Culture, rehabilitation, and facial birth defects: international case studies.

Responses to birth defects are influenced by their cultural and social context. Two multicultural societies, Israel and Nigeria, are reviewed for attitudes toward birth defects. Israel is a developed society where cultural and national origin affect utilization of health services. Differences between Western Jews, Oriental Jews, and Arabs exist in their explanations of etiology and their attitudes toward rehabilitation and community participation. Nigeria is a developing nation with limited health resources. Facial birth defects are stigmatized, infanticide remains a practice, and attitudinal barriers to the development of rehabilitation resources exist. The economic, demographic, and spiritual causes of infanticide are reviewed historically. The persistence of infanticide, though illegal, is discussed relative to issues facing the response of Western medicine to seriously afflicted newborns as well as prenatal genetic diagnosis. The importance of culture as a variable in cleft lip and palate research is stressed.