Protection of Rights of People Living With Disabilities

 By Linda Mupemo

Zambia Union of All Persons Living With 
Disabilities President Pascal Mulenga

Like most young ladies, Malumbo Mwape dreamed of becoming a mother in her future life. 

 

Unfortunately, Ms Mwape had polio when she was barely learning how to walk at two years old. The illness crippled her limbs leaving her with the option of only using a wheelchair for mobility.  

 

As fate would have it, Ms Mwape fell pregnant outside wedlock when she was 20 years old. 

She recalls how the situation angered and worried her parents at the same time. 

 

"I grew up being aided in doing most things. But a pregnancy was a different story all together. I had to carry my baby in my womb regardless of my physical state," she laments. 

 

Ms Mwape, now 27 years old, says health care providers termed her pregnancy as ‘high risk’ hence she needed frequent medical check-ups in addition to the mandatory antenatal visits. 

 

She delivered a healthy baby-girl at one of the health facilities in Luapula Province through caesarean section. 

 

It was when Ms Mwape went for a review that her doctor dropped a bombshell on her that would later change the trajectory of her motherhood. 

 

Her mother decided that she needed to undergo a medical procedure that would prevent her from ever conceiving again. 

 

She fought back her tears as she narrated the story.

 "The doctor explained that the right part of my body is too small to provide conducive space for the growth of a baby hence getting pregnant again would have resulted in either the baby or myself dying. So mom opted to put me on permanent birth control without my knowledge, " she says.  

 

One would think that before such a lifelong decision was made, consent would have been sought. 

Alas, this is an example of situations most persons with disabilities are subjected to. 

 

Infringement of Sexual and Reproductive Health Rights (SRHR) by families or care-takers is common among persons with disabilities in Zambia.

 

Additionally, barriers in accessing Sexual and Reproductive Health services worsen the situation.

 

According to the 2015 Zambia National Disability Survey, 7.7 per cent of the population is disabled. 10.9 per cent of the physically challenged persons are adults aged 18 years and above while 4.4 per cent  are children aged 2 to 17 years old. 

 

Recently, Minister of Health Sylvia Masebo was quoted in certain sections of the media as saying the Government has introduced sign language in Nursing and Midwifery Schools in a bid to enhance provision of health services to persons with hearing disabilities. 

 

However, there are many persons living with different disabilities who face challenges in accessing health services especially in rural areas. 

 

Milenge District in Luapula Province is one of the areas where persons with disabilities face limitations in accessing Sexual and Reproductive Health Services. 

 

Milenge District Health Director Mwila Katongo reveals that the health sector in the area is facing challenges in delivering equitable and quality health care services to persons with disabilities. 

 

Dr Katongo cites the lack of health personnel trained in sign language interpretation as a hindrance to offering quality health services to deaf and dumb clients. 

 

"Relatives of the deaf and dumb have some level of understanding of their needs. They have a way they communicate with them hence we rely on them to communicate with our clients living with disabilities," he explains.  

 

Further, Dr Katongo notes with regret that the department of health does not have any braille material to cater for those who are visually impaired. 

 

Suffice to say the presence of third parties, such as family members or sign language interpreters in medical examination rooms, invades their privacy and hinders the much-needed patient-doctor confidentiality.

 

Zambia Union for All Persons Living with Disabilities (ZUAPD) President Pascal Mulenga notes that the inequalities in the provision of Sexual and Reproductive Health Services to people with disabilities  makes them vulnerable to illnesses such as the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). 

 

Mr Mulenga says the situation is heightened by sections of society which regard sex as a taboo topic hence persons with disabilities have limited information on the matter as their family members or care-takers do not offer them sex education. 

 

Noteworthy is that some families are ashamed of having disabled  children hence they keep them hidden in their homes; the social exclusion further hinders their access to information on various areas of their lives. 

 

Mr Mulenga, who was born visually impaired, is one of the few physically challenged people who have had an opportunity to access education. He went to St Mary's School for the Visually Impaired and later to the University of Zambia.

 

 "I am lucky! I am educated hence I am enlightened on sexual matters. But not every disabled person has that opportunity. Some visually impaired people do not even know how to use condoms. This is a drawback in the fight against HIV and AIDS," says Mr Mulenga, who is also a Senior Lecturer at David Livingstone College of Education. 

 

Even though some people disassociate sex from persons with disabilities, they equally have sexual feelings like any other human being. 

The lack of safe spaces for persons with disabilities to talk about sexual matters impedes on their Sexual and Reproductive Health Rights. 

 

"It is rare that you find a visually impaired person or a deaf person getting Antiretroviral drugs from a health facility or accessing family planning services. Many persons with disabilities feel uncomfortable to freely express themselves in that area as people find it strange that someone in their state is sexually active," he says. 

 

Mr Mulenga wants the government to address the situation by incorporating disability needs into the delivery of health care services. 

 

He suggests that the Ministry of Health should come up with a deliberate strategy of making sign language a compulsory course in medical schools in a bid to fully equip health care providers. 

 

"Training all health practitioners on how to communicate with persons with disabilities will enhance the provision of health services to us including Sexual and Reproductive Health Services," he says. 

 

Notable is that health care is a human right and inequalities or lack thereof of health service delivery to minority groups is a violation of their rights. 

 

Article 25 of the United Nations Universal Declaration of Human Rights indicates that, "Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing, medical care and necessary social services."

 

Additionally, the Persons With Disabilities Act number 6 of 2012 seeks to promote the enjoyment of human rights and fundamental freedoms by persons with disabilities as it reads in part, "---ensure accessibility by persons with disabilities to the physical, social, economic and cultural environment and to health, education, information, communication and technology." 

 

Sexual and Reproductive Health Rights Activist Meanna Mbuzi says the Government should make strides in ensuring this human right is upheld without any form of discrimination.

 

“There is need to mainstream disability needs into the healthcare system to make sure its inclusive. Not catering for persons with disabilities or any group affects the entire population,” she says.

 

Ms Mbuzi says the government, in partnership with organisations championing disability rights, should provide relevant information and adequate communication materials, such as braille, for the blind and sign language interpreters for the deaf and dumb. 

 

She implores the government to make health infrastructure disability-friendly by including ramps and providing adaptable medical examination tables in health facilities across the country. 

 

Ms Mbuzi adds that persons with disabilities need to have access to information so as to enable them make informed decisions on their sexual practices, know when their rights are violated and use the right communication channels to report such incidences.  

“Persons with disabilities are prone to abuse and other ills. If the knowledge gaps are not addressed, Sexual and Gender Based Violence (SGBV) cases against persons with disabilities will continue to go unreported and leave such persons vulnerable,” she says.

Moreover, the United Nations (UN) envisions a future where member-states provide universal access to Sexual and Reproductive Health services. 

 

Sustainable Development Goal number 3; 7 reads, "By 2030, ensure universal access to Sexual and Reproductive Health services including for family planning, information and education, and the integration of reproductive health into national strategies and programmes."

NB - This article was published in Times of Zambia newspaper on 3rd December, 2022 and in Zambia Daily Mail newspaper on 5th December, 2022.