RESEARCH ARTICLES

Disability Around the World: Study Abroad in Diverse Cultural Contexts
Laura Eisenman, Ph.D., Michael Gamel-McCormick, Ph.D., Ashley Curran, B.S.,
Rachel McCulley, B.S., & Meghan Moritz, B.S.
University of Delaware

Kim Musheno, Association of University Centers on Disabilities

Abstract: During a short-term study abroad program undergraduates and instructors from the U.S. explored disability issues in diverse cultural contexts: Ghana, UAE, Nepal, and Thailand. Through qualitative analyses of personal narratives, student interviews, journals, and other products, student- and faculty-researchers learned that participating students developed more critical perspectives on the importance of culture in shaping disability experiences in the U.S. and abroad. 

Key Words: diversity, international travel, disability studies

      Although short-term study abroad programs cannot offer the in-depth or immersive experiences of semester-long or academic year programs, they can have important influences on studentsÕ personal and academic perspectives as compared to campus-based experiences. For example, studies have identified positive effects on studentsÕ perceptions of their personal development, functional knowledge of different cultures, greater intercultural awareness, increased confidence, and acknowledgment of the importance of reflection for personal and professional growth (Akande & Slawson, 2000; Chieffo & Griffiths, 2004; Pence & Macgillivray, 2008; Shames & Alden, 2005; Sutton & Rubin, 2004). Thus, Sachau, Brasher, and Fee (2010) suggested three overarching educational goals for student growth through short-term study abroad programs: increasing knowledge, shaping attitudes, and building confidence. Regardless of the length or locale, programs with the greatest impact engage students personally in frequent, structured interactions with local cultures and opportunities to reflect on the meaning of what they are learning (Chieffo & Griffiths, 2009; Jones & Caruana, 2010).
      
Program and Disability Studies Context

      These goals and approaches were integral to an Òaround the worldÓ short-term study abroad program that offered undergraduates a comparative exploration of disability. During a five-week winter session, 21 undergraduate students and three faculty instructors from the U.S. visited Ghana, United Arab Emirates, Nepal, and Thailand. Within the broader goals of the program, the instructors had a specific interest in developing studentsÕ understanding of disability as a cultural phenomenon. Therefore, activities and academic assignments were framed by two overarching questions intended to challenge students to consider culture as a lived, negotiated, and dynamic process of making meaning:  How is the experience of disability influenced by the culture in which one lives?  What factors influence the services and supports available to people with disabilities? Because of the short amount of time in each country, which had the potential for creating a superficial tour with limited impact, attention was given to selecting diverse countries and embedding frequent opportunities for engaging with local individuals and organizations who could provide insider perspectives on disability experiences. Selecting countries where students could engage with cultural features that might be novel to them while part of a supportive program context also created the potential for increasing studentsÕ awareness and knowledge of cultural differences and commonalities (Che, Spearman, & Manizade, 2009).
      
 	Although the students were not asked to directly engage critical theory approaches to disability studies, the program structure and assignments were intended to support students in consideration of disability experiences as socially constructed, multi-faceted, and consequential at social and personal levels (Hulgin, OÕConnor, Fitch, & Gutsell, 2011; Paterson, Hogan, & Willis, 2008). Consistent with Cypher and MartinÕs (2008) notion of a disability studies pedagogy that promotes studentsÕ Òcritical progress,Ó the program was designed to challenge students to think critically by developing content knowledge about disability while also engaging them in guided questioning about their observations of external situations and their personal assumptions. Gaining and processing content knowledge (e.g., learning about alternative perspectives and experiences of social inequality) can serve as a foundation for critical inquiry in situations where students may be unfamiliar with, resistant to, or have limited opportunity to reflect on cultural meanings of disability (Hulgin, et al., 2011). 
      
      This trip was developed by Laura Eisenman, Ph.D. and Michael Gamel-McCormick, Ph.D. as a new offering for students with an interest in disability; no prior study abroad programs at the sponsoring university had a disability focus. The impetus for the new program was the dramatic growth of the universityÕs interdisciplinary, undergraduate Disabilities Studies Minor; in the previous five years enrollments grew from approximately 50 to more than 200. However, the trip was opened to all students, regardless of whether they had declared the Minor. Through a combination of established international connections, acquaintances abroad and domestically, and consideration of air travel routing efficiencies, the faculty selected countries that would maximize comparisons across observable features of cultural processes such as economic resources, social customs, governance structures, religious practices, and disability policies. 
      
     The selected countries and primary locations within each included Ghana (Accra), the United Arab Emirates (Dubai), Nepal (Kathmandu), and Thailand (Bangkok). The students and faculty stayed in each country for approximately one week;  meeting with individuals with disabilities and their family members, advocacy groups, service providers, government, and non-government organizations. Planned cultural excursions were incorporated into the weekly schedule, and students undertook additional activities on their own. Also, students read assigned academic articles or chapters related to each country including the U.S., completed individual and small group written assignments, and met at least twice each week as a whole class to discuss what they were learning. The fifth week, students and faculty stayed at the University of Hawaii, Manoa, to prepare their final projects and meet with faculty, staff and students of that universityÕs Center On Disability Studies.

     Research Context and Design

     Based on many studentsÕ final comments about the impact of the program on their personal and future professional lives, the faculty leaders discussed the possibility of engaging students in a systematic examination of the experience for the purpose of sharing information about the program more widely. A search for research literature on undergraduate study abroad programs that focused on disability issues revealed a small number of studies about students who identified as disabled (Shames & Alden, 2005; Scheib, 2006) and guides on how to include people with disabilities in international exchange and study abroad programs (Mobility International, n.d.). Similarly, a search of the small, but growing literature on disability studies pedagogy identified suggestions for heightening sensitivity to cultural contexts (Hulgin et al., 2011; Paterson et al., 2008), but  did not uncover any studies dealing with international study as a means of doing so. Therefore, this case study fills a gap at the intersection of the two literatures by focusing on how a comparative study abroad influenced undergraduate studentsÕ understanding of disability.
     
     We positioned our qualitative inquiry as participatory and interpretive (Lincoln, Lynham, & Guba, 2011); acknowledging and capitalizing on the fact that students brought different backgrounds to bear on making meaning of the unfamiliar cultural experiences they encountered on the trip. As interpreters of their own experiences, what would they count as learning? In what ways did they make critical progress in understanding disability experiences? As faculty and student-researchers working together, we elected to foreground multiple student voices through the use of autoethnographic methods that would connect the personal and the cultural (Ellis & Bochner, 2000) and further incorporate other interpretations as identified through grounded theory methods.
     
     Method
     
Participants
     
     Following receipt of institutional review board approval for research involving human subjects, all 21 students who participated in the study abroad received an invitation from the faculty to become student-researchers on the project. The three students who accepted were females in their junior year during the trip. They completed the research as seniors. All three had a Disabilities Studies minor; two majored in human services and one majored in health sciences. None had studied abroad before. All three had relatives with disabilities.
     
     Another eight students agreed to participate in the study through follow-up interviews and permitting their completed coursework, such as journals, to be used as data sources. The other eight participants included one male who was a senior during the trip and seven females, including two seniors, four juniors, and one sophomore. Half had a Disabilities Studies minor. Six majored in nursing or health sciences and two majored in education. Three had prior study abroad experiences. None of the students self-identified as a person with a disability. However, two indicated that they had a sibling, parent or close relative with a disability.
     
     The demographics of the 11 participants were similar to those of the 10 students who completed the study abroad trip, but did not participate in the research activities. Those 10 included eight females and two males; four seniors, five juniors, and one sophomore. Their majors included:  education and human services (4), nursing and health sciences (3), and other social sciences (3). Five had prior study abroad experiences. One self-identified as having a learning disability, but did not officially request accommodation. Two indicated they had a sibling, parent or close relative with a disability.

Data Sources

     During the process of seeking informed consent, potential participants were asked if they would be willing to complete interviews, join a focus group, and share their course-related assignments or other artifacts of the trip such as blogs and photographs. In some cases, participants agreed to share their course assignments, but could not locate some items. In other instances, participants were willing to be interviewed but preferred not to have their journals used for the study. Although all participants agreed to join a focus group, scheduling proved difficult and no focus groups were held.

Personal Essays and Interviews

     Interview questions were developed by the authors in consultation with colleagues who had recently completed a study of undergraduates in a short-term study abroad program. The interview questions covered participantsÕ views about disability before and after the trip, experiences during the trip that influenced how they thought about disability, and their reflections on how those experiences may have influenced other areas of their life (e.g., career interests, personal goals, cultural awareness). Six participants completed interviews in person with the student-researchers or responded to the interview questions in writing. 
     
     Prior to interviewing other students, the three student-researchers individually constructed personal reflective essays about how the study abroad affected them. In their essays, the student-researchers identified a key encounter from the trip that they believed to be most personally influential.  They reflected upon why the encounter was important to them, how the encounter impacted their professional goals and personal views, and how other aspects of the trip also contributed to their changing perspectives.
     
Journals

     Nine students shared journals, which had two major components: (1) reflections on their ÒpositionÓ regarding disability and (2) reflections on key messages adapted from materials on the World Health Organization (n.d.) disability and rehabilitation websites. Before arriving in Ghana, students wrote a brief essay to establish their positions (component 1) as an observer of disability experience. Guiding questions for the essay (adapted from Race, 2007) included: (a) What personal experiences and characteristics inform your understanding of disability? (b) What social values, norms or conventions influence your experiences with disability in everyday life? (c) How does your customary physical environment shape your experiences with disability? (d) What are your expectations regarding the lives of people with disabilities in each of the countries we will visit? Initially, for the key messages component, each student selected and commented on three of 11 possible prompts that she or he thought was most pertinent to the lives of people with disabilities in the United States (e.g., Disability is a human rights issue; Poverty is a cause and effect of disability; Disability affects entire families; Disability is a continuum of experience which varies across the life span).
   
     Weekly, after visiting each country, students continued to write in their journals about both components. They wrote two to three paragraphs in which they reflected and elaborated on an idea from their original position essays given their experiences in the country just visited and another two to three paragraphs in which they identified and discussed three key messages they thought were most relevant to the lives of people with disabilities in that country.
   
     Each week during the trip, students collaborated in small groups to write summary notes about field visits and activities in each country and to write a brief story about an encounter that had a strong impact on one or more members of the group. In those cases where students participating in the research project included these items in their own journals, these materials served as supplemental journal data. One of the student researchers also shared her blog of the trip.

Other Course Materials 

      Prior to departure, each student selected a disability memoir (e.g., Gimp, Born on a Blue Day, The Spirit Catches You and You Fall Down) to read during the trip. During the last week of the trip, students wrote a four to five page essay in which they briefly described the content of the book; identified and explained the most important theme(s) or critical issue(s) raised by the author; discussed how the major themes or issues related to ideas about disability identity, culture, services, or supports raised during the study abroad; and reflected on personal and/or professional experiences with the issues raised by the book. Eight studentsÕ book reviews were offered as data sources. 
      
     Also during the last week of the trip, groups created presentations around a theme they identified as important to what they had learned from the study abroad experience. They included stories and information collected during the trip and, in some cases, additional supporting information researched during the final week in Hawaii. The themes chosen by the students included: poverty; religious beliefs; government structure; disability awareness; and inclusion.  Participating students were represented in each of the five presentations.

Analyses
     Analyses involved multiple rounds of the student-researchers (authors 3-5) and the first two faculty authors reviewing data sources, composing and sharing analytic memos, and discussing emerging themes. In the first round the three student-researchers constructed their post-trip personal essays (Chase, 2011; Ellis & Bochner, 2000) and discussed these with each other and the faculty to refine their ideas. Next, using coding, categorization, and inductive techniques of grounded theory approaches (Corbin & Strauss, 2008), the student-researchers independently reviewed the other studentsÕ interviews, journals, book reviews and final presentations to identify ideas of importance to the other students that were similar and different from their own. They met three more times with each other (once) or the faculty (twice) to review and refine their preliminary themes. Next, the student-researchers and faculty independently reviewed the data to confirm, refine, or elaborate the preliminary themes. They then discussed and came to consensus on a final set of themes, a conceptual framework for explaining the studentsÕ changing understanding of disability experiences, and illustrative examples. The final step involved a review of the findings by the third faculty member as a check on how well the findings reflected her own observations of the trip participants and their journal reflections, which she had read during the trip. As needed, her suggestions for clarification were incorporated.
Findings
     The following three sections each begin with a student-researcherÕs narrative elaborating on the central theme she identified. After each narrative, the theme is extended through conceptually-related examples from other students that illustrate changes in studentsÕ understanding of disability and the influence of the study abroad experiences. These central and extended themes include: (1) Cultural importance: Looking across and within cultural processes; (2) Family involvement: Fighting for resources and rights; and (3) Passion for advocacy: Making connections through shared stories. The three student-researchers characterized their personal narrative themes broadly as discovering; a concept intended to encompass new knowledge and altered perspectives. Similarly, all students provided evidence of their expanded knowledge of factors affecting the lives of people with disabilities (e.g., religion, poverty, family involvement, human rights, disability acceptance and awareness). Further, students noted how the trip excursions and academic exercises transformed their personal views and professional goals.

Discovering Cultural Importance

Ashley

      During the trip there was one significant event that really set into motion my discovery of cultural importance throughout the trip.  Having never traveled outside of the United States and being raised in a small town my view of the world and culture was limited. Growing up and learning with the same sixty students for the majority of my academic career before college created a narrow perspective in which I understood situations and thought about them. While meeting with the Ghana Federation of the Disabled I had my first moment of cultural shock. We were discussing some familiesÕ inability to care for their children with disabilities, which may result in a family leaving their child by the river to be eaten by a snake. Some local traditional beliefs view this as returning the child to the gods.  This information was appalling to me, and I was judgmental.  

      With our class discussion I started to recognize that my knowledge about different customs and environments was limited. When asked by our professors to relate the practice of abandoning a child by the river to something that may occur in America I was unable to even begin such a comparison. Our professors challenged us not to judge these families and we discussed what it must be like to raise children with significant disabilities with very limited resources.  Our professors also reminded us that in the United States families that are desperate and are not supported have made decisions such as leaving their child at the local hospital door, admitting them to an institution, killing them, or deciding to abort the child when they get information before birth.  In the United States we have the resources and technology to find out before the child is born if they may have a disability. In Ghana it is not very likely that the families will have the opportunity to get such information or have the resources to raise a child with a disability. While these two situations are not completely the same they can be easily compared. They both reflect local beliefs about disability. From this conversation it set me on a journey to look at all situations that we experienced with an open mind. I wanted to understand why something was the way it was and what was the underlying belief. 

      Through this trip I was able to recognize how culture can change perspectives. My cultural upbringing has taught me many lessons and values that I may not have realized if I had not been taught to look into them. I now am able to look at a situation and begin to think how culture and values may be impacting what is going on. Learning this key lesson at the beginning of my career journey provided me the tools to look deeper into culture and always recognize it while attempting to ÒfixÓ a problem. In the future I want to work in the education system creating a more equal education for all individuals despite any economic or cultural differences they may have. Appreciating and understanding oneÕs culture and that of others is necessary to build trust and a better future. 

Looking Across and Within Cultural Processes

      Looking more critically at oneÕs own cultural assumptions and recognizing variability within and across cultural experiences was a theme expressed by other students as they reflected on the impact of the trip. Summarizing in an interview, a student stated:
   
ÒThese experiences were memorable because they were so different from my own ideals and perspectives (Ghana), surprising in their simplistic yet complicated issue (Nepal), exemplified the influence people who have a platform have on others (Thailand), the risks some will take for the benefit of others (UAE), and realizing how similar yet different our experiences were from each other on the same trip (Hawaii).Ó

      Students agreed that the structure of the academic assignments supported their learning. For example one noted that: 
   
ÒWriting journals every week about certain topics helped me not only remember the things I learned but pay attention to detail in the first place, trying to figure out how to relate the information I was learning to one of the various topics we were given to write about weekly.Ó

      Another commented more explicitly about the value of the assignments within the study abroad context as a means of developing cultural awareness: 

ÒThese tasks helped to inform my understanding of disability by giving me the opportunity to talk with classmates and professors to hear and learn their perspectives on disability in their own lives and how they processed the experiences we had on our trip. É It made a great difference that the tasks were performed abroad because we were in the moment at the time and the experiences were fresh in our minds and hearts.Ó

      When reflecting on the dimensions and dynamics of cultural processes, students seemed most surprised by the role of religion. Numerous comments in individual journals and across several final presentations acknowledged the influence of religion in the lives of people with disabilities. They also observed variations in religious beliefs versus practices and the ways that religious perspectives were evolving as old traditions encountered new information. As summarized in one groupÕs presentation:

ÒAlthough religion has a powerful impact on how disabilities are viewed there is variation across each country and within each religionÉBefore studying abroad, as a group we were unaware of the impact that religion and culture have on the lives of people with disabilities around the world. We have realized that religion is equally as important in the U.S. but it is much more exposed and visible in the aspect of daily life in other countries.Ó

      As an example, the group shared this impact story:

ÒDuring our conversations [with individuals at a disability organization] our group members were given a chance to talk with the members about religion in Thailand and received information from three different perspectives. ÉThere was a variety of religions such as Christian, Muslim, and Buddhist. Each individual experienced their religion differently in society and had unique views on how religion affected their view on disability. [One explained] that while he understands he may have sinned in his past life  he does not believe he should be denied supports and rights in his current life. He believes that he is equally as entitled and should use his life to become the best he can be and expand the good within in him. Another member of the Buddhist faith [said] that he did not believe karma was the reason he was in the wheelchair. É A woman of the Christian faith believed that God is responsible for life and will guide her to something better. She believed life is a mission from God and it is her responsibility to teach empathy. A Muslim family viewed this as a test from God and that you have to help those around you. From this small group of people we were able to see a number of different ways religion is experienced for people with disabilities. ÉWe recognize that these individuals have found a way to not reject cultural beliefs; [they] keep their beliefs strong while finding an identity within their religion and culture.Ó

Discovering Family Involvement

Meghan

      As we visited the country of Nepal, I discovered how family involvement and the role of caregivers for people with disabilities are universally vital to the international community of people with disabilities. We visited one place in particular in the Kathmandu Valley, where a couple truly emulated this role. The center provides service and educational opportunities for young children with autism. It was created by a couple, who were initially inspired by their young son who was diagnosed with autism as a toddler. Together, they wanted to create a better life for their child, as well as other children and families experiencing similar situations. 

      The parents took advantage of their limited resources to establish a place where their child and others with autism could have the opportunity to learn. It was extremely refreshing to see such pro-active and passionate parents in a country such as Nepal where there was such distress. The country had numerous other crucial issues such as the lack of a waste management system and the recent struggle to transition to a democratic government. It was hard for me to imagine how a family could gather up the resources to provide for the community of people with disabilities. I was inspired because they overcame adversity to provide for their family and others in a country where people with disabilities and their needs are often a low priority. Without question, the family accepted the role of caregiver and understood what that entailed, all while helping other parents like them.

            	The acceptance of this multi-faceted role is one that is similar to parents and families that I have seen in the United States. I have a twin sister with cerebral palsy, and for the past twenty-two years, my parents have also accepted the complex role of a caregiver for a child with a disability. Through my family and my personal experiences, we have all learned the importance of family involvement. Throughout the trip, one of my initial thoughts in each country was how my sister would live and be treated. I thought about her identity as a person and if she would be seen as a curse or evil. I also thought about the accessibility of each place and her quality of life. As a result of the constant comparison of my sisterÕs life in the United States to the countries we visited, I developed a sense of renewed appreciation for the services and supports available in the United States.

      Within the United States, recognition of the rights of people with disabilities has evolved in the past fifty years in ways that some of the countries we visited have just begun. For example, in the U.S. there is an emphasis on seeing people with disabilities as people first; students with disabilities are enrolled in the educational system; and federal medical health insurance is available to many. These concepts and services are more rare in the countries we visited. In many places, people with disabilities struggle for acceptance as people and are still shunned from the public or seen as curses upon their families.

      Regardless of the social, education and medical obstacles seen in the other countries, the people and organizations that we had the opportunity to speak with were inspirationally optimistic. They accepted their role of advocates and self-advocates with determination and purpose, and were ready to take on the sometimes seemingly impossible fight of improving the rights of people with disabilities. Going into this trip, I was expecting to learn about other countries and how they viewed disability. I left with a more comprehensive view of not only the countries and their cultures, but how much work it takes to create awareness on a human rights issue. My sister and family have benefited from the hard work advocates, policy makers and people with disabilities have put in to the fight for rights, supports and educational opportunities. Visiting these countries made me appreciate the life my family has created for my siblings, my sister and me.	

Fighting for Resources and Rights

      Like Meaghan, other students recognized that people with disabilities and their families around the world often find themselves fighting for access to resources, as well as to establish and exercise their rights. Several students observed that individual people with disabilities and family advocates often took the initiative to tackle complex issues, including human rights, despite meager resources. For example, in the presentation on government influences in Nepal, the students stated, ÒIn a political arena wrought with turmoil, disability awareness, supports, service implementation seems a far-off dream. However, with a self-advocacy movement among the strongest we encountered during our travels, the promise for proper disability supports and services remains hopeful.Ó
      
      A student who brought prior disability-related knowledge to the trip stated, ÒI have felt strongly about the importance of disability rights and services for a few years, and the trip just strengthened those beliefs.Ó Further, students demonstrated an emerging understanding that disability concerns were fundamentally enmeshed with human rights concerns. Looking across the four countries visited, a student wrote: 
      
ÒIn Thailand, I observed many of the same challenges and accomplishments as the three other countriesÉThe challenges included establishing human rights for all people including those with disabilities, and attaining full and effective participation and inclusion of people with disabilities in society.Ó

      StudentsÕ reflections on rights and resources were often linked to comments about a renewed appreciation for what they experienced in the U.S.  For example, when reflecting on a conversation with local individuals about rights of women, a student commented, ÒYou always take the rights we have in the United States for granted until you hear a story like that and realize that not everyone treats people like the US does.Ó However, these appreciations also generated more complex responses that included surfacing critiques of the United States. This became especially clear as students commented on their deeper understanding of the impact of poverty on people with disabilities. In a group presentation on that topic, students noted: 
   
ÒWe observed quality of life for people with disabilities to be influenced by lack of: resources, financial stability, access to medical facilities, and sanitation. After our experiences in these countries we have a new outlook on poverty and disabilityÉ[We are] quicker to recognize poverty and disability in the US; [We] realize there can be difference in accessibility of services [even] if [you are] more financially stable in the US.Ó

      Another noted in a book review: 

ÒI appreciate the fact that the United States has more knowledge about disabilities and the fact that we have more acceptance than the countries we have visited, but it also makes me realize how much further we still have in order to achieve all of our goals and spread awareness to everyone in the states.Ó

      Students also recognized that different disabilities were differentially affected by a lack of information and resources. For example, one student reflected:
   
ÒOne of the key points I took from our site visits was the fact that most mental/intellectual disabilities are not accounted for...The schools [that are] available mainly focus on the physical sense; blind, deaf, physically impaired. Without the ability and resources to recognize these types of disabilities, no help or schooling can be given.Ó 

Discovering OthersÕ Passion for Advocacy

Rachel

      In Ghana, we were introduced to Emmanuel Ofosu Yeboah, a strong disability advocate. Emmanuel was born with a physical disability, and although it was customary for families in Ghana to Òforget aboutÓ their children with disabilities and not care for them. EmmanuelÕs mother was different; she wanted her son to have all of the same opportunities as other children. She ensured he could go to school, and when Emmanuel was old enough, he found work on his own. Rather than begging, a typical way of life for many Ghanaians with disabilities, Emmanuel traveled to the capital, Accra, to find meaningful work while still in school. By working, he made enough money to buy his own soccer ball, which was a rarity for children in Ghana. Then, instead of his schoolmates excluding him from playing with them, he controlled the game. As Emmanuel got older, he worked to raise awareness about disability by riding a bike across Ghana with one leg. This turned Emmanuel into a celebrity in Ghana, and later into a celebrity in the United States. The Challenged Athletes Foundation in San Francisco heard EmmanuelÕs story and brought him to the United States. While he was here, they provided him with surgery for a prosthetic leg. He returned to Ghana with a renewed sense of advocacy and has worked to help people obtain wheelchairs and other necessary devices. Additionally, the documentary EmmanuelÕs Gift was produced to tell his story, he has won an ESPY award from ESPN, and he has even become friends with Oprah! Emmanuel recently started construction on a school for students with disabilities in Ghana. His story shows that even with few resources, one can make great things happen, which was echoed throughout the trip.

      Although we visited many organizations there were three that really stuck out to me. First, in Dubai, we visited a nursery school started by two energetic, ambitious young women who had a vision of a school for children of all abilities because no such place existed in Dubai despite supporting legislation. We visited them the week before they opened their doors, and it was remarkable to see all of the hard work and dedication that they poured into the school even in the face of some local resistance. The second notable visit for me, because of my prior experiences with vocational programs, was the Technical & Skill Development Centre for the Blind & Disabled in Nepal. They provide training in areas such as computers, office management and English language, art and clay work, chalk and candle-making, knitting, tailoring, mobile telephone repair, and weaving. They also have an early intervention program and health and physiotherapy. In addition, they have an internship program that looked remarkably similar to an employment project that I worked at in the US. The Centre trains students in job areas, provides certification, finds them an internship/job, and then helps the student sustain themselves past the program. It was really interesting to see familiar concepts applied halfway across the world. Our visit to Ratchasuda College at Mahidol University in Thailand was also a significant visit for me, because I am very interested in school to adult life transitions, and especially access to higher education for students with disabilities. This interest has grown out of observing the experiences of friends with disabilities as well as the positive effects that college has had on my own life. Ratchasuda College was started in 1993 specifically for students with disabilities, especially those with hearing impairments. The dean of the college gave us an overview of the program as well as the currently disability situation in Thailand. Although there were separate programs in the college for students with disabilities, it was integrated within the larger university, and the courses were very accommodating to students with disabilities.

      One of the most remarkable things about the trip was the energy, enthusiasm, and dedication of everyone we met. People were excited to meet us and teach us about what they do in their country. Also, they were eager to learn from us about what we do in the US. Similar to our country, there are strong advocates who are looking for equal protections. Although our country still has much room for growth, they admired our progress, and wanted to learn from us. Their  undying passion to advocate for, teach, and support people with disabilities, as well as the desire to learn more about best practices, showed me that some of the rights we have here in the US are taken for granted. The mutual respect, understanding, and knowledge shared among our group and the people that we met was more of an education for me than anything IÕve learned here in Delaware. After our trip, I had a renewed perspective on disability rights. I also came back more confident in my goal of working in disability policy. A year before the trip, I declared a minor in political science. I knew that working in policy would have broader implications for people with disabilities in America. However, I saw this first hand in other countries, by seeing how limited and restricted people were by the policies in their countries. However, what they all had in common was that they did not let this stop them. I came back to the US knowing that it is possible for all of us to make a difference. Upon returning, I sought out an internship in Washington, D.C. to further my own knowledge and understanding of domestic disability policy to apply my education to our society. After graduating, I hope to eventually work in policymaking, and hope to one day travel again and share more information with countries around the world. 

Making Connections Through Shared Stories

      Interacting with disability advocates in multiple contexts and hearing advocatesÕ stories in their own voices had a strong impact on the students as they reflected on their personal views and professional goals. As one student stated:

Ò[Visiting organizations and talking to people with disabilities] was monumental in my new understanding. The personal stories and explanations we heard from the people who lived in these countries were inspiring and informative. I know that being able to personalize the issue made all the difference. It was truly special to interact with these people.Ó

      In some cases, these personal stories, while Òinspiring,Ó also up-ended studentsÕ expectations about how the world worked. For example, a student noted in a journal, ÒAlthough there seems to be many struggles in the lives of people with disabilities in Nepal, to my surprise there were many advocates who displayed extraordinary passion towards obtaining services and support.Ó Learning about advocatesÕ personal experiences and observing new or alternative ways people with disabilities were improving their own lives seemed to help students gain more nuanced insights into the nature of disability advocacy. One commented, ÒThese experiences were where the most was learned because the political and personal viewpoints came together. Actual people were providing insight on the policies and gave us a firsthand look on how families used their resources available.Ó One student also commented on the value of speaking with multiple individuals and groups in each country, ÒThe impact here is that we learned that we cannot take one sourceÕs information for granted but look at many different sources and compare and contrast them because different people in different positions have varied responses to the similar situations.Ó 

	Connecting through personal stories prompted several students to make a shift in how they thought about disability. One who had no prior personal or academic experiences with disability stated, Ò[The trip] has had an impact, I no longer use the word retarded, and I correct people when they use it. I look at my surroundings every day and note whether it is handicap accessible or not.Ó  Another studentÕs book review concluded with, ÒAs Emmanuel Ofosu YeboahÕs friend says, ÒItÕs not about thinking ÔOh man, I am glad that I do not have a disability like him; itÕs about thinking, ÔOh man, I wish I could be more like him [referring to Emmanuel and others who have disabilities].Ó  
   
      Throughout the trip several students commented on the allure of an Òaround the worldÓ trip, the possibility of returning to the visited locations as professionals, and the impact on their professional knowledge and goals. In a later interview, one student stated, ÒThis trip helped me realize that living/working abroad is something I would like to do in the near futureÉ I am interested in traveling back to one of the countries visited and put my [future graduate] degree to useÉÓ  Some reported a shift in their understanding of their ÒneedsÓ, such as one studentÕs commentary that, ÒThe entire experience was meaningful and humbling to me having to live out of a 15 lb suitcase. It really made me understand how to use only the essentials.Ó Another student reflected:
   
ÒI was initially drawn to this trip because I wanted to travel the world while   learning and experiencing cultures that I otherwise would not have the opportunity to travel to. After looking further into the trip I realized it was a great opportunity for me, as a nursing student, to develop an understanding of global healthcare issues and available services.Ó

      Another stated:

Ò[The trip] made me realize how important having an understanding of disabilities  is. I babysit for a girl with a disability and I often think about how difficult her life  would be in some of these countries. I am very interested in health care and this  has really made me realize how I want to continue in the health care field and  work with people with disabilities.Ó

Discussion

      Through this Òaround the worldÓ trip, students were challenged to think critically about their cultural assumptions and understanding of disability. The comparative nature of the experience supported them to more directly confront the influence of factors that had previously been less visible to them, such as the role of religious beliefs and poverty. For several students, this led to an emerging recognition of connections among disability issues and larger human rights issues, an appreciation for the resources and rights they had, and an acknowledgement that progress on disability issues was still needed in the U.S. as well as other countries. In some cases this recognition sparked or confirmed a desire to make a contribution to the disability field at home or abroad through their future professions or personal lives. Students agreed that seeing each country and meeting people through planned academic and cultural excursions, as well as their own informal forays, were instrumental to their academic and personal growth.
       
      Having limited or no prior experience with disability issues did not seem to create major barriers to learning for students. The opportunities to meet many different people with disabilities, their families, and other advocates coupled with the background readings and regular class discussions made the information accessible to students regardless of prior knowledge or major. Students typically reported gaining some insight into individual and family experiences of disability as well as a variety of approaches to services and supports for people with disabilities.
      
      The comparative approach assisted students to observe variability across experiences. However, students did require guidance from faculty during class discussions to push beyond simplistic comparisons of the most readily observable cultural differences.  Two aspects of the studentsÕ reflective work seemed most critical. First, students benefited from the structured opportunities that were embedded in journaling and class discussions to consider how their own beliefs and experiences differentially influenced what they noticed and counted as learning.  Second, personally engaging with multiple people and organizations within each country and then examining the variability of personal experiences within and across contexts helped students to develop more nuanced views of culture and disability. 
      
      We believe that the trip would have been enhanced if U.S. college students or an instructor with disabilities had joined the group. They may have offered additional insights into disability as a cultural phenomenon. However, the lack of physical accessibility and difficult terrain in several places we visited would have required in some instances an alternate itinerary and, in all cases, strong contingency planning with knowledgeable individuals residing in each locale (Mobility International USA, n.d.). Even with the advance communications done for this trip, the reality on the ground was often not what had been arranged. For example, in one location upon arriving late at night after a long flight, we learned that drinking water and other beverages were not available in the airport nor would any be available at the place we spent the night until a small restaurant opened for breakfast -- despite assurances to the contrary before our departure. Likewise, narrow city streets with gutters, no sidewalks, and heavy unregulated pedestrian, cart, and car traffic made navigating some streets a harrowing adventure under the best of circumstances. The participating students readily recognized the accessibility issues such circumstances presented. Accessibility itself could serve as the core of a problem-based learning approach in future disability-focused study abroad trips.
Conclusion
      In summary, this unique and challenging study abroad program met general learning goals for short term programs by making a positive impact on studentsÕ knowledge, attitudes and confidence. The program also accomplished a more specific disability studies pedagogy goal of supporting students to view disability from alternative perspectives. This was facilitated through encounters with people and organizations that highlighted cultural variations and afforded opportunities to forge personally meaningful connections to cross-cutting social issues. Within the framework of structured academic reflections, those connections became the impetus for students to identify personal change themes similar to those identified in service-learning study abroad programs (Gaines-Hanks & Grayman, 2009) and by students with disabilities themselves (Shames & Alden, 2005; Scheib, 2006). Students reported wanting to take action to use what they had learned to make a difference, whether that was through undertaking a disability-related policy internship, changing the language they used when talking with others about disability, or expanding their professional practices to more specifically address disability. Although we were unable through this study to follow the students post-graduation to determine what actions they actually took, this disability-focused study abroad experience produced a fundamental shift in their knowledge and attitudes, Òcritical progressÓ that should serve as a foundation for those future actions. 
Laura T. Eisenman, Ph.D. is Associate Professor in University of Delaware's (UD) School of Education and affiliated with UD's Center for Disabilities Studies as faculty coordinator of the interdisciplinary undergraduate Disabilities Studies Minor.

Michael Gamel-McCormick, is Professor in UD's Department of Human Development & Family Studies.

Ashley Curran and Rachel McCulley received a B.S. in Human Services with a concentration in Administration & Family Policy.

Meghan Moritz received a B.S. in Exercise Science with a concentration in Exercise Physiology.

Kim Musheno is Director of Legislative Affairs for the Association of University Centers on Disabilities.
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