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Background: South Africa is a multicultural, multiracial and multilingual nation with many different values, traditions and cultural practices. Different belief systems may give rise to different attitudes and practices relating to disability, which may impact on rehabilitation. The purpose of this study was to investigate the knowledge, attitudes and beliefs relating to disability in three broad cultural groups in the Western Cape.

Method: Sixty primary caregivers were interviewed by using a knowledge, attitude and belief (KAB) survey in a structured interview format. Probability and non-probability (systematic and purposive) sampling were used. The study used both quantitative and qualitative methods.

Results: While caregivers from coloured and white communities generally had become acquainted with disability from an early age, caregivers in black communities often only learnt about disability following the birth of a disabled child. All caregivers had only a rather rudimentary knowledge of the causes of disability, but held positive attitudes towards people with disabilities and their integration into society. The qualitative data showed some differences in beliefs between the three groups in relation to the causes of disability and the need for rehabilitation. The data also revealed negative experiences across the groups in relation to education and the availability of transport, particularly amongst caregivers from black and coloured communities.

Conclusions: Health professionals need to understand the culture, values, beliefs and expectations of their clients when providing rehabilitation services within a community-based model. There appears to be a need for improved disability awareness in schools and amongst transport service providers.

This paper puts forward an argument in favour of careful and critical analysis of culture in formulating communication strategies with and for specific groups, based on experience drawn from the Clown Project in Guatemala and other countries in Central America. The Clown Project uses labour-intensive face-to-face street theatre and dialogue, participatory workshops, and symbolic communication such as print-based material to reach those most vulnerable to the spread and impact of HIV and AIDS . The analysis takes into account relations of power within and between vulnerable groups, examining the centre-periphery dynamic between classes, genders, ethnicities, age groups, and other social identities. Both appropriately supported insider perspectives and appropriately processed outsider knowledge are recommended, along with ways of bridging science and the field, theory and practice

This paper discusses three issues...[for] consideration as part of the evolving discussion of disability in a cross-cultural context. The first concerns seeing socially constructed concepts and beliefs about disability as ideas and attitudes that are often, and increasingly, in transition and not as static conceptual frameworks. The second issue deals with determining the best methodology to understand disability in the individual, family, community and societal setting out of the many methodologies that can be employed in these situations...The third issue is about ensuring that the information gathered is disseminated broadly, which means sharing the information generated not only with those interested in disability issues, but also with those working on issues such as development policy, social change and justice, who know little about disability