Disability and rehabilitation in Zimbabwe: lessons and implications for rehabilitation practice in the U.S - Disability and Rehabilitation in Zimbabwe

Journal of Rehabilitation, Oct-Dec, 2002 by Elias Mpofu, Debra A. Harley

Conceptions of disability and the associated rehabilitation practices vary widely across societies, and are influenced by the unique sociopolitical and cultural histories of those societies. For example, differences in perspectives on disability and rehabilitation between nations or communities have been linked to differences in (a) cultural beliefs about disabilities; (b) availability and accessibility of scientific knowledge on disabilities and rehabilitation to the general public; (c) the social and economic goals that people in different nations or communities seek to achieve; (d) level of industrialization (or development) of nations and the material resources they have for supporting disability-related programs; (e) ideological commitment to enhancing the quality of life of all citizens; and (f) respect for individual human rights (Brown, 1991; Jenkins, 1998; Talle, 1995). Developed countries are characterized by a belief in natural-scientific explanations of disability, higher levels of formal education among their citizens, individualistic-egalitarian socioeconomic structures, higher levels of industrialization, more organized and better disability-related service resources. In contrast, developing countries tend to have a higher belief in metaphysical-spiritual rather than natural-scientific views of disability, collectivistic-hierarchical socioeconomic structures, lower levels of formal education, lower levels of industrialization, and less organized and less formal rehabilitation service resources (Brown, 1991).

These differences in socio-cultural contexts are important for a cross-cultural understanding of disability and rehabilitation. For instance, developed countries with their more complex socio-technical systems may present more challenges in activities of daily living (e.g., commuting, time management) than do developing countries which tend to have simpler socio-technical systems. A personal characteristic that is not disabling in less complex societies can be a disability in more complex, industrialized societies (Brown, 1991). For example, mild mental retardation is less disabling to community participation among subsistence agricultural farmers in rural sub-Saharan Africa than it would be in the industrialized US (Serpell, Mariga & Harvey, 1993). This is because the activities necessary for a subsistence agricultural economy are less intellectually demanding as compared to those necessary for participation in an industrialized society. On the other hand, persons with more severe disabilities in developing countries may experience more personal restrictions due to the unavailability of appropriate or enabling disability-related accommodations (e.g., assistive devices, disability laws) (Mpofu, 2001). Quite clearly, there are differences in the nature and quality of rehabilitation services between the industrialized and the industrializing countries. At the same time, there are also significant differences in perspectives on and practices in rehabilitation within the industrialized and industrializing countries (Jenkins, 1998; Serpell, 1983).

This article presents an overview of disability and rehabilitation in Zimbabwe. In particular, consideration is given to definitions of disability and rehabilitation from a Zimbabwean perspective, historical foundations of rehabilitation in Zimbabwe, and rehabilitation service structures in the country. Finally, some lessons that may be drawn from the Zimbabwean experience for the practice of rehabilitation in the United States are explored. Because of the international perspective, differences in terminology may exist, thus, common terms are used and when this is not possible, the terms are defined for clarity.

Geographical Location, Demography and Responsiveness to Disability

Zimbabwe is one of eight countries in Southern Africa together with Angola, Botswana, Malawi, Mozambique, Namibia, South Africa, and Zambia. It has a total area of 150,873 square miles (390,759 km2) and a population of about 11 million people (Government of Zimbabwe Central Statistical Office, 1994). About 95% of the population are Blacks and five percent other ethnic groups. Eighty percent of the population are Shonas (a cultural-linguistic group), 15% are Ndebeles, and 5% Asians, Whites and others. Eighty percent of the population lives in rural areas and 20% in the cities. Therefore, the country's economic base is largely agricultural, although manufacturing, mining and tourism are also significant sectors of the economy.

The Government of Zimbabwean Inter-Censual Demographic Survey (1997) established a total of 218,421 people with disabilities in the country (56% males; 44% females). This prevalence is equal to two percent of the national population. Seventy-five percent of people with disabilities lived in rural areas and 25% in urban areas.

Zimbabwe has been referred to as "one of the most disability-accessible countries in Africa" (Devlieger, 1998, p. 26) with greater availability of disability-friendly public transportation policies, disability legislation, and the vocational training and employment opportunities of persons with disabilities as compared to neighboring countries. For example, people with disabilities have free public transportation, and are eligible for a government disability allowance. Schools enrolling students with mental and sensory disabilities are paid a higher grant for each child with a disability that they enroll. If the number of students with disabilities attending an ordinary school reaches seven for students with visual impairment or hearing impairment or ten for students with mental retardation, the government deploys a special needs teacher at that school to assist with the teaching. Zimbabwe is the only country in sub-Saharan Africa with a Schools Psychological Services and Special Needs Department whose responsibility it is to identify, assess, and place students with disabilities in schools.