Transcript AL-ZUBAIR_Yousif_Ismail_ - Handicap International Seminars

SKILLS-BUILDING WORKSHOP ON DISABILITY,
HIV AND BEHAVIOUR – PART 1
Dr. Yousif Ismail Al-Zubair
Peace & Tolerance International Organization(PTIO)
-SUDAN
December,5th,2011
CORRELATION OF THE ANATOMICAL
CHARACTERISTICS OF MAN WITH HIS BEHAVIOR:
Consistency in personality and behavior.
 Personality
development
towards
selfrealization or self-actualization.
 Motivation of superiority is innate.
 Behavior
is goal directed towards the
completion of energy cycle.
 The perception of disability within the Person
with Disability (PWD) and the direct effect of
that on the behavior.

DISABILITY:
 Disability
occurs in all cultures creating
disruption of regular patterns of social
interaction, functioning and performance of
role-related responsibilities.
 Disability creates feelings of marginalization,
isolation, dependability, restricted mobility or
inability to fill role expectations.
 It enforces changing or ambiguous role
structure,
inadequate
social
status,
inconsistency and blocked aspiration or
uncertainty about outcome of personal efforts.
 It builds feelings of some PWDs that they have
suffered an injustice and that the society owes
them support and attention.
DISABILITY EFFECTS:
 Feelings
of PWD towards her/his disability vary in
intensity and duration with age, sex, culture
background faith and other factors.
 Culture factors influence the perception and
explanation of disability experienced by PWDs that
reflected in the sequence of their behavior.
 Restricted mobility, sensory isolation and social
incapacitation constitute grave deprivation that
curtail normal pattern of human interaction.
 the typical stigmatizing attitudes held by the nondisabled
towards PWDs that of a negative
prejudgment concerning their personal traits,
including what is called devaluation.

ATTITUDES TOWARDS DISABILITY:
 Person
with mild disability may have a greater push
to hide and deny her/his disability whereas another
with a severe one has little recourse but to accept
herself/himself as a PWD.
 The mildly disabled tend to direct their feelings of
disability outward whereas the severely disabled
internalized these feelings.
 Disability entitles PWDs, within limits, to exemption
from usual role demands to reach a recognition that
her/his state is inherently undesirable and
consequently pushed to seek help from others.
 The dependent- role does not suit some PWDs, for
whatever reasons, others submit reluctantly, but
some welcome the role.
CONT.
 Behavioral
incapacities and social isolation place
the PWD in a subordinate position where many
goals are inaccessible.
 Social stigma may devaluate the PWD, but
her/his own attitude may reflect devaluation to
the extent disability may not remain confined
to the actual limits of impairment.
 For those who loose a limb suddenly they come
to see that their bodies are forever changed or
scarred.
 They do not loose only the organ but their place
in society, self- perception and perception of
others.
CONT.
 Within
this realm, surgical amputation can be
defined as “the actual physical loss of the limb
as a part never again to be seen or felt, gone for
ever.”
 Those disfigured by traumatic incident, no
matter how young or old, must recreate
themselves.
 They must discover new ways of moving their
bodies to accomplish tasks that once were
completely easy.
 They must find new identities to fit new body
images.
BOREDOM:
 It
is one of the very important problems that face
PWDs during their daily life.
 Boredom does not mean the affective result of
cognitive deprivation alone, but also the result of
sensory and social isolation and restricted
mobility.
 The neurophysiologic reactions of the brain
functioning depends on continuing arousal
reaction generated in the reticular formation.
 This depends on constant sensory bombardment
to keep sensory stimuli ongoing to maintain
arousal and avoid monotonously repeated
stimulation of unchanging environment.
REPERCUSSIONS:
 Physical
disabilities
when
interfere
with
communications and mobility are expected to
disrupt social participation, recreation and
interpersonal relationships.
 Isolation due to permanent, partial or total loss of a
receptor system as in deafness or blindness has
many behavioral effects.
 They all lead to relatively high rate of emotional
maladjustment , social immaturity and negative
attitudes.
 Brain damaged persons display a wide array of
emotional responses which arise principally from
loss of inhibition and control over behavior.
PWDS VULNERABILITY TO HIV/AIDS & ADDICTION
OF ALCOHOL AND DRUGS:
 Lack
of education, lack of self- esteem and selfadvocacy skills, lack of understanding of social
norms
and
appropriate
behavior
and
communication difficulties are strong contributing
factors to the high incidence of vulnerability among
this population.
 There are physical abuse, neglect, sexual abuse,
psychological or emotional abuse and belittling.
 Systemic abuse (denied access to an appropriate
service due to perceived support needs).Passive
neglect (a caregiver's failure to provide adequate
food, shelter, etc..)
CONT.
Little attention has been given to the risk of HIV/AIDS for
individuals who have a physical, sensory, intellectual, or
mental health disability before becoming infected.
 PWDs are incorrectly thought to be sexually inactive,
unlikely to use drugs, and at less risk for violence or rape
than their non-disabled peers.
 Disabled individuals (both male and female) around the
world are more likely to be victims of sexual abuse and
rape than their non-disabled peers.
 Factors such as increased physical vulnerability, the need
for attendant care, life in institutions, and the almost
universal belief that disabled people cannot be a reliable
witness on their own behalf make them targets for
predators

CONT.
In cultures in which it is believed that HIV-positive
individuals can rid themselves of the virus by having sex
with virgins, there has been a significant rise in rape of
disabled children and adults. Assumed to be virgins,
they are specifically targeted.
 Bisexuality and homosexuality have been reported
among some PWDs’ groups, while awareness of
HIV/AIDS and knowledge of HIV prevention is low in
such groups.
 PWDs are at increased risk of substance abuse and less
likely to have access to interventions. It is estimated that
30% of all street children have some type of disability
and these young people are rarely reached by safe-sex
campaigns.

CONT.




Literacy rates for disabled individuals are exceptionally low,
thus making communication of messages about HIV/AIDS all
the more difficult.
Sex-education and HIV/AIDS programmes for those with
disability are rare, where AIDS campaigns are on radio or
television, groups such as the deaf and the blind are at a
distinct disadvantage.
Care and health services are not only often too expensive for
impoverished disabled persons, but it can also be physically
inaccessible—e.g, clinic steps bar the way for a wheelchair
user and consultation with a physician without a signlanguage interpreter is meaningless for most deaf persons.
Disabled people are less able to defend themselves from
attack and find it more difficult to seek recourse through the
courts, which are often physically inaccessible or do not have
sign language interpreters available..
CONT.
 Being
a disabled woman is an additional risk factor.
 Disabled women face unique challenges in
preventing HIV infection, because of their
heightened risk of gender-based violence, lack of
access to reproductive health care services and low
awareness of mother-to-child HIV transmission.
 Women with disability, compared with non-disabled
women and with men with disability, are more likely
to be illiterate, and stigmatized.
 These women are more likely to live in a series of
unstable hazardous relationships than to marry.
PWDS’ MOTIVATIONS TO RISKY BEHAVIORS
Challenging behavior in PWDs may be caused by a
number of factors, including biological need for sensory
stimulation.
 Social factors such as boredom, seeking social
interaction, the need for an element of control, lack of
knowledge of community norms, insensitivity to the
person's wishes and needs from those around.
 Psychological factors envisaged in feelings of exclusion ,
loneliness, devaluation and living up to people's
negative expectations or simply a means of
communication with peers and others.
 Challenging behavior is a method of communicating
dissatisfaction with the failure of those providing
services to focus on what kind of life makes most sense
to the PWD.

THANK YOU


END OF PART ONE
Skills-building workshop on Disability, HIV and
Behaviour – Part 1
SKILLS-BUILDING WORKSHOP ON DISABILITY, HIV
AND BEHAVIOR – PART 2
Dr. Yousif Ismail Al-Zubair
Peace & Tolerance International Organization(PTIO)
-SUDAN
December,6th,2011
SKILLS BUILDING: ON DISABILITY AND BEHAVIOR
Peer psychological support for Individuals Living with
AIDS(ILA):
 Peer psychological support aims to let ILA with disability
learn how to behave themselves through the experience
transferred to them from others who went through the
same ordeal.
 Severity and longevity of HIV/AIDS symptoms can be
lessened by social support received by ILAs.
 Emotional support will be helpful if it includes specific
and detailed disclosure, happens with a peer who
already have passed through the same experience .

CONT.
Individuals need information to gain a cognitive sense of
control over the events.
 Peer support enables them to express their emotional
reactions and gain sense of control and security.
 Peer education can include identification of the available
institution and individuals for help.
 Along with, a longer-term educational intervention to
help ILAs develop new skills to cope with their health
situation and to minimize stress in their lives.
 Skills such as relaxation techniques, physical activities
etc.

FAMILY ATTITUDE
Unconditioned support of the family is one of the major
factors that can help PWDs to overcome most of their
problems.
 Family support dos not always help, because families do
not receive counseling and help on how to assist a
family member that has disability.
 In their efforts to help they somehow promote
dependency of that PWD which in itself some sort of
disability.
 The disabled person role or status within the family has
something to do with the family’s attitudes toward and
acceptance of her/his disability.

CONT.




With an evident love and support of the family, PWDs are
remarkable in their creativity. They can devise ways of
achieving their goals when feel supported and encouraged.
Some families are not immune to prevailing stereotypes
about PWDs when they tend to protect rather than push.
There is a need to help the recently mobility-enabled person
to make what is often a Herculean effort to re-engage the
world and to make the assistive device part of her/him.
It must be clear that artificial limbs do not put food on the
table or ensure psychological health and social integration.
CONT.
Families who encourage
the expressiveness of
individual ideas, will push PWDs to be social risk takers,
extraverted people who reach out for others and have
feelings of that all family members will support each
other in time of need.
 Those families are more likely to promote high selfesteem, good social skills and positive adjustment in any
individual injured or otherwise with born-with disability.
 Lack of family cohesion and high conflict within the
family, are correlated with poor adjustment, learned
helpless and social shyness of PWD.

COPING SKILLS
PWD’s wellbeing depends highly on:
- to achieve sense of balance in emotions and social
relationships.
- to be aware of her/his abilities and limitations.
- to be able to get around in the social and physical
environment to reach socio-economic integration.
and participate in social, vocational and
recreational activities and identifies priorities.
 The well-being of PWDs need to have help to let them
feel some hope to continue deal with physical
adjustment, mobility challenges and the psychological
coping with the different difficulties of life.

CONT.
The psychological support for disabled ILA must be
moral and social.
 The aim is to provide them with practical support
reinforcing their reactions as “normal”, addressing
common fears, concerns and increasing their capacity to
tolerate disturbing emotions and sharing strategies for
coping.
 The aim is, also, to use a cognitive restructuring and
reforming methods to reach normalization of the
feelings and emotions of PWD towards her/his situation.

CONT.
One step of coping skills is to find a way to face your
fears. Fear is normal. Facing fears can increase selfesteem.
 Finding role models can help to establish and nurture a
supportive social net. Being altruistic means that you are
not going it alone, everybody needs a supportive social
network.
 Coping skills need to make use of personality styles to
feed into them-if they are dramatic, if they are
obsessive, and if they are aloof.
 We make use of all these and use them to our
advantage.

CONT.





Coping may face difficulties during the adaptation process
which are normal experiences of persons struggling to
develop new ways of feeling good about themselves.
Training and practice towards self-efficacy, particularly in the
domain of social skills are important elements for PWDs to
learn to deal with predictable hurtful reactions from some
naïve individuals in society.
They have to learn to be lovable that people will be fond of
their physical differences.
Coping skills are to make explicit the expectation that each
PWD is a human individual who can be strong and
competent, optimistic and autonomous.
At the same time, he/she can have moments of sadness,
despair or rage. Such uncomfortable human feelings must be
validated.
EMPLOYMENT AS A COPING SKILL:
PWD needs to feel the ability to be productive and
provide for one’s own and one’s family the basic needs.
 The desire to work goes beyond simply having an
income. It comes to reflect deeper psychological needs
to have breadwinner roles and status in the family.
 It reflects the need to feel capable, to demonstrate that
they are not a burden, to participate in society and to
feel and know that they are normal.
 Employment can have either intrinsic value(the meaning
of the work itself) or instrumental value( financial
benefits).

CONT.
Work can help PWD in a number of ways:
 - It can work as a source of identity, self-esteem and
prestige in the community.
 - It can work to structure and organization of the day.
 - Social support and companionship and involvement
in collective activities.
 - Role fulfillment in one’s family and a purpose for life
and psychological well-being.
 Men and women are channeled in the labor force into
sex-stereotyped roles. If disability makes it difficult or
impossible for traditionally-male vocation, this could
contribute to a loss of status, an identity issue or other
negative psychological impacts.

FAITH:




Use of religion and faith as a coping strategy has been shown
to mediate the relationship between the stressors and
physical and psychological health.
Faith resources aid individuals in crisis by: providing meaning
and comfort, giving a sense of control over adverse situation
that might appear hopeless, preserving or strengthening selfesteem and providing social support.
Religion works as a social support that comes along with
integration into a religion community and as a belief system
that gives meaning out of crises.
Where the stress of disability is beyond personal control,
religious coping might be effective due to the feeling that
every thing happened by the will of God.
PHYSICAL EXERCISE:
Exercise enhance brain function and help to learn and
remember better.
 Not only the physical exercise itself, but the importance
of social support derived from activity participation by
sports companions.
 Sport can be useful to the rehabilitation of PWDs to
break into the common cycle of decreased physical
activity
which leads to de-conditioning, reduced
endurance and diminished ability to handle daily life
activities.
 Sport is a very important tool to deviate PWDs from
following risky and hazardous behaviors and one of the
ways to defeat boredom.

THANKS


END OF PART -2
Skills-building workshop on Disability, HIV and Behaviour
– Part 2
Dr. Yousif Ismail Al-Zubair
 Peace & Tolerance International Organization(PTIO)
 -SUDAN
December,5th and 6th,2011
