When realism is critical

 Tom Shakespeare

After many years working in academia, I currently work at the WHO.   Our mission in the Disability and Rehabilitation unit is to support our WHO member states to improve their responses to disabled people.  We try to improve data.  We try to improve provision of rehabilitation and assistive devices.  We try to support de-institutionalization.  We try to improve access to mainstream health.  We try to ensure that doctors and other professionals are trained to include and respect disabled people.

If you look at disability globally, it is clear that many of the world’s billion people with disabilities face huge obstacles and lead miserable lives.  I became spinal cord injured on August 20 2008, and continue to flourish.   If I’d been African, I would probably be dead by now.  And many people in high income countries are feeling the effects of the global financial crisis.

What can my discipline, sociology, do to improve those lives and remove those barriers?  Writing the World report on disability, we were faced with huge gaps in data and research on disability, particularly from low and middle income countries.  Valiant Nordic researchers – Arne Eide, Einar Helander, Benedicte Ingstad and many others – have helped fill some of those gaps, just as Nordic disability organizations  have supported their brother and sister organizations in the South.  But much more remains to be done.

Mike Oliver once said to me that sociology basically comes down to counting people, watching people or speaking to people.  That is our contribution: to find out more about people’s lives, so that policy-makers and advocates can use our findings to make a difference.

Why, then, do so many social scientists prefer to generate theory, rather than to search for evidence?  TheUKsociologist Ian Craib once described social constructionism as a form of social psychosis.  Rather than engage with the world as it is, too many academics would rather deconstruct the terminology people use.  He called this a manic defence.

People will argue about boundaries and labels, but I would rather be realist about disability.  The best way to interpret the evidence is to say that impairments exist.  People with impairments generally have problems, partly generated by those impairments, and partly generated by the way societies fail to respond adequately to those impairments.

There is a space for cultural analysis, of course.  I love writing about films or novels or trying to recover disabled people from history.  All this is part of scholarship and it’s interesting and it’s fun.  But the pressing task, in my opinion, is to conduct empirical research on the everyday situations of people with disabilities, and discover what works to enable them to experience better, fuller, more included lives.


The author is a staff member of the World Health Organization. The author alone is responsible for the views expressed in this article and they do not necessarily represent the decisions or policies of the World Health Organization



Ian Craib, Social constructionism as a social psychosis.  Sociology February 1997 vol. 31 no. 1 1-15

WHO, World report on disability, WHO Geneva, 2011.  www.who.int/disabilities/world_report