By Lazarus Sauti
In Zimbabwe, women and girls make the largest number of people who are marginalised and abused.
The situation becomes a double tragedy for women or girls with disabilities, of which girls and women with disabilities are about 10 percent of the country’s total population, according to the World Health Organisation – a specialised agency of the United Nations that is concerned with international public health.
Persons with disabilities – those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others – have the same sexual and reproductive health needs as other people.
Yet they often face barriers to information and services.
Further, the ignorance and attitudes of society and individuals, including health-care providers, raise most of these barriers – not the disabilities themselves.
Tariro Mutondo (not her real name), 32, who has a physical disability, says she always feels marginalised and violated whenever she seeks knowledge on family planning issues.
“I am now shunning clinics and health institutions because of the nurses’ attitudes.
They always mistreat me when I seek knowledge on any family planning method. Their attitude and belief is that probably people with disabilities do not have sex lives,” said the mother of two.
Mutondo’s case just shows how people with disabilities, especially women are mistreated as they are often called names all because they are disabled.
Xoliso Norma Msebele, project coordinator of the Disabled Women in Africa, concurs.
“Women with disabilities, like Mutondo, face more challenges than men with disabilities and this is acting as barriers in their quest to access antenatal and other reproductive health services,” she said.
Msebele added that basic sexual and reproductive health services like family planning, emergency contraception and post exposure prophylaxis are not easily accessible to women and girls with disabilities.
“A lot of information on family planning services which is crucial for mothers is in audio format, making it difficult for a deaf woman to get it. Lack of this information may cause women to get pregnant,” she said.
Sekai Zungu, assistant information manager, at Women and Aids Support Network, blames stigmatisation, prejudice, discrimination as well as denial of access to health services as hindering women with disabilities’ access to sexual reproductive information.
She says even when sexual intercourse is done with consent, some sections of the Zimbabwean society still think women with disabilities do not have rights to do so.
“Have not you heard comments like ‘varume havana tsitsi shuwa, kumitisawo nechirema’ (how unmerciful was the man who made that (disabled) woman pregnant)?
“That is not sympathy, but stigmatisation and discrimination as it is intended to entail women with disability are asexual; yet like any other person, they are not only sexual, but have a right to sexually associate freely,” she observed.
Barbra Nyangairi, director for the Zimbabwe Deaf Trust, says women with disabilities, especially the deaf, are often isolated as they have difficulties communicating with other people.
Their challenges, she noted, emanate from the communication barriers existent in their everyday lives due to lack of sign language in communication.
For instance, she added, service providers like education, health and social services in most cases lack people with expertise to understand sign language resulting in women with disabilities missing on essential sexual, reproductive health and rights information.
“Most health practitioners often struggle to understand what deaf and mute women need as they are not formally trained in sign language. This is one of the major hindrances in delivery of services to women with this kind of disability,” she said.
Nyangairi also said deaf women do not have access to sexual and reproductive health information as most of the information is oral and not accessible to them.
More so, the modus operandi of inserting a female condom, for example, may be a challenge to women with disabilities, as it requires the user to squat.
This leaves disabled girls and women to the whims of men, who in most cases would opt out of condom usage.
Sharing Nyangairi’s sentiments, Zungu adds that there is also inadequate supply of user friendly facilities like adjustable beds in most public rural health centres in the country.
“With public rural health centres struggling to maintain proper sanitation amidst high patients’ numbers, women with disabilities are mostly affected,” she explains.
Senator Anna Shiri, who represents people with disabilities in Parliament, says issues of sexual reproductive health and disability should receive a holistic approach.
She is spot on as her views are also expressed by Rejoice Timire of the Disabled Women Support Organisation who adds that midwives should stop discriminating as well as stigmatising people with disabilities on issues to do with sex.
“We receive reports of midwives insulting women with disabilities that ‘unoreva kuti haugone kukwira pabed apa ko wakakwira sei pabed pawairara nemurume wako?’ (you mean you cannot climb this (maternity) bed, how come you climbed the bed to sleep with your husband?’).
“Honestly, who said sex must be performed on the bed?
This simply implies that women with disability are not entitled to sexual rights like everybody else, and this discrimination should stop,” she said.
Timire adds that increased information in sign language will improve wellbeing for the women, their children as well as their partners.
“Good communication is the bedrock of diagnosis and treatment; accordingly, health workers should be sensitised on the use of disability sensitive language and as many personnel as possible be trained in sign language.
“Nurses should stop using insensitive language when dealing with women and girls with disabilities. Utterances such as ‘munomboiitirei nhumbu imi muri zvirema’ (why do you fall pregnant when you are disabled) should not be tolerated.”
Nyangairi adds: “To protect and promote the sexual and reproductive rights of people with disabilities, the government should ensure that all health alerts have sign language, provide interpreters in health settings, train deaf women as nurses so as to increase access to health and train health practitioners in basic sign language.”
Like other cross-cutting development themes such as gender, youth, environmental sustainability that have been mainstreamed in development programming, researcher Collence Chisita says disability should be integrated in development programmes.
“Policy decision makers, health service practitioners, traditional leaders, programmers, development partners must ensure disability is mainstreamed in all sectors of programming and service delivery,” he said.
Chisita added that organisations dealing with people with disabilities must raise awareness so as to ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
Kudakwashe Ignatius Munyoro, an intern at Women and Law in Southern Africa, says society should seek to demystify the myths surrounding the sexual and reproductive health of women and girls with disabilities.
“To realise the Sustainable Development Goal three (3), which seeks to ensure healthy lives and promote the well-being of all at all ages, services offering sexual reproductive information must be established in communities so as to take services to the people,” he said, urging the government, at all levels, to also consider the needs of persons with disabilities in terms of ethical and human rights dimensions.
Munyoro added: “Guided by the Constitution of Zimbabwe as well as the Convention on the Rights of Persons with Disabilities, the government should also consider sexual and reproductive rights of people with disabilities when developing and implementing strategies, bills and policies.
“Further, the government should ensure that free and informed consent is the basis for the provision of healthcare to persons with disabilities, especially girls and women since they are vulnerable.”