological or ethnopsychological status

(see also Hughes & Paterson, 1997; Paterson & Hughes, 1999). This negative meaning may not appear in all domains of life, making impairment (like illness) a complex situational construct. When negative sanctions and exclusions, however, explicitly come into play in the form of particular social responses, this constitutes disability. From this perspective, the impairment-disablement sociocultural process is inherently negative. Whereas impairment is situated at the level of the cultural constitution of phenomena, that is, negatively following through with anomaly, disability is situated at the level of sociocultural response.

This is not the way that those conducting cross-cultural research usually define these terms. The World Health Organization (WHO) defines disabilities as "any restriction or lack resulting from an impairment of ability to perform an activity in the manner or within the range considered normal for a human being" (WHO, 1980, p. 28). However, even when disability is acknowledged as a negative process/response occurring between socio-cultural contexts and individuals (which it is in the current anthropological research literature), cross-cultural researchers will lapse into the familiar medical and lay meaning that implicates only individual bodies and minds. Rosing (1999), for example, in an otherwise insightful article on bodily/behavioral difference among the Quechua-speaking people in the Kallawaya region in the Bolivian Andes shows on the one hand an understanding of the disablement process as a sociocultural oppressive response to anomaly but yet continues to use the term disability to refer an individual's bodily/behavioral difference or impairment. She states, for example:

In the Andes disability can lead to two attributions (disability and vocation). In Western culture there is only one. In other words, in the Andes there is a culturally positive legitimization of disability— doubtlessly a great social resource for those affected. This is missing in Western culture. (Rosing, 1999, p. 40). Yet, this kind of dual usage simply obscures what is actually occurring and renders any analytical distinctions between terms of no consequence.

In the anthropology of impairment-disability a radical relativism and the terminological messiness that characterizes the field has tended to stand in the way of the development of critical approaches focusing on relations of power as reproduced in an actor's everyday practices that have taken root in anthropology as a whole (see, e.g., Dirks, Eley, & Ortner, 1994; Ortner, 1984). Yet, critical perspectives are essential in studying impairment and disability across cultures where multiple forms of integration and exclusion often exist side by side). However, some recent work in the anthropology of impairment-disability is finally beginning to take a critical view of certain social responses to anomalous bodies or behaviors (see, e.g., Hubert, 2000a, 2000b; Hyland, 2000; Kasnitz & Shuttleworth, 1999, 2001a, 2001b; Raji & Hollins, 2000; Sentumbwe, 1995; Shuttleworth, 2000b; Shuttleworth & Kasnitz, n.d. Turmusani, 1998, 1999a, 1999b).

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