HARRE - Disability, HIV and Aids Trust (DHAT) last this month held a stakeholders dialogue in Harare on service delivery for persons living with visual and hearing impairments under the banner: ‘Leaving no one behind: where is disability in health service delivery, let’s talk about it’.
DHAT country co-ordinator Hamida Ismail Mauto told participants from various health sectors that the dialogue is designed to raise awareness on visual and hearing impairment among health service providers, “engage stakeholders on disability participation in HIV/Aids and Sexual Reproductive Health activities and identify barriers and challenges in accessing health services for the visually and hearing impaired.”
Mauto said it has been realised that the low level of education among visually and hearing impaired persons stems from discrimination starting at the family level where parents do not give children with disabilities the same opportunities as the able bodied children.
“Family members have been found to have little understanding of the issues that affect their children with disability hence they have not been fully involved in socialising them.
“Such a setting continues to manifest at community level where people with disabilities are deliberately left out of the decision making process. The high level of poverty among women and girls makes them very vulnerable to sexual manipulation in order to earn a living.”
She added that the situation is further compounded by lack of specially trained service providers, especially health care providers to help people with disabilities. “Inadequate and inappropriate methods of disseminating critical HIV/Aids and sexual reproductive health information, therefore, leave the visually and hearing impaired persons with limited access to information on various aspects of HIV and AIDS, including reproductive health and rights as well as other critical areas of development. Such a scenario increases the HIV susceptibility and vulnerability of PWDs.”
An estimated 1 billion people, 15 percent of the worlds’ population, live with a physical, sensory (i.e. blindness, deafness), intellectual or mental health impairment.
While reproductive health issues are at the centre of people’s day-to-day lives, people living with disabilities are still to be properly educated on this important subject, as they continue suffering in silence.
Speaking at the same stakeholders’ dialogue meeting some of the people living with disabilities expressed concern on the lack of reproductive health.
“I only realised that l am pregnant when my tummy started growing big and sick regularly. I didn’t even have counseling from my aunties or anyone in the family pertaining marriage issues,” Faith Kwaramba, who is deaf and dump, said.
Kwaramba said she did not even know how far pregnant she was due to lack of proper teaching on reproductive health issues.
“We need nurses and doctors who understand sign language because I am a Zimbabwean citizen and l have the right to access health facilities as the Constitution posits in Section 83,” Kwaramba said.
She said there was a need for hospitals to engage with them so that communication is enhanced between both parties.
“If the Doctors and nurses provide us with the right information and medication we require, it will be easy for our relatives to take care of us. However they give us wrong prescriptions, hence killing us and worsening the situation so sign language must be effectively implemented at clinics and hospitals,” she said
According to Health ministry permanent secretary Gerald Gwinji, approximately 15 percent of the World’s population are living with disabilities, while 19 percent is among the female population.
This translates to two million people in Zimbabwe as five to 10 percent of all children in Africa grow up with some form of disabilities.
Gwinji said the prevalence of violence among persons living with disabilities is 1, 3 times higher than in the general population, adding that women and girls with disabilities are often at increased risk of contracting HIV as a result of their increased exposure to sexual violence.
Mauto said that people living with disabilities engage into sexual activities like any other people but they needed knowledge on how to handle it.
“Sexual and reproductive health service providers do not have adequate knowledge about disability issues or have misinformed or stigmatising attitudes towards person with disabilities. This is increasing poverty in the country due to an increase of child birth rates,” she said.
One of the advocates for people living with disabilities, Ephraim Balima condemned discrimination of disabled people, adding that disability is not contagious.
“I was given a wrong prescription and nurses went on to say l am HIV positive without even testing me. It worsened my situation and my healthy started to deteriorate due to lack of communication,” he said.
“Doctors and nurses do not understand us. The ministry of Health must work on the implementation of sign language with immediacy because I nearly died due to their negligence.”
However, Gwinji said the ministry was taking actions in ensuring the inclusion of people with disabilities.
“The vision of the ministry of Health is to have the highest possible level of health and quality of life for all citizens of Zimbabwe. Therefore health services are provided to all citizens without discrimination under the Public Health Act,” Gwinji said, adding that every person has the right not to be discriminated against.
He added: “The government has ensured that all Sexual Reproductive Health (SRH) programmes would reach all persons with disability especially those with hearing and visual impairment. Most persons with disabilities are benefiting from the SRH programmes designed to reach the general community but we do realise that the packaging of services may not be suitable for those with hearing and visual disabilities.”
Section 83 of the constitution on rights of the disabled states that the State must take appropriate measures, within the limits of the resources available to it, to ensure that persons with disabilities realise their full mental and physical potential, including measures to enable them to become self-reliant, to enable them to live with their families and participate in social, creative recreational activities and to protect them from all forms of exploitation and abuse.
Speaking at the same meeting, Tsarai Mungoni said the Constitution must include the disabled without limitations.
“People with disability must be represented with disabled people and the law is there but it is just a paper work. We need disability representation in key decision making position.
“We call for all these excusatory clauses in the country’s strategy documents to be removed that see disability as a charity and medical model,” he said.
Mungoni further said disability is different and communication barriers need to be recognised.
“The majority of Persons With Disabilities (PWDs) lives in abject poverty, no access to health care and worse still no access to information on HIV and SRH in accessible formats. I have not been tested for HIV because my confidentiality is not guaranteed,” Mungoni added
He said the information should be provided in Braille.
Nyamayabo Mashavakure, a senator who represents the disabled in the Senate said the government is trying to mainstream disabled persons’ concerns.
“Three-hundred nurses have been trained to provide services for the disabled people and sign language has been officiated in the 16 languages in the country. This number is small and more nurses are to be trained to cater for the people with disability,” he said.
Mashavakure added that because of economic challenges some of the equipment for the disabled people are very expensive and cannot be shared.
“We cannot sit down and relax while we are facing communication challenges. The government must use resources which are available to make it easy for us. The easy way of spreading education to the disabled can be done through CDs which are much cheaper than importing expensive equipment from countries like German and America,” Mashavakure said.
Charity begins at home but the government is silent about the inclusion of disabled people in the health sector.
Ruth Labode, a medical doctor, said disabled people must be united and work as a team in fighting this problem.
“There is nothing disabled persons can achieve whilst not united. Make noise together with senators and be heard because you will continue to suffer as well as your siblings,” she said.