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Remove Sexual health Barriers for Persons with Disability

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BY DORIS KATHIA

The World Health Organization (WHO) estimates that between 7% – 10% of the world’s population live with disabilities. In Kenya 4.6% people experience some form of disability and 10% of persons with disability (PWDs) live without assistive devices.

People with disabilities are often literally and programmatically invisible; they are excluded from or unable to access mainstream assistance programs as a result of attitudinal, physical and social barriers, they have historically been deprived of their sexual and reproductive health (SRH) rights. 

PWDs remain among the most hidden, neglected and socially excluded of all displaced people today. According to a 2013 study in partnership with International Rescue Committee (IRC), in Kakuma Refugee Camp, 2084 of the 128,560 refugees in the camp were registered as having disabilities, representing 1.6 % of the total population but there is a limitation on the means of identifying PWDs in humanitarian setting. 

Forced displacement affects diverse women, girls, boys and men differently. 

PWDs have diverse skills, capacities and needs, which are often not adequately recognized or utilized in humanitarian response and are more often seen as a problem than a resource. The loss of caregivers can leave persons with disabilities extremely vulnerable and exposed to protection risks. 

According to Article 25 (a) of the 2006 Convention on the Rights of Persons with Disabilities (CRPD), persons with disabilities should have the same range, quality, and standard of free or affordable health care including sexual and reproductive health (SRH) services and programs as provided to persons without disability. 

The emergence of the COVID-19 pandemic has shown that it is clear that we need to take action to create a more inclusive world to ensure everyone has equal access to basic human rights and services.

This includes people with disabilities who may face additional physical, information and communication barriers while seeking to access essential COVID-19 prevention and services as well as Sexual Reproductive Health and rights (SRHR) services.

They also may be unable to access crucial information leaving them uninformed and unprotected. In the worst cases, they may be denied lifesaving interventions. 

Marginalization and exclusion of PWDs puts them at increased risk of sexual violence, rape, domestic abuse, and physical assault especially for persons with intellectual impairments. Persons with Disability (PWD) may have less access to reproductive health information, which leads to low levels of knowledge about teenage pregnancies, healthy relationships, HIV/AIDS and sexually transmitted infections (STIs), safe abortion and high-risk behaviors.

There is also a higher likelihood of PWDs being subjected to forced sterilization, abortion, and marriage due to long-standing stigmatization. One of the misconceptions is that PWDs are asexual or hypersexual thus increasing their exposure to sexual abuse and subsequent health consequences.

Among barriers to accessing reproductive health services include lack of respect by providers. Pregnant women with disabilities are often discriminated against by providers and scolded by caregivers for becoming pregnant and bearing children; marital status is a huge factor that determines if a pregnancy is accepted. 

Embracing human diversity poses all of us with the challenge to remove barriers, assumptions and prejudices about PWDs and provide outreach support to those who are most at risk. 

To enable achieving a safe space for refugees PWDs, the government should take the initiative to train providers on respectful communication skills, provide information in multiple accessible formats, employ sign language and other interpreters in health facilities, expand SRH awareness activities and make camp infrastructure and all facilities, services and information accessible to displaced PWDs.

There is also a need to create community-based information campaigns to raise awareness and promote greater tolerance, respect and understanding of PWDs.