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disability to focus attention on the sociocultural, economic, political and
spatial barriers to participation that disabled people experience. An
individual's 'impairment' was seen as separate from the social, attitu-
dinal and environmental dimensions of 'disability' that exclude disa-
bled people. The 'social model' thus focuses on changing society to
facilitate the participation and inclusion of disabled people, rather than
on efforts to 'rehabilitate' individuals and overcome biological con-
straints of the body.
These understandings of disability have been crucial to improving
accessibility, achieving equality of opportunity and securing disabled
people's rights within the public sphere in the global North. The appro-
priateness of applying Western-centric social models of disability in
the global South has, however, been questioned (McEwan and Butler,
2007). The wider macroeconomic context, resource constraints and
limited availability of technical solutions to make environments more
accessible constrain the implementation of social model approaches to
disability in many low income countries. Furthermore, the chronic
poverty, limited income earning options, and restricted access to
health and education that many disabled people experience all mean
that access to basic services may represent a higher priority for disa-
bled people, governments and policymakers, rather than issues of
accessibility or assistive technology. Social model approaches have also
been criticized for failing to acknowledge the materiality of the body
and the effects of pain, chronic ill health and impairment on people's
everyday lives.
Debates about the need to reconcile both medical and social models
of disability in the 1980s led to the establishment of 'community-based
rehabilitation' approaches to supporting disabled people in the global
South. Such approaches aimed to provide rehabilitation through med-
ical intervention and care, as well as promoting the social inclusion
and participation of disabled people within their communities.
Community-based rehabilitation projects have been criticized, how-
ever, for being ill-conceived and lacking sensitivity to local cultures
and practices, including overlooking the existing care and support that
many families and communities provide for disabled people (McEwan
and Butler, 2007). Community-based rehabilitation can be seen as
reinforcing medical/charitable models of disability that were intro-
duced in the colonial era, perpetuating ideas that disabled people are
dependent and need to be supported by charitable fundraising and
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