Rehabilitation: lessons from a global society. (Editor's Comment).

It's hard to realize that it has been more than six years since the last time that my name appeared by an editorial comment of the Journal. For me it has been a great time of learning and changes. But I have continued to follow the Journal, as it will always have a place close to my heart. Paul Alston has done an incredible job in keeping the Journal useful and relevant to the needs of a very diverse professional audience.

The focus of this particular issue was prompted by some of my observations when I was away from the United States. While always treated well, there always seemed an underlying resentment toward Americans even in countries considered to be close allies such as Australia. That Americans as citizens of a country acknowledged to be the only superpower in the world today is not always seen positively by other nations was especially brought home by the events of September 11. America and Americans are often perceived by other countries as self centered and arrogant. We are perceived as thinking that we are better than others and who often foist our values and systems on others whether they like it or not. On the other hand, I also found that these same individuals often admired our standard of living, economic prowess and the principles of democracy. We are seen as being on the cutting edge with regard not only to scientific and technological creativity but also even in more mundane down to earth practical areas such as rehabilitation. Many nations would literally die to have a vocational rehabilitation system that is responsive to the needs of individuals with disabilities as we have. Yet this doesn't mean that the American way is the best or the only way to go.

I believe we must begin to view other countries as true partners and the notion that we can learn from each other! Disability and rehabilitation in countries other than the United States is different. It isn't a question of whether it is better, worse, or whether a country is "behind" as we and often persons from other countries are prone to say. Each nation and its people have something to offer if we will only pay attention, look at what can be learned, and to act.

I recently attended two lectures here at the University that were quite different in personality, style and substance and yet were so similar. The first was a talk given by Michael Moore of Roger and Me fame and the author of the current best seller titled Stupid White Men. The second was a speech by Lech Walechsa, former President of Poland and Nobel Prize winner. What tied the two together for me was the message by both men that we (everyone) need to get involved, work with others and not just sit back. Moore suggested that our institutionalized system wants us to become complacent so that the status quo is maintained. His thesis was that everyone has a role to play. Walechsa on the other hand pointed out that old political structures must be revamped to serve a new global society. He emphasized the need for us to look beyond the old and to do something.

For me, Walechsa's theme was reinforced by Thomas Frieden's book, The Lexus and the Olive Tree. Frieden argues that the tension between globalization and the ancient traditions of culture, land, tradition, and community doesn't have to always be. He believes that we can strike a balance "between globalization's inherently empowering and humanizing aspects and its inherently disempowering and dehumanizing aspects." Frieden concludes by saying that "our job as citizens of the world is to make certain that a majority of people always feel that advancing issues are leading the declines." That I believe is where rehabilitation fits in.

We, in rehabilitation, don't often think about globalization or how what we do may have impact worldwide. Many of us don't have the time, inclination, or in my case even the intellectual capacity, yet maybe we need to think beyond our borders to pick up on a recent business related buzzword or cliche. I recently came across a recent report by the U.S. General Accounting Office with the title of "SSA Disability: Other Programs May Provide:Lessons for Improving Return-to-Work Efforts." What was interesting to me was that these other programs were not only private sector ones but they included Germany, Sweden, and The Netherlands. It may be true we are the only major superpower left but we don't have all of the answers. We can learn from each other!

The articles in this issue include some developed in response to a call for proposals and others that were submitted through the usual editorial process. Their selection for inclusion was their worldwide coverage focusing on mutual benefit or lessons we can learn by working together.

The first article by Chen, Brodwin, Cardoso & Chan calls our attention to pay heed to attitudinal differences that have cultural roots. With our population rapidly changing in the United States, as rehabilitation professionals we must understand the impact that attitudes in a country of origin may have on current residents and citizens. The second offering by Marshall & Juarez comes from our next-door neighbor Mexico and specifically from women with disabilities from Oaxaca. The lessons learned may not be earth shaking but they certainly reinforce the notion that we rely not only on those from other countries who may be perceived to be the experts but the need to be inclusive of those who we may be prone to ignore. South America is the focus of the article by Upton, Fontan, Premuda, Lorenzo, & Quinteros. Specific disabling conditions such as traumatic brain injury occur across borders and a shared perspective can bring about improved intervention and understanding. The fourth article by Mpofu & Harley moves us across the ocean to the country of Zimbabwe with the continuing lesson that rehabilitation must truly be holistic. Our U.S. perspective and the corresponding philosophical duality and reliance on professionals may need revision.

The article by Walls, Hendricks, Dowler, Hirsh, Orslene & Fullmer of the International Center for Disability Information at West Virginia University focus our attention to the commonality or even universality in attempts to accommodate disability in society. The article by Waghorn, Chant & Whitehead from Australia speaks to the need to listen to those individuals directly involved with the conclusion was self-reported course of illness emerged as a practical predictor of vocational recovery. The last two articles in the issue come from Hong Kong, though now a part of China. Though Hong Kong has a well-developed generally western approach to rehabilitation, these articles highlight attempts to adapt instruments and ideas to a cultural context quite different than that most of us are familiar. Perhaps the lesson is that "borrowed" ideas and instruments when carefully chosen and normed can be used in settings outside the original context. Li & Tsang report on a Chinese version of the Becker Work Adjustment Profile and the Ng & Tsang article describes an adaptation of an intervention protocol to Hong Kong.

This issue contains a mix and diversity that is so characteristic of rehabilitation. My hope as editor is that you as reader will not only appreciate and learn but enjoy the process as well. I know it was fun and exciting to play a small part in preparing this issue.