Covid-19 magnifies vulnerabilities of women with disabilities

She got uneasy as soon as she stepped into the health facility’s reception. She was uncomfortable with the penetrating stares of the receptionist, her two colleagues and a few people waiting to be served.

Luckily, she was given some “preferential treatment” and was quickly ushered into a doctor’s room.  She exhaled with relief to be alone with the doctor, confident he would be compassionate and more professional, away from the frowns that greeted her at the reception.

So, she made herself comfortable and sat back in her wheelchair, ready to engage the doctor. The mother of one was here for Family Planning services, but needed proper advice from the doctor to determine the most appropriate method for her, although she desired contraceptives.

“I almost fell off the wheelchair when I heard the doctor’s response,” says Bella, recalling that day, a year ago.

Horrid tales

 “Looking at me straight in the eyes, he casually remarked that Family Planning was not for women like me and so, saw no need of checking me up,” the 29-year-old remembers.

“On recovering from my shock, I calmly and firmly repeated to him what I was there for - Family Planning services, and I expected no less. I think the tone of my voice brought him to his senses and he had no choice but to serve me,” she adds.

Christine is a 35-year-old mother of two with an almost incapacitating disability. She has no hands and her legs have complications that make her walk with a limp, giving her a physical appearance of a little girl.

She has horrid tales of her experiences in some health facilities as she sought sexual reproductive health services. She had a nasty experience during delivery of her firstborn in the hands of nurses at a government hospital. That traumatic experience drove her to deliver her second child at home.

Because of the stigma against women living with disabilities and their sexual and reproductive health rights - now compounded by Covid-19 challenges - the number of women seeking Family Planning and other sexual reproductive health services has drastically reduced.  There is thus a risk of more unintended pregnancies among these women.

“Family Planning is no longer an essential service among women with disabilities,” says Ms Jane Kihungi, executive director Women Challenged to Challenge. 

Health facilities

Although the organisation is yet to establish the extent of this situation, she says Covid-19 instigated challenges including fear of contracting the virus and difficulties in accessing health facilities that offer them, have forced women living with disabilities to keep off.

“Some of them say that a hospital is the last place they want to be,” she says.

“We worry about an increase in unwanted pregnancies among our members,” Ms Kihungi adds.

Since the first Covid-19 case was confirmed in Kenya in mid-March, women and girls with disabilities have to deal with barriers of accessing Family Planning and other Sexual Reproductive Health services. Most special clinics where some of them sought the services are closed because of Covid-19. The containment measures like curfew and the “stay home’’ instruction have also compounded the women’s challenges.

The pandemic, which has disrupted lives of millions globally, has largely created new obstacles for women seeking SRHR services such as Family Planning. They include challenges of access to clinics, other health facilities and misinformation.

Apart from stigma, Ms Kihungi says there is fear of ending up at quarantine facilities.

“There is a deep fear of going into quarantine because there is a general lack of facilities that are friendly to people with disabilities,” she notes.
“The fears are real.”

She says the organization is concerned that there is no support including access to sexual and reproductive health rights and targeted information for the vulnerable community, especially women and girls with disabilities during the Covid-19 period.

Road blocks

“We are in the process of doing a comprehensive survey on effects of Covid-19 on the lives of women and girls with disabilities. It is important that we act swiftly given the unprecedented nature of the pandemic which has visited untold difficulties upon us,’’ she says.

A study by 'Women Challenged to Challenge' shows that women and girls with disability encounter more roadblocks and discrimination when seeking the same SRHR sought by other women of reproductive age.

Healthcare facilities and providers, as well as the national and county governments should thus consider health needs of women and girls with disabilities, as part of the Covid-19 response.

The stigma that has come with the pandemic, Ms Kihungi says, largely contributes to the reluctance by women in this category to voluntarily test for the virus.

“We are almost seeing a situation of history repeating itself – the era of serious stigma against (those infected and affected by) HIV/AIDs in the 1990s. A woman with a disability who has lived in isolation and is mentally challenged, is now even more isolated. It is a case of double discrimination and isolation,” she says.

The International Disability Alliance, a network of global and regional organisations of persons with disabilities, says exclusions, barriers and discrimination against women and girls with disabilities also apply to Covid-19 and responses to it.

The forms of discrimination include denial of sexual and reproductive rights, attitudinal barriers like stigma, lack of access to community support and information, inadequate healthcare as well as being at heightened risk of violence, among others.

“Women and girls with disabilities may have increased risk for exposure to complications of Covid-19, and are disproportionately affected by the negative impacts of quarantine measures,” the organisation notes.

Sexually active

The National Coordinating Agency for Population and Development (NCAPD), in its Policy Brief 3, says sexual reproductive health services are often inaccessible especially to women on wheelchairs and those with vision, hearing and intellectual impairments. 
A Kenya National Survey for Persons with Disabilities (PWD) study, in addition, found that nearly two-thirds of women with disabilities do not have access to reproductive health services yet they are sexually active.
“Reproductive health of PWDs is usually not given attention,” indicates the survey.

“It goes with the myth that PWDs are not sexually active and have no need to control their fertility or be provided with HIV/AIDs services.’’

In the Policy Brief titled: Women with Disabilities need Reproductive Health Services too, NCAPD suggested creation of what it described as “disability-friendly corners’’ at reproductive health service facilities.

“Since the quality of service depends so much on the service providers, it is necessary to ensure they are aware of the special needs of PWDs. This calls for integrating PWDs’ needs into the training curricula for the service providers,” it adds, putting the number of women with disabilities at 58 per cent of Kenyans in that category.

According to the survey, 13 per cent of women with disabilities had been pregnant between ages 12–19 years, compared with about two per cent of their counterparts of the same age group.