Learning from our neighbor: women with disabilities in Oaxaca, Mexico. (Women with Disabilities in Mexico).

   "Everyone has [her] own Atlantics to fly. Whatever you want very much to
   do, against the opposition of tradition, neighborhood opinion, and
   so-called `common sense'--that is an Atlantic."

   Amelia Earhart cited in, Amelia Earhart by Virginia Morell National
   Geographic, January 1998

For the first author, principal investigator of the Vecinos y [Neighbors and] Rehabilitation research project, one Atlantic was, in fact, only a 50-minute drive from home. The border between Mexico and the United States is a frequent destination of friends, family, and colleagues who visit the sun mecca of Tucson, Arizona. We go to Nogales to shop--to find cheap Kahlua and vanilla. We go a bit further to an "Arizona beach," either San Carlos, Sonora or Puerto Penasco, the "Rocky Point" crazy-college-kid beach town, also in Sonora. Importantly, we typically do not go to Mexico with concern for the educational and employment opportunities of the general public there. We are not particularly concerned with the health care and human services of our neighbors to the south. We are not particularly concerned with the human fights or the health and well-being of the indigenous people of Mexico, nor do we think there is anything we can learn from them.

Getting to Mexico became an Atlantic when rehabilitation researchers wanted to secure U.S. Department of Education funds in order to research the needs and resources of indigenous people with disabilities--to "broaden the context" for the research conducted through the American Indian Rehabilitation Research and Training Center and the Rehabilitation Research and Training Center of the Pacific. Funding for international rehabilitation research was possible. The idea of working in partnership with Mexico as a neighbor--a neighbor from whom the United States could learn in terms of better understanding indigenous people with disabilities--came from the Rehabilitation Act of 1973, as amended, which states that National Institute on Disability and Rehabilitation Research (NIDRR) funds may be used to "conduct ... a program for international rehabilitation research, demonstration, and training...." However, comments from peer reviewers of the first research proposal were not positive. Comments from some colleagues were similar: "We have our own problems, why go to Mexico?" Comments from some public servants challenged the premise that Mexico would have any experts from whom the United States could learn and further challenged the idea that what we proposed to do was even true research, saying, "This looks like public service." Nonetheless, in time, support was found for the "Atlantic crossing" and with funding through NIDRR, the Vecinos project--research conducted in the state of Oaxaca, Mexico--began in 1994 and was completed in 1999. These five years of modestly funded research reinforced our conviction that the United States and Mexico should be working more closely together to benefit indigenous people with disabilities in both countries (Marshall, Burross, Garcia Juarez, & Santiago Gonzalez, 2000).

The state of Oaxaca is located in the southeast of Mexico. It is considered one of the poorest regions of Mexico and one of the most heavily indigenous. By way of comparison and as one rationale for looking to Oaxaca as a place to learn from indigenous people with disabilities, the indigenous population of the United States is reported at less than 1% of our total population (Sanderson, 2001), a factor which contributes to American Indians being considered "invisible." The indigenous population of Mexico has been calculated at 6.5% of the population, but in accordance with Mexican Census regulations, this count includes only those persons over age 5 who can speak their Native language (Ayllon Torres & Chavez Flores, 1993; Marshall, Gotto, & Bernal Alcantara, 1998). Such a criterion, that the Native person be conversant in her or his Native language, would most certainly reduce a count of the number of indigenous people in the United States who would be considered Native. Using Mexico's more stringent census requirement that persons be over age 5 and speak a Native language, the indigenous population of Oaxaca as reported by the 1990 Mexican Census is 34%. Using the requirements of the United States federal and/or tribal governments (Sanderson, 2001), it is estimated that at least 90% of the Oaxacan population is indigenous. Political scientist Jorge Castaneda (1995), now Mexico's Minister of Foreign Affairs, described Mexico as "a country of three nations: the criollo [Spanish or white] minority of elites and the upper-middle class, living in style and affluence; the huge, poor, mestizo [mixed white and Indian] majority; and the utterly destitute minority of what in colonial times was called the Republic of Indians--the indigenous peoples of Chiapas, Oaxaca [emphasis added], ... known today as el Mexico profundo: deep Mexico" (p. 38).

After several years of conducting research in Oaxaca, the authors continue to believe that access to health care and human services, as well as the rehabilitation needs of indigenous people with disabilities, are areas in which Mexico and the United States should be working more closely together--and learning from each other. Consider the comments of former President Clinton's senior White House counselor, Thomas McLarty, that "Mexico [is] a neighbor, where we share an 1,800-mile border; a major partner, our third-largest trading partner, with over $130 billion of trade between the two countries ... and a friend" ("Clinton's goal," 1997, 12A).

It is beyond the scope of this article to detail how data from research conducted during each phase of the Vecinos project have been utilized in Oaxaca and all of the many ways people in the United States have benefited as well. Each year of the research targeted either a different geographic region or a different population; research processes and results were described in detail in final reports (Marshall, Gotto, & Bernal Alcantara, 1998; Marshall, Gotto, & Galicia Garcia, 1998; Marshall, Gotto, & Garcia Juarez, 1999; Marshall, Gotto, Perez Cruz, Flores Rey, & Garcia Juarez, 1996; Marshall & Santiago Gonzalez, 2000). We hope that this article will lead the interested reader to each of the individual final reports, or to the summary report that gives an overview of findings from each of the studies (Marshall, Burross, Garcia Juarez, & Santiago Gonzalez, 2000).

In sum, the Vecinos project focused on indigenous people with disabilities in the state of Oaxaca, and variously targeted adults, children and adolescents, and women to determine the circumstances and needs unique to each group. The needs of individuals with disabilities included increased medical care and information; physical rehabilitation; access to education, employment opportunities, and training; and emotional, financial, and physical support for the individuals and their families. In general, children and adolescents indicated higher needs for education and health care whereas older respondents more often cited needs related to employment and support.

Apart from final reports documenting each year of research, an earlier publication coming out of the project presented the Vecinos' history and results from the first year (Marshall, Gotto, Perez Cruz, Flores Rey, & Garcia Juarez, 1998). A second publication allowed the research team to reflect on the topic of "mutual benefit" to the two countries involved, as well as providing a brief synopsis of the first two years of research (Marshall, Gotto, Perez Cruz, Flores Rey, & Obaldia Mitchell, 1998). A third publication allowed researchers to reflect on the needs of indigenous women with disabilities, as identified in the first three years of our research (Marshall, Santiago Gonzalez, Garcia Juarez, & Bruyere, in press). Importantly, the current article allows us to a) reflect on lessons learned during the full five years of research (a final and sixth year of funding was provided for research utilization planning); b) share information about the needs of the women with disabilities living in the urban capital of Oaxaca City, our fifth year of research; and c) profile action programming that resulted in an attempt to address some of the identified needs.

Recently, an advocate for international rehabilitation wrote that "future initiatives need to be established to promote opportunities for neighboring countries to share positive outcomes and expertise, to generate and possibly share access to training activities and facilities, and exchange examples of good practice, by means of exchange visits...." (Price, 2001, p. 39). We support exchange visits; a personal interaction, a face-to-face meeting, witnessing the workings of a successful rehabilitation program--all can be most beneficial and result in mutual learning. However, for the United States and Mexico a first step must be taken which demonstrates value for the lessons to be learned in working together in rehabilitation. One such step should be a bi-national agreement that permits and facilitates rehabilitation processes, such as work adjustment training, on either side of the border. The need for such a bi-national agreement is given below.

The Needs of Women with Disabilities in Oaxaca

Data have indicated that individuals with disabilities in Oaxaca have needs that are consistent across gender, age, and location (Marshall, Burross, Garcia Juarez, & Santiago Gonzalez, 2000). However, it can be argued that particular attention needs to be paid to the concerns of women with disabilities (Marshall & Santiago Gonzalez, 2000); while even considering the needs of indigenous women is controversial, specific information regarding their needs is very much needed (Marshall, 1992). For example, in the United States, a national survey of women with disabilities, conducted by the Center for Research on Women with Disabilities (CROWD), received 475 questionnaires completed by women with disabilities, of which 2% reported being Native American; however these data were not analyzed by racial or ethnic status (Nosek, Howland, Rintala, Young, & Chanpong, 1997). A major finding of the CROWD survey was that "self-esteem in women with physical disabilities is more strongly influenced by social and environmental factors than by the fact of having a disability" (p. 5). Would this finding hold true specifically for indigenous women?

Answering this question was of particular interest given the social and environmental circumstances of indigenous women with disabilities in Oaxaca--assuming that lack of education and lack of employment can constitute key social and environmental influences in an individual's life. Dr. Margaret Nosek, Director, CROWD, Baylor College of Medicine agreed that we needed to understand better the needs of indigenous women with disabilities and agreed to advise Vecinos researchers in modifying the survey instrument used by CROWD (personal communication, May 22, 1998). With input from a Oaxaca-based community research team, we intended to produce a culturally-appropriate instrument in terms of content, as well as a culturally-sensitive procedure for conducting a survey of indigenous women with disabilities. Thus the final year of Vecinos research occurred in collaboration with CROWD, specifically in regard to modifying the CROWD survey instrument for use with indigenous populations and training four members of the Oaxaca-based research team in using the instrument. The research was driven by the following questions:

1. What is the employment status of indigenous women with disabilities?

2. What are the barriers to employment that indigenous women face, including "hidden" barriers such as cultural requirements (e.g., "buena presentacion" [attractive appearance]), self-esteem, relationship needs, access to medical attention, etc.)?

3. What is the education status of indigenous women, especially in regard to their employment goals?

4. What types of rehabilitation services (e.g., assistive technology, guidance and counseling, education, etc.) are most used by indigenous women with disabilities and by whom are they provided?

Research Participants and Research Process

A full accounting of the research design and results appears in the final report documenting this effort (Marshall & Santiago Gonzalez, 2000). In brief, members and networks of the Asociacion de Mujeres con Discapacidades de Oaxaca (AMUDO) [Association of Women with Disabilities of Oaxaca) in Oaxaca City, Oaxaca, formed the basis of the participant population. A total of 52 women were interviewed using a structured questionnaire derived from the CROWD survey instrument. Interviews were conducted by the community research team during the spring and summer of 1999.

Results and Discussion

In terms of questions that this research project attempted to answer, we were particularly interested in the employment status of indigenous women with disabilities in Oaxaca; identifying any barriers to employment; the women's educational status, in particular in relationship to their employment goals; and the types of services or resources the women utilized. It is important to note that no women with mental retardation or mental illness were included in the sample.

Of the 52 females interviewed, all were adults, ranging in age between 18 and 43. All were born in Mexico, with the majority being of Zapotec heritage. Specifically, the women identified with the following indigenous groups or the regions where these specific indigenous groups dominate: Zapotec [65% (34)], Mixtec [6% (3)], Chatino [6% (3)], Chinanteco [4% (2)], and Mixe [2% (1)]. For nine women (17%), the specific ethnic relationship was unknown.

Most of the women interviewed had had polio. As one person reported two disabling conditions, the disabilities identified totaled 53 and were as follows: 37% (19) polio, 12% (6) an amputated limb, 10% (5) spinal cord damage/injury, 10% (5) hearing impairment, 10% (5) blind/visual impairment, 8% (4) other type of disability, 6% (3) hemiplegia, 4% (2) muscular dystrophy, 4% (2) spina bifida, 2% (1) cerebral palsy, and 2% (1) stroke.

The majority of women interviewed were single [81% (42)], followed by 8% (4) who were married and living with their spouse. An additional 7% (3) were living with partners in union libre (free union). Three (7%) women reported being married but were separated from their spouse. The married women (n=7, including those separated) reported having been married at 21.6 years of age, on average; at the time of the interview, they had been married 8.3 years, on average. As most of the women were single and most also lived with at least one other family member such as parents or siblings, their living situations provide an interesting contrast to the majority culture of the United States. This observation is made given that the average age of the women was 28--an age where women with disabilities in the United States (at least women of the majority culture) would be, more than likely, living independently.

Education. It is important to note that age of entry into the education system for these women ranged from age 4 to age 24; indeed, 10 of the 52 women interviewed were age 10 or older when they began their studies. The women entered the educational system on average at 8.4 years of age. A plurality [23% (12)] had completed their education through the sixth grade, sexto de primaria. An additional 17% (9) had completed education through middle school/junior high, tercero de secundaria. Two persons (4%) reported having completed high school. In terms of higher education accomplishments, one person reported having an associate's degree, carrera de dos anos, and two persons (4%) reported having a bachelor's degree, licenciatura. One person reported never having attended school. Excluding two persons who identified as students and the one person who had never attended school, the median level of completed education was 8th grade, segundo de secundaria. For some women with disabilities in Oaxaca, the opportunity as adults to obtain a general equivalency diploma through what is referred to as the "open system" may be their only opportunity for accessing an education. As only one example, a young woman, age 18, with whom the first author was acquainted in Oaxaca, and who was participating in the open system, had no formal education; the woman had had both legs amputated and it is unknown as to whether or not this was the only cause of her lack of access to education.

Employment. Coupling information given by the women about their activities with responses to questions regarding monetary income, it appeared that fewer than half of the women [44% (23)] had paid work; most had no form of personal income at all. Of the 23 women who did report income from employment, the majority [61% (14)] reported that their work was only temporary, and almost half [48% (11)] reported that their work was only part-time. The majority [57% (13)] also reported that they did not receive any benefits, such as health care or retirement contributions, with their work income. In addition, the majority [57% (13)] reported that their income was not sufficient for their basic life needs such as food, clothing, and housing. In other words, work was typically temporary and without benefits and frequently part-time. Descriptions of paid work included such statements as: "I help my mother in selling bread" ["Ayudo a mi mama en el puesto de pan"],.... Additional areas of employment included: laundress (3 women), servant/maid (3 persons), secretary (2 persons), attorney, bakery worker, demonstrator of products, executive secretary, manual laborer, restaurant worker, social worker, stationary store employee, and street vendor.

Most women reported some difficulty with vigorous or moderate activity, but most had little to no difficulty with daily activities (bathing and dressing themselves) and reading information in print. These factors speak to the abilities of these mostly unemployed women to perform the very kinds of duties that are necessary in many employment situations. It is interesting to note that in terms of functional limitations there was a statistically significant difference in the functional limitation levels between women who did not work [M = 19.70] and those who worked but whose work did not meet basic needs [M = 24.15] F(2,46) = 3.53, p = .037. However, while those who worked indeed had a higher level of functioning, the quality of the work which they were actually able to obtain did not "pay off" in terms of meeting even their basic needs.

Abuse. In attempting to understand and document both the needs and resources of women with disabilities in Oaxaca, the researchers attempted to understand the "whole" woman. Women with disabilities advising the research team had agreed that personal issues, not typically addressed in Oaxaca, would be essential to understanding women with disabilities and their role in the workforce. For that reason, we were interested in understanding how women with disabilities viewed their sexuality and what their experiences had been in terms of any form of sexual abuse or harassment. Questions regarding abuse were described as questions about "threatening experiences." While these questions were prefaced with the statement, "The following questions are very personal and about abuse you may have experienced [and] if you are not comfortable answering, you may choose not to respond," all of the women chose to answer. Remarkably, over a third of the women had experienced emotional, physical or sexual abuse or sexual harassment in the workplace.

Self-esteem and personal relationships. For items related to self-esteem, most of the women reported fairly high levels of self-esteem and only one responded that her life had turned out "worse than expected." Thus high levels of self-esteem among these women with disabilities would have to be seen as a resource to employment. Similarly, these women in general, including those who had roles as parents, reported being well-adjusted in their personal relationships. They also reported positive relationships with their own parents.

Conclusions

Our findings give a picture of women with disabilities in Oaxaca that reveals them as having high levels of self-esteem, content with their personal relationships, but struggling to find adequate employment and education. In discussing the politics of body imagery, Higgins and Coen (2000) noted from their experiences in Oaxaca that the "high level of self-esteem expressed by so many. in Acceso Libre [a grassroots consumer organization] cannot come from assuming that their bodies fit into `normal' images of beautiful bodies" (p. 267). While the observations of these anthropologists mirror our own findings in terms of high levels of self-esteem, more importantly they link issues of self-esteem with body image--a cultural force in Oaxaca that has the power to exclude women with disabilities from employment. Oaxacan women with visible disabilities have not yet developed the political force to change the perspective of employers who will only hire "attractive" women, but they do appear able to maintain a positive perspective about themselves. Higgins and Coen found the level of self-esteem of people with disabilities in Oaxaca, including women, remarkable:

   They have rethought or reconfigured their body imagery not in response to
   ... postmodern debates but because it is the context of their personal
   agency and intimate everyday lives. Their answers may not be the answers
   for others, but their logic of discovery might be useful to everyone (p.
   267).

Thus, as discussed above, the confidence and self-esteem of the women with disabilities interviewed in this research could certainly serve as a resource for them, both in their daily lives and on the job; it could also benefit others, given that their "logic of discovery" can be shared.

Nonetheless, the fact is that public perception of the bodies of women with disabilities does no doubt present a barrier to employment in Oaxaca--perhaps all of Mexico. The first author of this article had the personal experience of providing testimony for an immigration heating in the United States in which a woman with a disability from northern Mexico charged that Mexican employers' view of her disability constituted such a level of discrimination that she would never obtain employment in Mexico. Her request for political asylum in the United States on the basis of discrimination related to her disability was granted.

The Vecinos researchers were very cognizant of the caution of Dr. Nosek, who warned that "if people don't know the range of options that could be made available to them, they articulate their `needs' in a very limited way" (personal communication, June 18, 1998). While our research interviews may not have made the women interviewed more aware of a comprehensive range of options and needs, their need for increased education, a more informed public, and access to adequate employment was clear to them, and now also to us--and documented by more than one source of data. We do not believe we are biased in our conclusion regarding the needs of these women when we quote the Vecinos Year 5 on-site research coordinator, Claudia Santiago Gonzalez, who stated, as we first began to conceive of this research, "Para me, educacion es la columna vertebral de la mujer--la preparacion" [For me, education is the backbone of the woman--her training].

It is important to note that in addition to our own analyses of the survey results the Oaxacan public was also invited to discuss the research results in a public forum held in Oaxaca City on August 19, 1999. Their discussions in roundtable sessions led to the conclusions that a) information for the community regarding disability and b) education for women with disabilities were the two greatest needs. The position of the participants in the public forum appeared to be that once the community became fully informed regarding the capabilities of women with disabilities and once the women themselves were more fully educated, employment would follow.

A Call for Leadership Training and Opportunities for Employment

An underlying theme in our research in Oaxaca has been concern with the role of women in setting their own agendas to address their identified needs. This they have historically not been allowed to do, although they can certainly articulate their concerns. Women with disabilities in Oaxaca are very much a part of their culture, where tradition has placed them in roles, certainly public roles, that are responsive to men--not leaders of men, and not leaders of themselves. While we do not advocate the abolition of public norms and cultural traditions, we believe that the experiences of women in Nicaragua can inform the women of Oaxaca. Speaking of the Nicaraguan organization of women with disabilities, Por un Futuro sin Barreras [For a Future without Barriers], Rosa Salgado Alvarez (Equipo, 1998) commented:

   Our organization is an organization focused on the improvement of women
   with disabilities, however if we can, we also give assistance to men with
   disabilities. Some men have protested, but we explained to them that this
   is an organization that accepts and helps both men and women. The
   difference is that here, the ones that make the decisions and direct are
   women. We think to continue this way. Everywhere, in all organizations, it
   has always been the men who manage and direct (p. 15).

For the women with disabilities in Oaxaca to formalize their organization, AMUDO, and to successfully program and carry out their information, education, and employment agenda, we believe that training in a) administration and management, b) securing and managing fiscal resources, and c) program and fiscal accountability, is essential (McFarlane, Marshall, Garcia Juarez, & Santiago Gonzalez, 2000). We also believe, of course, that the women with disabilities themselves must be the leaders in and integrally involved in developing any solutions to problems such as lack of access to education and training, lack of employment opportunities, and solutions to abuse.

The Development of the Women's International Leadership Institute

In summarizing our experience in working together in the Vecinos project, women with disabilities in Oaxaca wrote (Marshall, Santiago Gonzalez, Garcia Juarez, & Bruyere, in press):

   We have achieved many things together but we have many more to achieve. We
   have to find resources so that all of our members can be paid a just salary
   and to fund our projects such as our textile painting workshop, a coffee
   shop, and the production of earrings.... Only by joining our efforts and
   networking with others in the struggle will we know that a more just world
   exists for women with disabilities.

This need for networking, for channeling resources to support women's educational and career goals, led to the formation of the Women's International Leadership Institute (WILI). Specifically:

   The purpose of ... WILI is to promote women's leadership potential,
   employment and economic self-sufficiency through educational programming,
   skill-building and charitable acts.... WILI was organized in response to
   the problem of women in poverty who do not have the education or leadership
   skills to improve their economic situation--women whose day-to-day
   activities are so focused on survival at minimal subsistence levels that
   they cannot move forward in terms of increasing their own education (and
   thus improving their economic situation) or skill-level in terms of
   economic self-sufficiency (http//www.wili.org).

A non-profit organization based in Tucson, Arizona, WILI is attempting to develop leadership and employment skills among the women with disabilities in Oaxaca, and thus to include training opportunities as well. However, we face many obstacles. Most recently, in the spring and summer of 2001, the U.S. State Department denied the visas of two women accepted to receive work adjustment and job training in restaurant management in Tucson. The women had requested the visas for a one-month training experience. The visa denial was based on the rationale that the women did not have employment in Oaxaca or funds in the bank. Only after a popular Tucson news columnist called attention to the problem--the United States' refusal to permit the work adjustment and job training of two women with disabilities from Oaxaca--were the visas granted and the training accomplished (Portillo, 2001a; Portillo, 2001b).

Role of the Local Coordinator in Action

I, Lourdes Garcia Juarez, am a member of an organization of people with disabilities and was invited to participate through WILI in a project of work for women with disabilities. I was given the opportunity to look for women who would work in a coffee shop in Oaxaca. One day, walking down the street in my city of Oaxaca, I saw Maria del Pilar talking with a person and I heard what she said. When the other person left, I asked her if she would like to participate with me in this project. She said "no" because she couldn't see well. I told her that I was looking for women with disabilities to set up a coffee shop in Oaxaca that would be owned and managed by them. They would receive training in Tucson, Arizona. She asked me what a disability was. I answered that it is a diminishing of one's abilities, but that doesn't mean you can't do things. I gave her my address and told her to think about it. After a time Maria del Pilar came to my house and asked for me. She asked me if I knew someone who would give her work. I told her that at the moment no, I didn't. I asked her if she had thought about what I had told her. She asked when and where it would be and I told her that she would have to stay in touch with me and I would tell her. Today Maria del Pilar is a member of the project and was trained for a job in the coffee shop.

There are many women like Pilar in Oaxaca. Julia is a woman with a disability in her sight who, despite not having any education, has struggled to come out ahead. She arrived at my house with a cousin who knew what I was doing. I told her about the project and she was very interested; I asked her if she could wait. She said "yes" immediately--that she didn't have work because she couldn't see well. Now Julia also is trained for work in the coffee shop. The women of Oaxaca know that it is difficult to find opportunities to work and that is why we are taking advantage of the opportunities we have had, demonstrating, with our work, that disabilities don't stop our ability to work.

My Commitment to WILI

Forming a part of WILI, for me, is a very important commitment. I received the position of local coordinator of WILI in my city of Oaxaca in Mexico with the purpose of helping women in extreme poverty. With the responsibility of coordinating, I have to find the way to aid women who, aside from struggling with extreme poverty, also have to deal with problems of disabilities, few educational opportunities and women who are not offered well-paying jobs because of their age. That is why they become the poorest of the poor We give them an opportunity to develop within their community....

When a woman with a disability in Oaxaca is fortunate enough to find employment, immediately she has to fight for the right to training and assistance in climbing the employment ladder. Employers generally believe they have done a noble act in hiring a woman with a disability; she should not expect or demand anything else from them. At the same time, employers hesitate in promoting or advancing the woman with a disability for fear that additional responsibilities might worsen her condition. Popular belief has it that women with disabilities are weak and sickly. Thus, we believe that it is through self-employment that women with disabilities can best achieve self-support and economic independence.

Potential Lessons and Global Collaboration in Rehabilitation

This article provides an overview of research conducted in Oaxaca, Mexico that documented over a five-year period the needs of indigenous people with disabilities, in various regions of the state. The last year of Vecinos research was highlighted--research that focused on identifying the needs of women with disabilities in an urban area, the capital city of the state, Oaxaca City. The information from the Vecinos project can serve to inform rehabilitation practitioners and educators of culturally-sensitive intervention and research procedures. The Vecinos project has demonstrated the successes which can be born of cooperative research efforts between researchers and grassroots leaders with disabilities. The research was based on a model of participatory action research (PAR) that involves the use of professional expertise to support the goals and efforts of a particular community-based group (Bruyere, 1993). And yet, these successful research experiences ultimately led also to cultural clashes.

For example, tradition in Oaxacan society does not allow a public voice for women. Tradition in Oaxacan society maintains that only "attractive" women--women whose legs do not give evidence of polio, for example--should be allowed employment. Clashes with a male-dominated disability movement were perhaps inevitable when attempts were made to enable women with disabilities to speak strongly and publicly about their needs, and to develop those leadership skills to design and manage their own employment solutions. Potential lesson: Rehabilitation professionals who believe in respecting cultural differences and honoring the cultural traditions of others are challenged in their beliefs when such traditions deny the voice and the human rights of segments of populations. Women with disabilities in Oaxaca serve as an example of this dilemma.

Pratt (1999), as editor of Rehab Management International, noted in an editorial that "rehabilitation is an international discipline--known, studied, and practiced around the world" (p. 9). And while many governments speak of and provide funding for international collaboration and the sharing of information among "experts," it is important to note that the expert appears most often to be defined as the doctoral level informant. In the United States, we do not typically see the world's indigenous people with disabilities, such as women in Oaxaca with an average education level of 8th grade, acknowledged as experts and accorded access to speaker's platforms and international travel opportunities. Garland-Thomson (2001) noted that, "discrimination, more than impairment, is what people with disabilities have to surmount" (p. B12). It is discrimination, then, discrimination against persons without formal education and credentials, that blocks access of the world's indigenous people with disabilities to government-funded conferences hosted in capital cities, to exchange of "experts" networks, and to recognition as having approaches to life that could serve as models for the rest of us.... Potential lesson: Access to public education is essential--for all of us; a point that, unfortunately, cannot be better made than by seeing the evidence of denied public education such as in Oaxaca. Nonetheless, we must learn to include in our thinking and in our policies the fact that "experts"--those persons to be considered in international exchanges of rehabilitation professionals--can include those persons who do not have formal education, and who certainly do not have advanced degrees, but who possess the expertise of direct experience and the expertise of cultural mastery.

Discrimination is also found against people who do not have jobs and economic resources--discrimination blocked women with disabilities from entrance to the United States--even when their need for training was documented and private funds from U.S. citizens were made available to support their stay. Potential lesson: The United States has a responsibility to reevaluate the relationship it has with its neighbor, Mexico, and to consider working together in rehabilitation. Formal agreements could be put in place that facilitate rehabilitation practices between the two countries, practices such as vocational evaluation, work adjustment, job training, and job development. WILI has provided an example of this process. Women with disabilities participated in work adjustment and job training in Tucson at a highly regarded and award-winning restaurant, followed by job development taking place in Oaxaca, with plans for the women to open their own small cafe--a self-employment strategy in which they believe they can succeed.

Finally, Oaxaca offers a reminder that the family is a fundamental and essential center of community life within indigenous cultures. Oaxacans live family involvement ... from children's birthday parties where the mothers participate in a game of "musical chairs," to wedding receptions where children dance and play until 3 and 4 o'clock in the morning, to the family outing of mothers, grandmothers, children, nephews, aunts, uncles, and parents going dancing together once a month. Oaxacans live what we in the United States can perhaps only recall from 1950s television--and even then, it was only a stable nuclear family that was presented, not the inter-generational family that psychologists now urge us to consider as a remedy for societal problems (Pipher, 1999). Loving family relationships, as well as intergenerational family relationships, were evident throughout the years of Vecinos research in Oaxaca. Even if "loving" is removed from the variable, certainly the potency of a committed family relationship remains (Higgins, 2000; Marshall, Gotto, & Bernal Alcantara, 1998). Potential lesson: The role of the family in a collective society is to be acknowledged and honored in rehabilitation service delivery.

We know it is important to allow students with disabilities the option to be an integral part of their family, school, and community, rather than simply being placed in special homes, schools, and institutions. More difficult for majority culture disability advocates and policy makers in the United States to understand is the need and desire of indigenous families to maintain integral ties with their adult relative who has a disability--indeed with all their relatives! Relating this to stopping school violence in the United States, psychologist William Pollack was quoted as stating, "The potency of a loving family relationship is much stronger than even the best--dare I say it--potentially useful anti-violence program and certainly greater than any single-minded, required zero-tolerance curriculum, and more productive and less dramatic than any magnetometer or gun-sniffing dog" (Smith, 2001, p. 38). Counselors and psychologists concerned with teaching Americans "how to do it" in terms of developing loving and intergenerational family relationships have the option to direct their attention south, to the land of Zapotecs, Mixes, Mixtecas, and other indigenous peoples of Mexico.

Lessons can only be learned and absorbed when the topic is fully embraced; thus the lessons presented in this article are considered "potential lessons." Learning from Mexico is not a position in which rehabilitation professionals in the United States typically find themselves. Nor is it a position in which our policy makers find themselves. However, Mexico should not constitute an Atlantic for us. There is no formidable sea separating us. Mexico is our immediate neighbor and a land with large indigenous populations--populations that operate very much as collective societies and that recognize the family as the fundamental unit of a society. For rehabilitation professionals who face immigrant clients from collective societies and for policy makers who understand that we have much to learn from global collaboration, the indigenous people of Mexico have much to teach us.

References

Ayllon Torres, T & Chavez Flores, J. (1993). Mexico: Sus recursos naturales y su populacion, 2nd ed. [Mexico: Its natural resources and its population]. Mexico, D.F.: Limusa, Grupo Noriega Editores.

Bruyere, S. M. (1993). Participatory action research: Overview and implications for family members of persons with disabilities. Journal of Vocational Rehabilitation, 3(2), 62-68.

Castaneda, J. G. (1995). The Mexican shock: Its meaning for the United States. New York: The New Press.

Clinton's goal in Latin America: To be `appropriately supportive.' (1997, May 1). USA Today, p. 12A.

Equipo de Libros de Nicaragua. (1998). Como y porque nos organizamos: La experiencia del Centro de Promocion de la Rehabilitacion Integral (CEPRI). In Discapacidad Internacional, 5(1), 8-17.

Garland-Thomson, R. (2001, January 26). The FDR memorial: Who speaks from the wheelchair? The Chronicle of Higher Education, B 11-12.

Higgins, M. J. & Coen, T. L. (2000). Streets, bedrooms, & patios: The ordinariness of diversity in urban Oaxaca. Austin: University of Texas Press.

Marshall, C.A. (1992). The power of inquiry as regards American Indian women with disabilities: Divisive manipulation or clinical necessity? Journal of Applied Rehabilitation Counseling, 23(4), 46-52.

Marshall, C. A., Burross, H. L., Garcia Juarez, L. & Santiago Gonzalez, C. (2000). Assessing the needs and resources of indigenous people with disabilities: Benefits for the United States in terms of research utilization. Final Report. San Diego: San Diego State University, Interwork Institute, Rehabilitation Research and Training Center of the Pacific (Available in English and in Spanish from the Interwork Institute; San Diego State University; 5850 Hardy Avenue, Suite 112; San Diego, CA 92182).

Marshall, C. A., Gotto, G. S., & Bernal Alcantara, J.A. (1998). Vecinos y rehabilitation (Phase III): Assessing the needs and resources of indigenous people with disabilities in the Sierra Mixe. Final Report. Flagstaff: Northern Arizona University, Institute for Human Development, Arizona University Affiliated Program, American Indian Rehabilitation Research and Training Center. (Available in English and in Spanish from the American Indian Rehabilitation Research and Training Center, Institute for Human Development, Northern Arizona University, PO Box 5630, Flagstaff, AZ 86011).

Marshall, C.A., Gotto, IV, G.S., & Galicia Garcia, O. (1998). Vecinos y Rehabilitation (Phase II): Assessing the needs and resources of indigenous people with disabilities in the Mixteca region of Oaxaca, Mexico. Final Report. Flagstaff: Northern Arizona University, Institute for Human Development, American Indian Rehabilitation Research and Training Center. (Available in English and in Spanish from the American Indian Rehabilitation Research and Training Center, Institute for Human Development, Northern Arizona University, P.O. Box 5630, Flagstaff, AZ 86011).

Marshall, C. A., Gotto, G. S., & Garcia Juarez, L. (1999). Vecinos y rehabilitation (Phase IV): Assessing the needs and resources of Oaxacan children and adolescents with disabilities in transition from school to work. Final Report. San Diego: San Diego State University, Interwork Institute, Rehabilitation Research and Training Center of the Pacific (Available in English and in Spanish from the Interwork Institute; San Diego State University; 5850 Hardy Avenue, Suite 112; San Diego, CA 92182).

Marshall, C. A., Gotto, G. S., Perez Cruz, G., Flores Rey, P., & Garcia Juarez, G. (1996). Vecinos y rehabilitation: Assessing the needs of indigenous people with disabilities in Mexico. Final Report. Flagstaff: Northern Arizona University, Institute for Human Development, Arizona University Affiliated Program, American Indian Rehabilitation Research and Training Center. (Available in English and in Spanish from the American Indian Rehabilitation Research and Training Center, Institute for Human Development, Northern Arizona University, PO Box 5630, Flagstaff, AZ 86011).

Marshall, C. A., Gotto, G. S., Perez Cruz, G., Flores Rey, P., & Garcia Juarez, G. (1998). Working together as neighbors: Rehabilitation researchers and indigenous people with disabilities in Mexico. Journal of Vocational Rehabilitation, 11(1), 53-63.

Marshall, C. A., Gotto, G. S., Perez Cruz, G., Flores Rey, P., & Obaldia Mitchell, B. (1998). The Vecinos Project: Demonstrating mutual benefit in rehabilitation practice between the United States and Mexico. Asia Pacific Disability Rehabilitation Journal, 9(2), 54-58.

Marshall, C. A. & Santiago Gonzalez, C. (2000). Vecinos y rehabilitation (Phase V); Assessing the needs and resources of indigenous women with :disabilities. Final Report. San Diego: San Diego State University, Interwork Institute, Rehabilitation Research and Training Center of the Pacific (Available in English and in Spanish from the Interwork Institute; San Diego State University; 5850 Hardy Avenue, Suite 112; San Diego, CA 92182).

Marshall, C. A., Santiago Gonzalez, C., Garcia Juarez, L., & Bruyere, S. (in press). AMUDO and the Vecinos Project: Striving together to meet the needs of indigenous women with disabilities in Oaxaca, Mexico. In A. Hans (ed.), Women and Disability. Sage and Reday.

McFarlane, F. R., Marshall, C. A., Garcia Juarez, L. & Santiago Gonzalez, C. (2000). From the ground up. Rehab Management International, 10(1), 26-27.

Nosek, M.A., Howland, C.A., Rintala, D.H., Young, M.E., & Chanpong, G.F. (1997). National study of women with physical disabilities: Final report. Houston, TX: Center for Research on Women with Disabilities.

Pipher, M. (1999). Another country: Navigating the emotional terrain of our elders. New York: Riverhead Books.

Portillo, E., Jr. (200la). Visa denial was no little thing. Tucson/Region, Section B, Arizona Daily Star, July 14.

Portillo, E., Jr. (2001b). No one gives Mexicans a reason to stay in Mexico. Tucson/Region, Section B, Arizona Daily Star, August 25.

Pratt, K. M. (1999). International collaboration. Rehab Management International, 9(1), 9.

Price, P. (2001). Ethics and inclusion: Diversity and equity. Asia Pacific Disability Rehabilitation Journal, 12(1), 34-43.

Sanderson, P. L. (2001). American Indians: An overview of factors influencing health care, disability, and service delivery. In C.A. Marshall (Ed.), Rehabilitation and American Indians with disabilities: A handbook for administrators, practitioners, and researchers (pp. 27-41). Athens, GA: Elliott & Fitzpatrick, Inc.

Smith, D. (2001). Families make the difference. APA Monitor, 32(11.), 38.

Catherine A. Marshall
Northern Arizona University

Lourdes Garcia Juarez
Oaxaca, Mexico

Catherine A. Marshall, Ph.D., CRC, Director of Research, American Indian Rehabilitation Research and Training Center, Northern Arizona University, P.O. Box 5630, Flagstaff, AZ 86011. [e-mail]