Discrimination rife in reproductive medical services

About 900,000 Kenyans live with some form of disability. Mildred Omino, a gender and disability rights activist spoke to the Business Daily on the stigma that women with different forms of disabilities face in accessing sexual and reproductive health services.

What are some of the challenges that the disabled face in accessing sexual and reproductive health rights?

A lack of information in accessible formats. The education materials are not available in braille formats or easy-to-read versions for women with intellectual disabilities.

Basics such as the expiry date of products are not provided in braille format. For example, how do women with visual disabilities determine whether products such as contraceptives are authentic?

Hospitals do not have sign language interpreters, posing a communication barrier to deaf women. In most cases, they are also physically inaccessible to women with mobility impairment, especially where doctors are situated upstairs in clinics without ramps for wheelchair users or with slippery tiles for crutches users.

Disability and sexuality is heavily stigmatised with the myth that women with disability are asexual. This is a hindrance to service delivery. For instance, there are cases where health workers receive pregnant women with disabilities with sentiments such as "who did this to you?" or "Wanaume hawana huruma." These shifts focus from quality service delivery to pity and propagating the ideology that sexual and reproductive services are not meant for women with disabilities.

The design of some products and services is limited to women without disabilities. For example, procedures such as transvaginal ultrasound require women to be in a position that is almost impossible for women with physical disabilities, and fixing the female condom poses a major challenge.

How have healthcare providers contributed to these barriers ?

First, their misconception that women with disabilities are asexual. It takes away equity in service delivery by creating an assumption that women with disabilities do not belong to that space, hence the planning, design, implementation and monitoring becomes disability exclusive or as an afterthought.

Even the medical curriculum lacks content on disability interventions concerning sexual and reproductive health. Health workers, therefore, are unprepared to serve women with disabilities. They assume that all pregnancies that occur to women with disabilities are not choice-driven but maybe as a result of rape. So, they push to procure abortion for them, sterilise them and deny them parenting rights on the premise that they cannot parent due to their disabilities.

Do forced abortions and sterilisation happen in Kenya?

Forced sterilisation presents legal complexities in the Kenyan context.

While it could be happening in Kenya, most women with disabilities might not have the technical and financial capacities to pursue the matter in courts and get justice. For example, a woman with a physical disability discovered that she could no longer have children when she tried having her third baby, only to realise that she was sterilised after having her second child. They stopped her from having more children on assumption that she would have challenges in raising them.

How has poverty contributed to the lack of access to menstrual health?

Most persons with disabilities are poor.

The world report on disability of 2011 states that 80 percent of persons with disabilities are poor and live in developing countries.

Most girls get menstrual health awareness in schools. This means that those who are out of school are missing out. It is also estimated by the UN that only one percent of women with disabilities are literate.

Poverty excludes people from education, employment and the ability to access quality health care. Education enables people to know their rights, claim the rights, and challenge human rights violations. Sexual and reproductive health and rights are luxuries, yet it is a basic need. To women with disabilities, it becomes an unattainable right!