Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=cdso20 Disability & Society ISSN: (Print) (Online) Journal homepage: www.tandfonline.com/journals/cdso20 Emotional ‘journey’ of street beggars with vision impairment: a study from Ghana Zulfawu Ibrahim, Norah Nkornu & Dr. Kwaku Oppong-Asante To cite this article: Zulfawu Ibrahim, Norah Nkornu & Dr. Kwaku Oppong-Asante (2024) Emotional ‘journey’ of street beggars with vision impairment: a study from Ghana, Disability & Society, 39:4, 1014-1031, DOI: 10.1080/09687599.2022.2114881 To link to this article: https://doi.org/10.1080/09687599.2022.2114881 Published online: 27 Aug 2022. 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The study employed a qualitative research approach specifically phe- nomenology. Twenty-five (25) participants were purposively sampled from three (3) busy streets in the Greater Accra region of Ghana. Participants were interviewed using a semi-structured interview guide and data collected was ana- lyzed using Interpretative Phenomenological Analysis (IPA). Findings showed that visually impaired street beggars expe- rienced personal losses such as jobs, relationships and inde- pendence. In addition, the results showed that participants experienced daily challenges with regards to street begging. Further, street beggars with vision impairment reported a range of emotional experiences due to vision loss and street begging. The findings are discussed in relation to enhancing care and management of street beggars with visual impair- ment in Ghana. Points of Interest • Persons with vision loss are likely to struggle with the disability due to associated challenges such as loss of jobs, relationships, independency etc and these are likely to negatively affect their emotions. • The study found that persons with vision loss had to resort to street begging due to limited or lack of support from family in order to meet basic needs. • Street begging has been associated with some challenges such as accidents, harassment, low self-esteem and others. The participants in this study face daily challenges with street begging as they experience verbal abuse by passersby. Hence, the interaction of experience of © 2022 informa UK limited, trading as taylor & Francis Group CONTACT Zulfawu ibrahim zulfawu33@gmail.com https://doi.org/10.1080/09687599.2022.2114881 ARTICLE HISTORY Received 16 March 2021 Accepted 15 August 2022 KEYWORDS Vision loss; street begging; lived experiences; emotional well-being; quality of life http://orcid.org/0000-0003-3233-987X http://orcid.org/0000-0002-2470-450X http://orcid.org/0000-0002-0206-3326 mailto:zulfawu33@gmail.com https://doi.org/10.1080/09687599.2022.2114881 http://crossmark.crossref.org/dialog/?doi=10.1080/09687599.2022.2114881&domain=pdf&date_stamp=2024-4-9 http://www.tandfonline.com DISAbIlITy & SOcIeTy 1015 vision loss and challenges with street begging could negatively affect their mental health. • based on the findings, the researchers suggest that persons with dis- ability in Ghana would require some form of psychosocial support to help them deal and adapt to their disabilities and also develop new skills appropriate to their level of functioning. Introduction Globally, the number of persons with vision impairment in 2010 is approx- imately 285 million, of which 39 million were blind and 246 million having low vision (WHO 2017). Although Africa is reported to have 11% of the world’s population, it has higher percentage (19%) of the world’s blind population and vision impairment than other continents (IAPb 2010). A recent national study conducted in 2017 indicated the prevalence of blind- ness and visual impairment in Ghana to be 0.74% and 1.07% respectively (Kumah, Wiafe, and baffoe 2018). A review of literature on vision loss showed negative link between vision loss and psychological well-being (Kempen et  al. 2012; Zeeshan and Aslam 2013; brunes, Flanders, and Augestad 2015; Amedo et  al. 2016; Augestad 2017). This is because persons affected mourn their vision loss and other related losses such as their jobs; independence, interest activities, and they may experience process of grief which includes denial, anger, depression, bargaining and finally acceptance (Schilling and Wahl 2006). These emotional experiences are fuelled by the challenges in adapting or adjusting to the vision loss especially when vision loss was acquired later in life (Nyman et  al. 2012). There is expression of cognitive, emotional, behavioral and social responses to the vision loss (Pinquart and Pfeiffer 2011; Kempen et  al. 2012; Stevelink, Malcolm, and Fear 2015). Further, previous studies have established a positive relationship between social support and psychological well-being of persons with stressful life events such as chronic vision loss (Reinhardt, boerner, and Horowitz 2006; Papadopoulos et  al. 2014). Persons living with chronic conditions mostly rely on significant others such as family and peers for empathy and support with activities (Stevelink, Malcolm, and Fear 2015). However, one of the major perceptions about understanding disability in Ghana is influenced by our belief systems; and many forms of disability are perceived to be a curse or punishment from God for sins committed by the victim or their families either presently or in the past (Kassah 2005). These beliefs have negatively affected the way Ghanaians relate with persons with disability (Kassah 2008). More so, the Disability Act in Ghana was adopted in 2006 with the aim of providing equal access to education and employment at all levels and sectors of the economy (Kassah 2008). The institutions responsible for 1016 Z. IbRAHIM eT Al. implementation of such act face challenges due to poor infrastructure and information, improper documentation systems, and lack of coordination in terms of planning of initiatives (Ghana Statistical Service 2014). Also, there is quite limited number of rehabilitation centers for persons with disability across the country. The public rehabilitation centers face challenges such as insufficient funding from the government and donors, poor infrastructure, inadequate teaching and learning materials and stigmatization of staff mem- bers (Acheampong et  al. 2021). The few private centers available are not accessible to everyone due to high charges hence persons from lower socio-economic status are unable to afford. Therefore, the chances of persons with disability from benefitting from these opportunities and developing new skills in order to function are limited. Despite the legislation, persons with disability still experience discrimination in accessing opportunities in education and employment (Afoakwah and Dauda 2016; Dassah et  al. 2018). consequently, negative societal perception about persons with disability and lack of implementation of policies has resulted in stigma and limited oppor- tunities. This reduces the chances of survival for persons with disability especially in urban cities. Among persons with disability, visually impaired persons are more likely to be unemployed (Mojon-Aziz, Sousa-Poza, and Mojon 2010; clement, Douglas, and Pavey 2011; Giesen and cavenaugh 2013) since vision is critical in executing most activities. consequently, many persons with vision impairment engage in street begging (Hasse 2010). begging can be defined as the practice of appealing to others for favor, which could be in the form of gifts such as money, clothes or food without expecting a refund or reciprocal act (bukoye 2015). Through the act of begging or asking for alms, many disadvantaged groups such as persons with vision impairment are able to afford some basic needs such as food. However, the act of street begging is reported to elicit stigma from the public as beggars are perceived to be lazy, dependent, and nuisance and only few people are kind to them which may expose beggars to abuse (Ali 2019). begging does not only affect the beggars and their families negatively but also causes feelings of inferi- ority complex among them (Ahmadi 2019). Also, the act of begging on the street poses risks to the beggars such as being hit by moving vehicles, harassment and sexual abuse of female beggars, exposure to harsh weather conditions, among others (Mortimer 2005; Kongoley 2017). Despite these negative occurrences, begging seems to provide beggars with all the good feelings associated with work in Ghana (Kassah 2008). Despite the distress that could result from experiencing vision loss and resorting to street beg- ging; there are actually limited studies that have looked at understanding experiences of visually impaired street beggars. Therefore this study sought to understand the psycho-social experience with vision loss and the transition to street begging; and also the meanings street beggars with vision impair- ment attach to the interaction of these experiences. DISAbIlITy & SOcIeTy 1017 Aims and objectives The main aim of this study is to explore and understand the lived experi- ences of street beggars with vision impairment in Ghana. The objectives of this study were: • To understand the experiences of being visually impaired and a street beggar • To understand the subjective feelings attached to vision loss and street begging Research process The study employed a qualitative design specifically phenomenology to understand and make meaning of the experiences of street beggars with visual impairment. The voices of persons with disability especially in devel- oping country like Ghana have been suppressed and marginalized. Therefore in order to understand their experiences, Hosking (2008), proposes that this can be achieved by listening to them and valuing their perspectives. The critical Disability Theory (cDT) first proposed by Horkheimer in 1937 was developed from the critique of the traditional theory of disability (bio-medical model), which served to focus on the limitations of disabilities and gives medical professionals the final decision on what is best for persons with disability (Olkin and Pledger 2003).) ; these limitations are shaped by society’s assumptions resulting in oppression and infringement of rights of persons with disability. cDT argues that traditional researchers describe what they observe without having a relationship with the individuals being studied (Hosking 2008). However, cDT encourages researchers to engage in interac- tive relationship with persons with disability and give them the opportunities to voice out their own experiences from their perspectives. It was very important to emphasize that persons with disability are more knowledgeable and are expertise of their experiences. Therefore disabilities studies are suggested to aim at empowering individuals with disabilities and provide goals for social transformation (bohman 2005). Hence, phenomenological approach was selected because it allowed persons with disability to express themselves and make meanings or interpretations out of their own experiences. Sampling The sample consisted of 25 participants (16males and 9 females). Participants were purposively selected from three towns in the Greater Accra region of Ghana. These are highly populated areas with lots of commercial activities which cause heavy traffic making it easier for persons with vision impairment 1018 Z. IbRAHIM eT Al. to beg for alms. Participants were included in the study if they met the following inclusion criteria: 1) completely visually impaired and a street beggar; 2)18 years and above, and 3) consented to be part of the study. Data collection A comfortable place was arranged close to each location where persons with visual impairment begged for alms to reduce any form of distractions. Participants were approached on the streets and the purpose of the study was carefully explained to them and their caregivers who were with them. Those willing and consented to participate were moved to the arranged location but participants who wanted to be interviewed in the presence of their caregivers were allowed. A semi-structured interview guide was used for the study because it is flexible and allowed for probing issues of interest (Smith and Osborn 2007). Questions asked were open ended which allowed the participants to freely express themselves and also gave the researcher the opportunity to probe further into their experiences. The interview guides were translated into one local language (Twi; most pre-dominant local lan- guage in Accra) and back-translated to english language. This process was necessary for participants who could not read and write in english. The interview guide consisted of two parts: first part solicited socio-demographic information such as age, educational level, number of years with impairment, etc., and the second part consisted of questions exploring experiences of street beggars with visual impairment such as; tell me about your life before you became visually impaired (probe: relationship with relatives, significant others, work, marriage)? How have things been different when you became visually impaired [probe: everyday activities, work, dependency, relationship with relatives and significant others; reasons for being on the street, stigma)? etc. The interview guide was pre-tested and responses were analyzed; unclear statements were edited. The interviews lasted between 30 min to one hour. Data analysis The interviews were audio-recorded and were transcribed verbatim to english. Analyses of the data were done using the Interpretative Phenomenological Analysis (IPA). IPA was chosen for this study because it explores in detail how people make sense of their personal and social world and give detailed interpretation of these experiences (Smith and Osborn 2007). The study was analyzed following Smith and Osborn (2007) recommended guide of Phenomenological Analysis. Firstly, most of the interviews were conducted in one local language (Twi); the data was translated and transcribed verbatim into english language. The first stage of the analysis involved reading of the transcribed data several times to become familiarize with it. Initial notes were DISAbIlITy & SOcIeTy 1019 then developed to capture any interesting or significant comments from the respondents. The use of language and non-verbal utterances were all taken into consideration. These initial notes were then transformed into phrases which captured the quality of the responses. The emergent themes were then listed on a sheet of paper and then searched for connections between them. As the themes emerged, it was checked in the transcript to make sure they were consistent with the primary source or expressions from the par- ticipants. Some of the themes had similar characteristics and they were grouped together to form superordinate themes to help explain the emerging themes. Through the immersion process, repeated patterns of participants’ experiences and feelings of vision loss and street begging were identified. In order to ensure validity of the results of this study, the researchers compared and then redefined the themes. Also, there were back and forth engagements between the researchers until the data was completely ana- lyzed. In addition, we ensured continued engagement with the text in every step of the data analyses to ensure that each interpretation was a reflection of the participants’ accounts of their experiences. Ethical considerations ethical approval to conduct the study was obtained from the ethical committee of Humanities (ecH), University of Ghana, with reference number ecH 030/18-19 and the Department of Social Welfare, Accra. All participants gave their consent to participate in the study and also for their responses to be audio-recorded; consent was also taken from the caregivers. The par- ticipants were made aware that they could withdraw at any point of the interview or take breaks in between the interview whenever they felt the need. The participants were assured of anonymity of the data, thus, their identifying information such as names and where they lived were not taken. Results Twenty-five (25) street beggars with vision impairment participated in the study. Their ages ranged from 21 to 76 years, with the mean age being 45.4. Out of the twenty five (25), 16 (64%) were males with nine (36%) being females. Over half of the participants (n = 13) had primary education (Junior High School, Grade 9). The maximum years lived with vision impairment is thirty (30); and maximum years of street begging is seven (7). Only nine (9) of them were married. However, all participants in this study acquired their vision loss later in life. After rigorous and careful analysis of the transcribed data using IPA, three (3) superordinate themes emerged: Personal losses, existential challenges and emotional experience with vision loss and street begging. 1020 Z. IbRAHIM eT Al. Personal losses The participants had an established life before experiencing loss of vision. They had comfortable occupations or livelihood, good relationships with family and significant others, etc. which positively impacted their sense of identity (Afari, Ward, and Khine 2012; Grant, berg, and cable 2013). As social beings, we develop our sense of identity based on groups we are attached to such as race, gender, ethnicity, religion, job status etc. (Mcleod 2019). These identities are not developed by individual traits but rather from the relationships we encounter with society in a collec- tive context (Giddens 1991). Thus, social identity is a feeling of belong- ingness within a social category or group (Hogg and Abrams 1988). This can be related to the participants in this study as they identified them- selves with their various jobs as farmers, hairdressers, drivers, carpenters, mechanics, traders; and made meaningful meanings from their relation- ships with family and significant others. This is evident from the account of participant 1: I am a trained mechanic and before experiencing vision loss, I was able to go to work as usual and make some money. I could support myself, mother and younger siblings. (participant-1, male) It is manifested in participant 1’s statement how he identifies himself with his job status as a ‘mechanic’. This is a socially acceptable job for young men and they are normally perceived to be physically strong due to the demanding nature of the job. This identity gave him the ability to feel responsible as he is able to financially support himself and family. loss of vision resulted in personal losses with job/work, independency and relationships. Participants lost their old identities due to these challenges. Goffman (1963) in his work on ‘total institutions’ argued that inmates in institutions go through series of ‘identity stripping’. They lose their status and identities prior to being institutionalized and experience series of humil- iations and degradations (Rowe 2011). This concept can be related to the experiences of participants in this study. They lost their socially desirable identity status attached to their jobs, family as well as their independence. Participant 21 narrates: How can I work without my sight? I was a trotro (mini-bus) driver and with this blindness I could not drive again. The bus was not mine so I had to give it up and stay home. (participant-21, male) The identity of this man as a bus driver has been eroded by the experi- ence of vision loss. It can be observed from his statement ‘How can you work without your sight?’, that loss of vision was perceived by him as an inability to pursue any goal successfully including work. Another identity ‘stripped’ by loss of vision from participants is the important roles they contributed DISAbIlITy & SOcIeTy 1021 within the family settings when they had their sight and actively working. They were perceived to be responsible and accepted within this social group. I am married with four children who were in school before I lost my sight. I farmed and my wife also helped with the farming too. I was able to take care of myself, pay my children’s fees and save some money as well.(particicpant-6, male) Due to loss of work, participants had to rely on family and friends for support whether physical, financial or emotional. The perception of the disability from significant others shifted from perceiving participants as being responsible to being a burden, ‘The manner in which my extended family used to treat me changed. I hardly see them visit or check up on me. They are not helping at all especially when my parents died’ (participant-6, male). This par- ticipant had a close relationship with his family members but felt a sense of change after the vision loss. He was financially supportive to some of his family members when he had his sight and working but felt neglected when he needed their assistance. There is expectation of support from his family during his difficult time especially with the loss of his parents. He reports, ‘If you have money everyone wants to be around you, but when they (family) know you have to depend on them they tend to shun your company’; a feeling of loneliness and disappointment can be sensed from the participant towards his family. Participant-6 continues to confirm the erosion of his status within the extended family setting due to inability to work and support his imme- diate family. ‘when you are working people talk to you with respect but when you lose everything they now don’t see your importance in the family anymore’. It was also evident from the account of participant 11 that her husband likened her disability to unattractiveness. She reported, ‘My husband stopped coming close to me because he felt I’m no longer beautiful. Hmmm….’ (participant-11, female). Disability is perceived to deviate from the norm thus this excerpt shows she was previously perceived to be attractive with her sight but lost that identity from her husband. The utterance ‘Hmmm’ within Ghanaian context signifies how overwhelmed one feels and this is seen in the case of participant-11. The participants also identified themselves as part of the abled group before they experienced their disability. However with loss of vision, they struggled to execute basic needs such as bathing, cooking, walking, personal hygiene, independently which placed them into a new category as persons with disability. Participant-12 recounts an event where he felt the need to use the washroom but experienced challenges; ‘I needed to use the toilet badly and nobody was around to help me so I defecated on myself and the whole room was smelly’. being able to self-care is an important part of identity of abled persons. There is the threat to self-esteem when one has to depend on others since your private space is evaded. 1022 Z. IbRAHIM eT Al. Existential challenges with street begging The phenomenon of street begging results from a number of factors such as poverty, physical disability, civil war, culture, bad habits (e.g. drugs), reli- gion (Amman 2006; Ogunkan and Fawole 2009; Namwata, Mgabo, and Dimoso 2011). More so, there is strong association between disability, poverty and begging throughout literature (Groce, Marie, and Murray 2014). There is an increased risk of persons with disability becoming poorer due to restricted access to education, healthcare and employment opportunities. Participants had to transition from being responsible working individuals to accepting a new identity as street beggars. Although street begging is per- ceived within the Ghanaian context as socially undesirable and lacking con- formity to social norms (Ingstad 1997); it was the only choice for the participants to survive in order to meet their basic needs. Street begging comes along with challenges or stressors which were reported by all par- ticipants. Verbal abuse or harsh words from the public was reported by all participants as a stressor they experience almost daily. In the case of participant-23, she was verbally abused by a passerby who felt she was using her disability to take advantage of people. I remember we approached a car to ask for some assistance as we do always, a lady started complaining that, if everyone comes to the street to beg because they have problems, then the street would have been filled up by now. (Participant-23, female) Society holds the notion about street beggars as overly dependent and this may have affected perceptions and reaction towards visually impaired street beggars. beggars are mostly non-defensive when they are publicly confronted as the act itself is demeaning which affects their level of confidence. Emotional experience towards vision loss and street begging Dealing with loss of vision and resorting to street begging as a way of survival is quite challenging as reported from the participants. Hence there was the need to explore the subjective feelings of the participants towards these experiences. Participants experienced range of negative emotions towards their vision loss; which were primarily influenced by negative per- ception about disability coupled with the personal losses they encountered. The word ‘sad’ was commonly used by the participants to describe their feelings about their condition. Unhappiness and loss of hope captured the descriptions of sadness in the extract of Participant 12, ‘Hmmm, when it (loss of vision) happened, I felt I was in this darkness where no one could find me. I was sad and I remained quiet for days asking myself, is this going to be my end’. (participant-12, male) DISAbIlITy & SOcIeTy 1023 Darkness in his statement connotes negative events such as loneliness, loss of hope or anything that serves as danger. This analogy influenced the feeling of sadness as he felt trapped and helpless. The utterance ‘Hmmm’ in the local context is normally associated with pain or being overwhelmed with a particular situation. It also connotes worry or distress. This expression of darkness or dark world is also seen in the extract of participant-14, who was diagnosed with glaucoma and later loss her vision, ‘you realize it is still dark to you because you cannot tell the difference with your eyes open’. (participant-14, female) From the account of participants, anger emerged as a result of inability to perform daily tasks easily; seeking late treatment and abandonment from love ones. Participant 11 felt she was abandoned by God who was supposed to protect her. She narrates, ‘I just felt angry at God and everyone for leaving me. I lost my sight and lost everything, my job, my wife. So I felt God has aban- doned me, my siblings also do not check up on me. I am all alone with this boy (son) and he is the only one I have now’. (Participant-11, female). Ghana is considered a religious country hence it is not surprising for this participant to depend on God for protection from future uncertainties. She felt neglected by God and her family who from her account were supposed to be sup- portive when she needed them. Feelings of fear with loss of vision were also captured from the findings. The participants expressed thoughts of worry about the future with loss of vision and the impact it may have on their relationship with others. This is expressed below: The doctor told me it will become worse if I did not treat my eyes, so noticing my sight was getting worse gradually was really scary. I went to my church, friends to seek for help to raise the money but I could not get the money. (participant-2, male) There is feeling of helpless knowing that he was gradually losing his vision. This could arouse feelings of anxiety and despair. Although it was not explicitly stated, fear due to anticipating vision loss could affect sleep and appetite resulting in some form of psychological distress. In order to reduce this fear, some of the participants were in denial about actually losing their sight. ‘It was hard to accept it. Days ago I could see, now I can’t see. These were the thoughts I had’, (participant-21, male). The transition from having sight to vision loss was too sudden. Thus denial gave him the time to grad- ually process the traumatic news or event. It is seen as a common defense mechanism which helps individuals to mentally minimize the effect of the trauma or situation (Holland 2018). On the other hand, the act of street begging is perceived to be non-conforming to societal norms. The giver is considered to be good while stigma and immorality is associated with the receiver (erskine and McIntosh 1999; Jones 1999) which raises suspicions (Johnson 2007). Thus the 1024 Z. IbRAHIM eT Al. participants expressed lack of pride for street begging and wished they had other alternative source of income to cater for their basic needs. A feeling of displeasure with street begging was expressed by participant 23, who feels humiliated with street begging: Street begging is not something that I will even wish for my enemy. It is humiliating but I don’t know for the others. If I have help or my sight, I don’t know what will bring me here. I wish I lost my legs rather than my sight; I would have still managed to sell my used clothes. Oh yes I can manage in a wheel chair. I really can. (participant-23, female) She had pride when she was able to make income from selling second-hand (used) clothes but lost all of that due to her disability and eventually resorted to street begging. It is surprising to note from her statement that vision loss was perceived as degrading and if given the choice, she would have preferred being disabled with her legs; since she would be able to see and manage to move around. lack of pride was also expressed by participant-22 ‘It was not my plan to be here (street) but since I am here (street) I have to manage with the ‘wahala’ (trouble). It (street begging) is not something that I am happy or proud about’…. The term ‘wahala’ is used within the local context to express disturbance or problem and this is as a result of the harsh treat- ments visually impaired street beggars experience from passersby. Discussion The present study explored the experiences of street beggars with vision impairment in Ghana. The participants identified themselves with the roles they played in their work environment and with family. They engaged in non-formal jobs such as farming, trading, driving, hairdressing etc. and were financially supportive for the families. These factors helped to shape their identity within their communities. Society places every individual within a shared collective group thereby shaping our social identities (Tajfel and Turner 1979). We are identified by others with our characteristics within our communities, school, occupations, marital status, religion etc. These groups are an important source of pride and self-esteem (Tajfel and Turner 1979). For instance to be called a father, you will have to adopt that identity and begin to act in ways you believe a father should. Findings from this study indicated that street beggars with vision impairment lost these identities that were important and socially acceptable including work, independency and relationships. Work became a challenge as persons who acquire disability later in life and unable to access rehabilitation may find that their education or skills may not help them if they are unable to execute their previous jobs (Groce, Marie, and Murray 2014). This resulted in financial challenges and difficulty in achieving some basic needs such food and shelter. Also, loss of vision resulted in daily challenges such as activities of daily living. Activities DISAbIlITy & SOcIeTy 1025 that were previously executed such as bathing, domestic work, moving around became a challenge (Hochberg et  al. 2012). Hence street beggars with vision impairment had to go through a process of transitioning from abled persons who were respected and active in their communities to per- sons with disability who are perceived as inactive; thus it meant losing their old desirable identities. The participants relied on significant others for phys- ical, emotional and financial support. The findings showed that street beggars with vision impairment received little or insufficient support from family and friends. Families of participants perceived their disability as a burden due to the participants’ inability to cater for their needs. Our emotional well-being can be negatively affected when we feel or perceive neglect or lack of care from love ones (Reinhardt, boerner, and Horowitz 2006; barbieri et  al. 2016) especially in times of challenges or painful transition. In line with literature, a study by Verstraten et  al. (2005) found elderly persons with visual impair- ment who reported receiving low levels of social support experiencing an increased level of loneliness. Persons with vision loss who perceive any form of support from love ones are less prone to depressive symptoms and more likely to adapt to the vision loss (Reinhardt, boerner, and Horowitz 2006). Also vision loss was seen as unattractive by the spouses or partners of the participants which negatively impacted their relationship with significant others. Individuals are perceived as abnormal when they are born with or develop some form of disability. Such individuals are often stigmatized because the impairment is perceived to deviate from the normal group in terms of physical attributes and personality traits (Hosking 2008). loss of jobs or occupations coupled with neglect from love ones was the main reason reported by the participants for engaging in street beg- ging. Persons with disability are trapped in a cycle of poverty where the choice to beg becomes the last resort for survival (Groce, Marie, and Murray 2014). lack of food, proper housing and healthcare, employment coupled with effects of stigma and isolation from significant others limit the abilities of persons with disability to cater for themselves and their families as well (Mont 2010; Trani and loeb 2010; Groce et  al. 2011). This has implications for the individual and household thereby increases the likelihood of turning to begging (Groce, Marie, and Murray 2014). Street begging created an avenue for persons with visual impairment the ability to provide for their basic daily needs such as food. However, findings from this study showed that street beggars with visual impairment experience stressors on the street while they engage in the act of begging. They are negatively judged by passersby as being overly dependent (Stones 2013) when they approach them for alms and this was expressed by all partic- ipants. Struggling with moving vehicles and motorbikes was another stressor for street beggars with visual impairment arousing verbal abuse from the drivers and riders. 1026 Z. IbRAHIM eT Al. Further, all the participants experienced range of emotions with the vision loss and street begging. With vision loss, the negative emotions were as a result of the personal losses. The word ‘sad’ was the most dominant word used to express how they felt about the loss of sight. Uncertainties about the future with vision loss resulted in fear and anger. This finding is in line with research indicating that vision loss can result in challenges with mental health due to difficulty to work or pursue interest activities (Demmin and Silverstein 2020). Older adults with vision loss in previous literature have been reported to experience emotional challenges because they perceive the vision loss to negatively affect their ability to pursue personal meaningful activities (Teitelman and copolillo 2005). Kempen et  al. (2014) reported that persons with visual impairment may experience decrease in morale and self-esteem since they have to be dependent on the assistance of others; and this may result in feelings of depression. Further loss of vision affected their independence, making it difficult or impossible to perform those activ- ities. The threat or the actual loss of such activities influenced the negative emotions (Stephens 2007; Thurston 2010), which is consistent with the find- ings of this current study. Some of the participants initially were in denial and had difficulties accepting the vision loss at the first stages of the dis- ability. Persons with vision loss experience trauma and stress as they go through the normal grieving process (Schilling and Wahl 2006). During the early periods of vision loss, between 0-2 years, individuals are reported to be more in a denial state; than patients who have lived with the vision loss for more than 2 years (bergeron and Wanet-Defalque 2012). On the other hand, in every society, street begging is commonly perceived as degrading to the individual (Ahmadi 2019); and this makes it shameful and could have a negative impact on the psychological well-being of street beggars with vision impairment. All participants expressed lack of pride with street beg- ging and hoped they had other alternatives that could help meet their basic need which doesn’t require seeking empathy. Conclusion The findings of this study show a deep insight into interpersonal effects of vision loss. It shows the challenges associated with vision loss with partici- pants losing their status in society due to losses such as of jobs, relationships, independence. Further, it gives us a deep understanding into the journey with vision loss and the reasons the participants resorted to street begging. It can be concluded that emotional experiences of participants with vision loss and street begging were negative which could negatively impact on their emotional well-being, hence their quality of life. This study forms basis for researchers to explore more on other forms of disability and street begging. DISAbIlITy & SOcIeTy 1027 Recommendation Persons who develop the vision loss later in life are more prone to emotional challenges, hence, persons with disability in Ghana should be provided with training or therapies that would help them deal and adapt to their disabil- ities and develop new ways of managing daily activities such as work in order to earn a living; hence this will go a long way in reducing street begging among persons with disability Further the findings suggest the need to create public awareness on understanding disability and the importance of social support during stressful experience such as vision loss. This would help reduce stigma towards per- sons with disability and improve interpersonal relationships with them. Mental health professionals who work with individuals with disabilities should explore areas such as social support and develop interventions that would help strengthen them. lastly, with regards to the effective implementation of the disability act in Ghana, it is recommended that the policy be evaluated to investigate whether objectives are achieved or not, its effectiveness and result of the act. Limitations of the study The authors intended to work with street beggars born with vision loss and those who acquired later in life. However, participants who showed interest to participate in the study all acquired the vision loss later in life. Hence, the emotional experience with vision loss reported in this study may not apply to persons who were born with the disability. Disclosure statement No potential conflict of interest was reported by the authors. 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