Conceptualizations of disability are lacking in the Asian academic literature, just as they are in the West. However, Chinese authors have been studying the phenomenon of disability for decades (Baolin & Huang, 1999; Chan, Hua, Ju, & Lam, 1984; Huang, Guo, & Bricout, 2009; Tam & Watkins, 1995; Tsang, Tam, Chan & Cheung, 2003; Yip, 1998; Zhang Hampton, 2001), and they urge researchers in non-Western countries to study the attitudes of non-disabled towards disabled persons (Chan et al., 1988). While varying aspects of disability have been investigated, overarching understandings of the ways in which disability is constructed are lacking. Models of disability developed in Asia are sorely needed (Gilson 2010), but before models responsive to the culture in various Asian countries can be proposed, descriptions of how disability is viewed in those areas must be defined. This paper articulates views of disability from the perspectives of university students with disabilities, instructors, and staff in Hong Kong.
In the growing field of disability studies, various models of disability have been identified in the past two and a half decades, which frame how disabled people are treated in a medical and sociological sense, educated as world citizens, employed in the private and public sectors, represented in popular and niche media and literature, cultivated as friends and partners, and perceived as family members. One of the most pervasive of these is the medical model of disability. The medical model of disability characterizes disability as a state of abnormality, attributable to the individual (Evans, Assadi, & Herriott, 2005; Fein & Asch, 1988; Garland Thompson, 1997). The disability is seen as a failure of that person's body (Johnson, 2003). It is the job of the medical, rehabilitation (Kirby, 2004; Michalko, 2002; Smart, 2001), and education (Ainscow & Miles, 2004; Harry, 1992) communities to restore as much functioning to the person with the disability as possible, since disability is seen as something to be avoided or cured. Should the best efforts of the medical profession fail in curing an individual, the person with the disability is directed to graciously accept help from the non-disabled community (Kirby), thereby increasing their dependence on those who have less personal experience with disability (Zames, Fleischer & Zames, 2001). Because Hong Kong was ruled by Great Britain from 1842 until July 1, 1997 (Yip, 1998), the teaching of its professional citizenry, such as those in the medical, rehabilitation, and education systems, has been heavily influenced by the medical/rehabilitation model of disability (Yip, 1998), as has been the case in the West. For example, rather than focusing on community reintegration for people with psychiatric histories, governmental and non-governmental agencies seek to reduce stigma about mental illness by segregating patients from the public (Yip, 1998). The medical model's prevalence in Hong Kong is illustrated by the way disability is defined in the Disability Discrimination Ordinance of Hong Kong:
- total or partial loss of the person's bodily or mental functions;
- total or partial loss of a part of the person's body;
- the presence in the body of organisms causing disease or illness;
- the presence in the body of organisms capable of causing disease or illness;
- the malfunction, malformation or disfigurement of a part of the person's body;
- a disorder or malfunction that results in the person learning differently from a person without the disorder or malfunction; or
- a disorder, illness or disease that affects a person's thought processes, perception of reality, emotions or judgment or that results in disturbed behavior, and includes a disability that-
- presently exists;
- previously existed but no longer exists;
- may exist in the future; or
- is imputed to a person (Section 2 (1) Chapter 487)
Many disabled people pinpoint those practicing the medical model of disability as having devalued them (Shapiro, 1993; Smart, 2001) and prefer a rights-based perspective (Young & Quibell, 2000). As people with disabilities become more integrated into Hong Kong's society and workplaces, Chiu and Chan (2007) note that the public's willingness to tolerate discrimination against them diminishes. The social model of disability fully acknowledges the continued marginalization and economic deprivation experienced by disabled citizens (Longmore & Umansky, 2001; Wallis, 2000). Rather than the problem of disability being thrust upon the shoulders of disabled citizens, society is identified as the problem. Society has provided inadequate services of support and integration for disabled persons (Evans et al., 2005; Michalko, 2002; Oliver, 1998; Shakespeare, 2006).
And yet, the social model of disability (Cuskelly, 2000) was developed almost exclusively by white males (Shakespeare, 2006) from Western cultures (Linton, 1998). The social model of disability minimizes the effects of impairments in its emphasis on societal discrimination. But this perspective overlooks disabilities that fluctuate in severity and disabilities that result in diminished functioning over time (Shakespeare).
While Asian models of disability are not yet fully developed, it is critical to understand the academic literature that does investigate disability in Hong Kong. Tam and Watkins (1995) compared the self-concepts of Hong Kong Chinese adults with and without disabilities. They surveyed 135 physically disabled and 146 non-disabled people, and found that the people with disabilities had lower self-satisfaction than did the non-disabled participants. In a survey of 338 postsecondary, non-disabled Hong Kong students, it was found that students' attitudes towards people with mental illness and mental retardation were more negative than towards people with physical disabilities (Chan et al., 1988).
Qualitative explorations of the construct of disability in Hong Kong are absent from the literature published in the English language. Furthermore, the perspective of disabled higher education students and those who work in higher education is also missing. Thus, the purpose of this study was to understand how disability is constructed in Hong Kong in one higher education institution as perceived by multiple stakeholder groups (i.e., disabled students, instructors, and staff). Since disabled students around the world are attending higher education in increasing numbers (Gilson, Dymond, Chadsey, & Hsu, 2007), such a study in Hong Kong is warranted. In addition, a study whose investigators understood disability from a non-medical approach was needed to expand the literature about disability in Hong Kong.
Qualitative research has enjoyed a surge in popularity over the past few decades (Bogdan & Knopp Biklen, 2003; Brantlinger, Jimenez, Klingner, Pugach, & Richardson, 2005; Sherman & Webb, 1988). Qualitative researchers assert that providing rich descriptions of participants' lived experiences through the analysis of interviews yields data grounded in concrete knowledge and experiences more so than do many quantitative designs (Oakley, 2000). Brantlinger et al. suggest that descriptive information from qualitative studies lends itself particularly well to an understanding of people with disabilities.
This qualitative study took place in the spring and summer of 2006 on the campus of a large, urban university in Hong Kong Special Administrative Region (SAR) of the People's Republic of China. The university's students represent many geographic regions of the globe, as do its faculty. Courses are offered in English, Chinese, and other languages. However, all students matriculating at this university must pass English proficiency examinations, for the medium of instruction for the majority of courses is English. In terms of geography, the SAR of Hong Kong is quite small, 380 square miles (Cohen, 2000), and there are only eight universities in Hong Kong. In order to preserve the anonymity of the university, information about the university and its programs has been deliberately limited.
At the time of this study, 18 students had self-identified as having disabilities at the university's disability services (DS) office. The DS had been in existence as a formal office within student affairs since the early 1990s. The DS was staffed part-time with a student affairs administrator and a secretary.
Criteria for participation in the study included fluency in English, enrollment at the university for at least one year, and having a disability for at least one year. These criteria were chosen because the language of the primary interviewer was English, and students' command of the English language was essential to obtaining a thorough understanding of their experiences with disability. Though English proficiency was a requirement of matriculation at the university where data were collected, proficiency ranged within the university's student body. The English fluency criterion may have reduced the number, and the diversity, of students willing to volunteer as study participants. In addition, having a minimum of one year in higher education with a disability ensured that students had sufficient experiences upon which to draw.
The university's DS office identified six students who met these criteria and disseminated information about the study to each student through personal phone calls to them. Five students agreed to participate. These students majored in English education, geography education, mathematics, political science, and literature. All student participants were born and raised in Hong Kong and were ethnically Cantonese. For purposes of this study, participants selected their own pseudonyms. Since many Hong Kongers use English names as well as Chinese ones, it should not be assumed that the use of an English name indicates a specific ethnicity.
Berry was 21 years old and used a white cane for mobility when in unfamiliar places. From the age of two Berry was completely blind. His parents were both visually impaired, but his sister could see normally. His hobbies were going out with friends to dine, running, and attending religious activities. Berry attended a residential school for the blind from kindergarten until the age of 15. At that point he transferred to a secondary school for boys with and without disabilities bound for higher education.
Clint was 28 and had begun to lose his sight in his early teens; he could see steps when lighting was optimal. He could still discern colors and shapes. Clint had not received orientation and mobility training and had not learned braille well enough to use it in his daily life. Clint did not use a white cane for mobility. No one else in Clint's family had a disability. Clint enjoyed the fine arts, and he often attended plays and musical concerts, either alone or with his girlfriend. Clint was educated in his neighborhood school, and little adaptation was made to the curriculum or instruction he received to accommodate his vision loss. As Clint's vision continued to dissipate, he began experiencing heightened anxiety. At the time of our interviews together, Clint reported emotional instability and nervousness at times.
Soon after her birth, Kathleen's right leg was amputated above the knee. Kathleen was 20 and wore a prosthetic leg at all times when in public. She reported being able to climb stairs and walk up and down escalators and steep hills. Neither Kathleen's mother nor her brother had disabilities. Kathleen had an active social life with her friends. She attended clubs as well as religious activities. Kathleen went to her neighborhood school from kindergarten onwards. She was excused from recess and physical education classes. No other adaptations were made for her disability while in school.
Po Sing was 22 years old; he had moderate hearing loss in both ears and wore hearing aids during class. Po Sing was extremely active on campus. He had served as the chair of his dormitory's activities committee, volunteered with various organizations, and held down two part-time jobs while at university. Po Sing was the sole member of his family with a disability. He attended his neighborhood school from kindergarten until graduation from high school. Other than allowing Po Sing to sit at a location conducive to his hearing during class, he was not offered any adaptations to the curriculum or instruction he received in school.
Tony was 21; he had a severe hearing loss in his left ear but never wore hearing aids and only disclosed his disability to a few trusted friends and staff at university. He had a heart condition as a result of heart surgery performed when he was an infant. The heart condition only prohibited him from running or exerting himself for long periods of time. Tony was active in the university's bridge club. He enjoyed reunions with his extended family, at which sports and eating were the main activities. Tony lived at home with his family — none of whom had a disability. He attended his neighborhood school from kindergarten until his graduation from secondary school. He was allowed to wear headphones to better listen to oral English examinations in school; this was the only accommodation for his hearing loss.
Once the students agreed to participate in the study, they were asked to recommend course instructors to approach for study participation in order to learn about their views of disability. Five female and four male instructors were recruited for interviews. Their countries of origin were Mainland China, Hong Kong, Great Britain, Spain, Switzerland, and the United States. Instructors taught in a variety of disciplines — environmentalism, mathematics, sociology, history, literature, and pedagogy. To further broaden the perspectives studied, six university staff who worked in student affairs (including disability services), the library, the student counseling center, the equal opportunity office, and the physical plant were recruited through a judgment sample (Krathwohl, 1997).
Six interview protocols were developed after reviewing the literature related to higher education and disability and the Chinese education system: one protocol for staff interviews, one protocol for instructor interviews, and four protocols for student participants. Two other academic colleagues having expertise in special education, one with lived experience in disability, and three academics from Eastern Asia reviewed the protocols and provided feedback on clarity, cultural nuances, and grammar that was incorporated into the final protocols.
Each disabled student was interviewed four times over a four-month period and was asked how they viewed their own and others' disabilities, how they defined disabilities, and how they were treated by those with whom they came into contact regarding their disabilities. Specific areas of inquiry within student interview protocols included primary, secondary, and postsecondary education; past and current home-life; socializing with friends and acquaintances; and views of personal and societal constructions of disability. Within the student interview protocol designed to understand disability more deeply, participants were asked to define disability, to explain how various individuals (i.e., family, friends, and university instructors) viewed disability, to describe images of disability in their own minds, and to describe people who had disabilities similar to their own but with varying levels of functioning.
Staff and instructors were interviewed once each. The interview protocols for instructors and staff were intended to gather information about the attitudes of such individuals towards serving disabled students. Staff and instructors were asked to describe their earliest recollections of people with disabilities and were invited to define disability.
All interviews were digitally recorded in audio on a laptop. Interview questions were generally posed in the order they appeared in the protocols, but participants were encouraged to answer fully and were allowed to answer questions out of order. When participants struggled to recall appropriate English vocabulary to explain their meanings during interviews, they spoke phrases in Cantonese, and the researcher asked a native Cantonese speaker to translate participants' words into English.
Data Interpretation and Subjectivity
In qualitative studies the person collecting data becomes integrally linked with study participants. Peshkin (1988) cautions, "Whatever the substance of one's persuasions at a given point, one's subjectivity is like a garment that cannot be removed" (p. 17). The disclosure of the biases researchers bring to their work is, thus, warranted. To that end, the first author of this manuscript (who collected the data), is blind and is influenced by the disability studies and independent living movements of the United States. She has lived for extended periods of time in Germany (ten months), Hong Kong (eleven months), and the United States (the remainder of her life). She recognizes that shared experiences between herself and her disabled participants might have allowed her to elicit more personal answers from research participants than might have been obtained by a non-disabled researcher (Greene, 1997). Additionally, she acknowledges her precarious role as a Westerner attempting to understand phenomena in a culture foreign to her own. Interpretation of the findings of this study is, therefore, biased.
The interviews with disabled students, instructors, and staff at the university were transcribed in their entirety. With the intent of amplifying the participants' perspectives and minimizing the bias brought to data interpretation, member checks were undertaken (Lincoln & Guba, 1985) by asking participants to read summaries of their interviews and provide feedback to the researcher. Content analysis (Brantlinger et al.; Schwandt, 2001) was used to sort the data according to questions posed in the interview protocols. The data were then sorted according to categories of meaning. The second author read twenty-percent of the coded data and discussed the codes with the first author. Through face-to-face and email communication, consensus about codes was reached. Analysis was done across interview populations to reveal points of convergence and divergence between disabled students, instructors, and university staff. Rather than the use of triangulation (Smith, 1978), complimentarity was employed (Greene, Caracelli, & Graham, 1989) to compare and contrast findings. Member check feedback was reread as the findings were written up to ensure that participants' viewpoints were articulated appropriately.
The findings presented in this paper are organized according to the perspectives of those holding the attitudes in question. University instructor and staff attitudes towards disability are followed by student participant perspectives. Themes that emerged across participants are explored in the discussion section.
Instructor and Staff Attitudes Towards Disability
Instructors and staff often understood that, in general, disabled people would prefer not to elicit pity from others. "Most of the disabled persons just want to be regarded as normal," observed an instructor. Another instructor referred to Kathleen when saying, "I don't regard her as someone who is handicapped. I regard her as someone who has some problems walking." The instructor's attempt to downplay the importance of disability and to emphasize the normality of the person was in contrast to a different instructor's view: "I think … we should pay more attention to disabled people, both in China and in Hong Kong." While the former instructor wanted to minimize the disability label, the latter instructor felt society should provide more assistance to disabled students.
Staff related specific measures taken to respond to the presence of disability within the student body and the university staff. An employee charged with fielding discrimination complaints described the disabled students he came in contact with as reasonable when lodging their complaints. On the other hand, he related a concern he had with a small number of students who experienced paranoia as one of the symptoms of mental illness. He was eager to address their concerns but explained that their perceptions of persecution often made it challenging to convince them that their concerns were being adequately addressed. Another staff member arranged disability awareness training for dormitory residents who complained about the presence of cleaning staff with mental retardation in their living quarters.
Several instructors felt that the presence of disability made a student stronger or a harder worker. Other ways of admiring disability were also expressed. One instructor thought that people who lose one sense hone their other senses to a more acute degree than do people who have all five senses intact. Two instructors felt that disabled students "are self-motivated and always strive to become stronger." Another instructor told a story of visiting a residential school for blind students in Hong Kong and being touched by the affection shown by the students for the janitor and other school staff. She was also impressed by how the students negotiated their environment in such a carefree manner. She told of them running up and down stairs without fear: "They had an amazing sense of determination, courage, much stronger than the sighted people do." A mental health counselor acknowledged the added stress and extra planning required of disabled students:
I started to realize the kind of … of day to day pressure that … you have to deal with the public, how they look at you.… Sometimes, it's a sense of anger that can arise. That, despite so many years, people still react the way they react. Trying to be too over-concerned and not treating them as, as someone they should empower. Rather, as someone they need to take care of.
Two of the instructors had what could be characterized as temporary disabilities themselves. While they expressed gratitude towards fellow public transit passengers for their assistance and towards other members of their faculties for covering when they could not teach class, they were reluctant to label themselves as disabled. Their reluctance to do so seems to be a reaction to the stigmatized label of disability (Tsang, Tam, Chan, & Cheung, 2003). Perhaps they were ashamed of their own physical weaknesses. Other explanations might be that they were in denial about the seriousness of their conditions or did not consider temporary disabilities as actual disabilities.
Disabled Students' Attitudes Towards Themselves
Student participants' attitudes towards their own disabilities were often in flux depending on the situation in which they found themselves. In the case of the less visibly disabled students, disclosure of disability depended upon the situation. Kathleen was comfortable removing her artificial leg while showering at her dormitory and while receiving a facial at the beauty salon but did not do so while attending classes. Because the purpose of the beauty salon was to relax and that of the classroom setting at university was to be a proper student, Kathleen's reluctance to remove her artificial leg in class was likely done to obviate uncomfortable reactions from her peers. Tony and Po Sing rarely disclosed their hearing impairments to their instructors at university, indicating a different stage of acceptance than those with more visible disabilities. Po Sing explained that he was hesitant to wear his hearing aids in class during his freshman year: "I will try not to use the hearing aids. Because, I found … that it is rather visible to others. So, it gave me some kind of feeling that I was inferior to others." He noticed that his grades suffered, since he could not hear everything that the instructors in his classes were saying. Therefore, he began wearing his hearing aids in class at all times.
Disabled student participants portrayed their disabilities in different ways depending upon their audiences at the time. When around non-disabled people, they often put a brave face on their conditions. When socializing with disabled students, their stronger emotions came out. As an example, the Reference Librarian characterized the disabled students she came into contact with as happy: "They don't feel bad because they … are disabled or handicapped." However, the very students she spoke of when offering that characterization had mixed emotions about their disabilities. She specifically mentioned Clint. In the interviews with Clint, he spent a considerable amount of time talking about the barriers he faced as a person with two disabilities (psychiatric and visual).
Being a burden to others was a concern mentioned by both visually-impaired participants. Clint recognized that his girlfriend felt pressure about the emotional toll that he experienced when encountering so many barriers because of his disabilities. He saw the obstacles presented in his life due to his disabilities as more severe than for similarly-impaired others because of his self-described narcissistic personality. Clint felt that he focused on the barriers that impeded him more than others with disabilities. He was over five years older than the other students interviewed. Perhaps that is why he understood barriers and concentrated on the negative aspects of his disability more than the other student participants.
Another negative emotion experienced by student participants was the feeling of inferiority in relation to others. Berry felt inferior to people with low vision, since he often found himself depending on them during group activities: "Totally blind people are a bit inferior. … We are very dependent." One of Berry's instructors sensed his aversion to being burdensome: "I think that Berry is also very, very conscious of the fact that he doesn't want to put like, additional pressure on colleagues."
Shame and frustration were common topics addressed by all but one student. For example, Po Sing spoke of being frustrated when trying to learn foreign languages because of his struggle to hear them clearly. Kathleen told of riding a rollercoaster in an amusement park. When the rollercoaster went upside-down, her artificial leg did not bend like everyone else's legs did. She laughed to cover up her embarrassment. Clint understood that his choice of a major was limited by his visual impairment. "Maybe I have … good potential for mathematics or science. But, … I cannot do it." Clint also lamented the fact that he could not recognize his friends' faces as they greeted him, impeding his ability to make friends. Kathleen and Clint claimed not to feel anger or resentment towards people who were less affected in their disabilities than themselves. However, Kathleen did report resenting women in nightclubs who could wear high heels and dresses.
The students interviewed grappled with issues of self-identity and their disabilities. Kathleen vacillated between thinking of herself as disabled and rejecting that label. "Since I was very young, I tell myself I have no difference with other people." Although Po Sing felt positive about himself most of the time, he wondered why he had to have a disability: "Why did God bring me these kinds of challenges? … If I can really be a normal person without any disability, I can even achieve higher." And yet, Po Sing understood that other students admired him:
They appreciate my effort put to overcome my disability problem … to strive hard to improve my own weakness, and also to equip myself with more skills and techniques to enhance my competitiveness. If I can achieve more than them, I think that they will appreciate more.
The struggle for independence so familiar to disabled people was related by Berry; since his disability impacted daily living more than anyone else interviewed, his struggle to be as independent as possible makes sense. When Berry first enrolled as a university student, his classmates were very eager to go so far as to walk him to and from class. As he gained confidence, Berry began to chafe at their constant assistance and longed to learn independent routes around campus. After much deliberation and worry that he might offend those who kindly helped him, he sent out an email to his classmates, asking them to not help him so much. Since that time, Berry was able to demonstrate his own independence. When reflecting back upon the emotional realization that he came to about himself as he learned to politely turn down some help, Berry stated, "But, I think it's quite a long process for me to do it." Whereas Berry characterized true friends as those who would allow him to do things himself, Kathleen felt that others being helpful to her demonstrated friendliness. Kathleen welcomed the help of fellow students; they would carry her coffee for her as they walked to all-night study sessions together.
All of the students except Clint felt that they had to compensate for their disabilities by being more diligent students. As the basis for understanding this phenomenon, four out of the five student participants noted that other students looked down on them. Kathleen told of a music student who questioned why the music department admitted her, since she had a physical impairment. After Kathleen explained to this student that she used her left foot to manipulate the pedals on the piano, instead of her right foot, the student was supportive of her admission. Po Sing spoke of compensating for his disability as a means of transforming other students' attitudes about his disability: "If someone looks down on me, I will try even harder, so as to change the mind of that person. So, it makes me more eager to improve myself in different aspects." An unstated implication of their compensation was that their disabilities were seen as negative. Such negative constructions of disability were likely internalized by the student participants from the influences of family members, friends, and service providers.
Even as students related situations that depleted their self esteem, other events increased their self-confidence. Berry advocated making a street crossing near his dormitory safer for visually-impaired people. After the street crossing became safer, he felt more confident as a university student. Kathleen used to hesitate to reveal her different gait by not dancing at all. During her freshman year, she was asked to dance at a bonfire party by one of her classmates. She now dances in nightclubs. Kathleen said, "I'm proud of my confidence.… I'm not afraid to show my disability."
A point expressed by student participants throughout the interviews was the idea that disability was seen as a minimal part of a person's overall set of characteristics. Berry's statement summarizes the feelings of the rest of the students in general when they reflected on how their instructors at university treated them: "Most of them don't think I'm inferior." Tony's statement was echoed by Po Sing and Kathleen: "The people treat us just like normal." The reason they gave for this statement was that few people realized they had disabilities, since theirs were not as visible as those of Berry and Clint.
Student participants were quick to downplay the importance of their disabilities in their relationships with others as well. As an example, Clint spoke of his girlfriend and suggested that the majority of their relationship difficulties centered on typical miscommunications between women and men, rather than on his vision status or his mental illness: "I think that disability is not any obstacle for the development of our relationship." Tony described his friends' reaction to his disability: "They just feel it as normal."
Berry and Kathleen's reflections on their disabilities were more personal. Berry pondered the interplay between disability and personality. He wondered whether his shyness in large groups was due to his personality or to his disability. In doing so, Berry comprehended the inexorable influence of disability and personality that occurs when disability is acquired early in life. Kathleen chose to draw strength from a famous role model with a disability. She felt that if Franklin Delano Roosevelt could lead the United States in spite of his inability to walk, he was not disabled.
Student Participant Views of Others With Disabilities
When the student participants were asked to decide which disability they would prefer to live with, Kathleen's statement is representative of all but two of the other student participants: "My disability is quite minimal.… What I lost is just a leg.… So, I would simply choose my current situation." The tendency to minimize the effects of disability was common across all student participants. After encouraging her to choose another disability, Kathleen went so far as to choose a life-threatening condition such as having a heart attack, since that type of disability would not be visible. Perhaps her choice was indicative of the invincibility so commonly displayed by young adults. Berry and Clint preferred to have mobility impairments; the ability to remain active in one's community and to enjoy reading were cited as the reasons for this choice. Thus, among the student participants, mobility impairments were seen as disabilities that would not impact life greatly.
The participants were asked how they viewed people who had more significant manifestations of the same disabilities they had. To a large extent, fear and the loss of independence were mentioned by participants answering this question. Kathleen described a friend of hers whose back and arms were different than most people's. "Her appearance, actually, is worse than mine, and sometimes, I thought that her chance of marrying is quite low." However, as was the case in many of the interviews conducted, Kathleen's perspective of her friend was multifaceted. While the previous statement demonstrated a certain amount of pity, the following one illustrates the fluidity of her feelings regarding her friend: "Because the way she acted, she talk just like a normal person. I didn't feel any sympathy, didn't have special feelings. But, I admired her English."
Student participants listed the disabilities they would dread above all others. Two out of the five students selected blindness. Though the researcher asking participants these very questions was blind and had demonstrated the capabilities of blind people, the participants seemed to view blindness as a disability that would restrict them substantially. Kathleen's reason given was, "If you lose vision, half of life's joy will be cut off.… So, if I couldn't see things, I'm afraid my life is not lived to the fullest." She added that she admired many famous blind people and was grateful because they could remind her of how lucky she was to be able to read books. Po Sing's reason for dreading blindness above all other disabilities was that he was excited to experience the world. He felt that, if he were blind, he would be frustrated and curtailed in experiencing the world fully.
Three students dreaded having disabilities that would affect their cognitive and mental functioning. As with the reasons given for dreading blindness above, the students' reasons for fearing disabilities of the brain and mind ignored strategies people with such disabilities regularly employ to function on a daily basis. The disability Tony wanted least was one that would interfere with his ability to concentrate, "Because I like to think logically. If I cannot concentrate, that would be disastrous for me." Berry dreaded having an intellectual disability that would interfere with his capacity to express himself to others: "It seems you cannot communicate with them. No matter how we help them, I think they cannot perform as a very normal person." Clint's reason for fearing mental illness was similar to Berry's reason for dreading an intellectual disability. Clint feared having a mental illness that interfered with his rationality.
Though the attitudes towards disability of various constituents — disabled students and university instructors and staff — were shared in this paper, there were themes that cut across those roles. Disabled students were hesitant to disclose their disabilities. Though some instructors and staff admitted to having personal contact with disability (i.e. being disabled themselves or having family members with disabilities), they were reluctant to name those conditions as disabilities. A medically-oriented understanding of disability was apparent among many of the students, instructors, and staff interviewed.
Some disabled students were reluctant to label themselves as disabled, presumably to avoid the unstated but very real social comparisons that come with stigmatization (Coleman, 2006; Murry, 2009). Tsang, Tam, Chan, and Cheung (2003) suggest that the stigma of disability is particularly strong in Chinese society, since others may attribute the presence of disability to inferior origin of the family, parental failure, or sin committed by the family. As is often the case in the West (Hartman-Hall & Haaga, 2002; Weiner & Wiener, 1996), the majority of the student participants preferred not to disclose their disabilities if given a choice. However, this statement must be understood in its intriguing complexity. Those with psychiatric, learning, and health disabilities often face some of the most insidious disability discrimination (Weiner & Wiener). Other community members tend to question the legitimacy of non-visible disabilities (Hartman-Hall & Haaga); this process can undermine the goal of seeking accommodations. Therefore, non-visibly-disabled students' reluctance to disclose their disabilities can be understood as a coping strategy. How much of one's disabled self was disclosed by students depended upon the situation and the actors in that situation, an idea alluded to by Goffman (1963).
It is less apparent that the reluctance to acknowledge disability among staff and instructors in this study was a coping mechanism. University staff whose jobs were at least partially designated as serving disabled students specifically reported greater amounts of interaction with such students than did staff designated to serve the student population as a whole. It is possible that staff designated to serve disabled students were merely more aware of disability as a type of diversity than were other staff, thereby at least partially explaining the difference. On the other hand, both the staff and instructor participants often denied having disabled family members but when questioned carefully did disclose that their parents or other older relatives did have age-related disabilities. Those instructor and staff participants with chronic or acute medical conditions themselves almost never characterized them as disabilities either. Their use of watered-down terms such as chronic sickness seemed to be employed in an attempt to convince others and themselves of their fitness to carry out the duties of their jobs. Their preference to focus on what they still could do, as opposed to their limitations, seemed to fulfill a need to remain positive at the expense of comprehensive self-reflection.
The medical model of disability infiltrated the educational and social services provided to disabled Hong Kongers according to these findings and to Baolin and Huang (1999). The medical model's emphasis on the pathology of disability shifted focus away from the attitudinal barriers present at the university studied (Smart, 2001; Stodden et al., 2003). Because those in authority within the disability services system are so highly respected in Hong Kong, the questioning of the medical model as the most appropriate way to understand disability may be stifled. If DS providers in Hong Kong come into contact with other service providers for disabled people, it is reasonable to assume that DS providers might have internalized some of the faulty assumptions of the medical model. Therefore, an understanding of how Hong Kong service providers in the off-campus sector view disability is critical.
The limitations inherent in this study design must be acknowledged. Data were collected by the first author, who is neither linguistically, culturally, nor ethnically Cantonese. Therefore, the results gathered likely lack detail and depth that could have been solicited had she spoken Cantonese. It should also be acknowledged that interpretations of the data reflect the researcher's Western upbringing and view of the world. Although the first author lived in Hong Kong for 11 months while collecting these data, her interpretations may be different than those of a native Hong Kong Chinese researcher. Finally, the inclusion of more female participants and individuals with a wider range of disability types would have brought more richness to the findings.
Qualitative studies exploring the construct of disability in Hong Kong would be welcome (Chiu & Chan, 2007; Gilson, 2010), as the literature located on the topic was largely quantitative (Leung, Se-Fong, Ting-Pong, Chi-Chiu, Wai-Sum, Chun-Pan et al., 2008). The cultural understanding of hidden disability in metropolitan Hong Kong, in the large cities on the Chinese Mainland, and in the poor, rural areas of China should be investigated using qualitative methods. For, as Chiu and Chan point out, few studies of attitudes towards disabilities such as mental illness have been conducted in non-Western countries. As more disabled Hong Kongers join the non-segregated workforce, the attitudinal and physical environments they encounter should be analyzed in order to reveal best practices and to improve other workplaces.
An examination of social justice in Hong Kong was largely fruitless during this study. The students interviewed did not use language that indicated their willingness to advocate strongly for themselves. However, had the interviews been conducted in the students' native language, their responses likely would have included more topics pertinent to this issue. Since one's status determines whether one is able to question current practices (Zhang Hampton, 2000), self-advocacy takes on an entirely different context in China. If one equates disability rights work with criticism of the current system, it likely encounters a roadblock in the academic system in Hong Kong, which Kwok (2000) characterizes as stifling criticism. The nuances affecting advocacy in Eastern and Western regions of the world are very different and warrant further examination.
Clearly, the increased public participation of disabled Hong Kongers and of students at university will change how disability is perceived in subtle and tangible ways in the coming decades. The authors hope that this study encourages Hong Kong Chinese to conduct research in Cantonese which appropriately situates the context and meaning of disability rights advocacy in Hong Kong. Perhaps such research will serve as a catalyst for sparking further disability rights advocacy in Hong Kong and greater China. Until disabled Hong Kongers assert their rightful places as the foremost experts about their lives, as called for by Chiu and Chan (2007), the medical model's negative portrayal of disability will largely prevail, to the detriment of the quality of life of disabled Hong Kongers and Mainland Chinese. No longer do disabled Hong Kongers need to be silenced. Disabled people in China are now beginning to claim their identities as fully-fledged citizens (Korhman, 2005).
The authors would like to sincerely thank the Centre for Advancement in Special Education (CASE) at the University of Hong Kong for hosting the first author during her Fulbright fellowship in Hong Kong. The hospitality shown by the CASE staff testifies to the kindness of the people in Hong Kong. The authors' thanks also go to the State Department of the United States of America and the Institute for International Education, who awarded the first author the Fulbright grant which allowed her to live, research, and volunteer in Hong Kong for 11 months in 2006. Finally, the Faculty Development and Research Committee of Moravian College in the United States generously awarded the first author funding to prepare this manuscript during the summer of 2009.
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