Four types of stigma

​There are different ways of thinking about stigma, and we’ve found it useful to consider four main types. The one most commonly discussed is social stigma, but it’s important to discuss the other types and how they can interact and lead to discrimination.

 

 

Social stigma 

Social or public stigma describes negative attitudes and prejudice held by people in society against people with disabilities, including negative stereotypes. These negative attitudes are often driven by fear and/or traditional beliefs about disability, shaped by the culture and social norms in that context.

They can result in discriminatory actions like exclusion, unfair treatment or denial of opportunities and rights.

People with disabilities may also stigmatise others with different types of disabilities, especially those with intellectual disability, mental health or complex disabilities.

 

Experiences of social stigma

“First of all is the stereotype that people have, the mindset that people have, and the attitude people have towards people with disability.

“It’s like the system is already there, people have already set their mind that people with disability are vulnerable, people who cannot work for themselves, but that is not the case.”

Source: Sightsavers IT Bridge Academy

“Have you ever walked into a place full of people and everyone turns to look at you? When will we learn to accept everyone the way they are? And how can we overcome the stigma attached to being someone with disabilities?”

Source: Inclusive Futures

“Since I started attending school I was never the head girl, because there was discrimination. They were saying that I can’t see, I can’t control them. It really not easy for me because there was a series of provocation.”

Source: Sightsavers ICSP citizenship and political participation project

Aliyu has Buruli ulcer, a skin disease caused by bacteria that leads to ulceration and skin loss.

“I have been separated from my family by other family members and was given a different room away from everyone. I am not allowed to sit in their midst and have conversations or be involved in discussions. They only talk to me from afar, all because of my ailment. I want to be assisted with medicine that will treat me so I can return to my family.”

Source: Countdown project (PDF), which used Photovoice methodology to capture the stigma experiences.

Have you ever walked into a place full of people and everyone turns to look at you?
Elizabeth, Kenya

 

Internalised stigma

Internalised stigma, also known as self-stigma, describes the internalised oppression that people with disabilities can feel.

This can lead to feelings of low self-esteem and shame, frequently resulting in self-exclusion and isolation.

 

Experiences of internalised stigma

Sadeh is a youth disability advocate.

“Some of us, the disabled people, we are not mingling with people. We are putting ourselves separately, and at times when we normally go into certain areas, they are pushing us aside.

“If I mingled with the crowd, it will affect me because when you stand in the lines, I was feeling that some people won’t accept me because I am disabled, that I won’t be able to perform the task.”

Source: Sightsavers ICSP citizenship and political participation project

Shuaibu is a younger man affected by lymphoedema, which causes swelling of body parts. He uses photos to express how he feels.

“This photo [below] is of a rusted plate that nobody would like to use. It has no use. With this ailment I sometimes feel I don’t have use to my family. No one would like to see his body spoiled to this state if there is no way out. It represents how my health condition is.”

Source: Countdown project (PDF), which used Photovoice methodology to capture the stigma experiences.

A rusty bowl with scratches and holes sits upside down on a dirt floor.

Joy Shu’aibu is Sightsavers’ country director in Nigeria.

“People self-stigmatise themselves in some situations because they feel that they have many more challenges and should not be seen prioritising their healthcare.

“The community’s perspective and attitude also is stigmatising, because people feel that people with disabilities should not be concerned with sexual reproductive healthcare.”

Listen to Joy discuss how internalised stigma can affect womens access to family planning:

With this ailment, I sometimes feel I don’t have use to my family. No one would like to see his body spoiled to this state.
Shuaibu, Nigeria

 

Stigma by association

Stigma by association, sometimes called affiliate stigma, describes when stigma extends to others closely connected to a person with a disability, such as family members, or health professionals associated with that person.

It can be particularly common for a mother to be blamed for having a child with a disability.

 

Experiences of stigma by association

“When I had those children with eye issues, some people started saying that it could be because we didn’t observe some traditions and customs, and that is why it happened.”

Source: Sightsavers eye health project, Tanzania

“People would laugh at me saying you have given birth to a child with a disability! They laugh at you and tell you that your child doesn’t see, she is blind. After treatment, some people even now call her blind.”

Source: Sightsavers eye health project, Tanzania

Margaret’s son was born with a disability. Her community believed a disability was a curse, so they began ignoring her and excluding her from social gatherings, and her husband abandoned her.

After attending a disability training workshop, Margaret learned more about disability. She educated her husband about the medical causes of disability, and he returned home. She also formed a parent support group to help other parents of children with disabilities.

Source: Kupenda

People would come and laugh at you and tell you that your child doesn’t see, she is blind.
Rudia, Tanzania

 

Structural stigma

Structural stigma refers to discriminatory laws and policies, and related issues such as poor allocation of funding for disability.

It can also refer to organisational systems and cultures that, either intentionally or unintentionally, limit opportunities for people with disabilities and compound stigma. This can include lack of attention to addressing barriers of accessibility.

Experiences of structural stigma

Juimo Odette is a municipal councillor in Yaounde 2 town hall council in Cameroon. She explains some of her experiences of structural stigma and discrimination.

“My first application for municipal councillor at the town hall was rejected, and the rumour was that as a blind person, how could I read administrative documents if I don’t have eyes? Also, often during the campaign you have to go into the local communities, but people don’t like to hold my hand to support me, or I was being discouraged from going. So I arranged for my people, who are used to supporting me, to come with me. It affected me and it made me even stronger.

“Discrimination is experienced by people with disabilities on a daily basis because we don’t like to support them in education, or within political parties some political parties reject people with disabilities’ ambitions. If you don’t belong to a political party, you cannot have access to decision-making, so I find this quite serious.”

Source: Sightsavers Cameroon political participation project

In Sightsavers Ghana Somubi Dwumadie (Ghana participation programme), inclusion champions highlighted the lack of prioritisation given by the national and local government to budgeting for sign language interpreters in the Upper East region. This meant there was almost no coverage in that area, and consequently a lack of participation of deaf people in meetings.

In Tanzania, the National Elections Act emphasises voter accommodation, but disqualifies those of ‘unsound mind’ from vying for office (with a lack of definition).

In Zimbabwe, the 2013 constitution removes MPs or commissioners unable to perform duties due to ‘physical or mental incapacity’.

Ghana’s Mental Health Act 2012 uses derogatory words such as ‘mental retardation’, promotes guardianship, capacity assessment tests, seclusion and restraint, and involuntary admission in hospital.

Some political parties reject people with disabilities’ ambitions.
Juimo, Cameroon