. . . disabled persons bemoan struggles in accessing sexual reproductive health services,
. . . blame their struggles on the government’s failure to mainstream disability issues in health training.
“DISABILITY doesn’t mean the inability to have sex.
“Despite our disability, we have normal human needs like sex and like other human beings, we also want to have sex and have it in the safest possible ways which do not compromise our health.”
This is the impassioned plea from disabled persons, particularly the visually impaired, who say they constantly endure nightmares in their quest to access sexual reproductive health services across the country.
They have accused health services providers of violating their sexual reproductive health rights (SRHR) due to stereotypes and misconceptions that disabled persons have no sexual feelings and therefore cannot engage in sexual intercourse.
A member of the Lesotho National League of Visually Impaired Persons (LNLVIP), Lerato Mathaku (not her real name), said, “health professionals link our disability with being sexually inactive to an extent of denying us our rights to sexual health services”.
Ms Mathaku, a mother of a 12-year-old son, said one of her worst experiences in accessing family planning services was when a nurse at a village health centre made fun of her, saying she could not understand why she needed contraceptives.
She said due to her blindness, she was always quizzed by nurses demanding to know why she was sexually active when she was visually impaired.
“They don’t understand that I am also human and I live a normal life. I have sexual feelings and a partner despite my blindness. They think that just because I am blind, I have no feelings at all and therefore I shouldn’t be seeking contraceptives,” Ms Mathaku said.
Ms Mathaku said such stereotypes were not only embarrassing but also depressing to the disabled because the stigma prevented them from enjoying their lives and fulfilling their normal human needs for sex.
She said through persistence, some health workers now understood her needs and they now provide her with her favoured oral contraceptive pills which she religiously takes to prevent unwanted pregnancies.
The LNLVIP’s sexual reproductive health rights and African Disability Protocol Country Coordinator, Keketso Mangope, weighed in on the issue, saying health workers and communities across the country held “preconceived and misguided” notions that visually impaired persons “cannot and do not” engage in sexual activities. Thus, they encounter discrimination whenever they seek SRH services, Mr Mangope said.
“Health professionals are products of their societies and they live by the stereotypes and preconceived ideas that people with disabilities cannot be sexually active and make informed choices on reproductive issues.
“What I am saying is from the findings of a baseline study that we conducted at some of the hospitals including Queen ‘Mamohato Memorial Hospital (QMMH) and Makoanyane Military Hospital to ascertain if they had the expertise to provide services to visually impaired persons. We found that the expertise was lacking.
“In most cases, health professionals do not provide the required services. They treat us as victims. They ‘sympathise’ with us and utter words like, ‘who is the evil person who has impregnated a blind person?’. They fail to understand that we are normal human beings like anyone else and we have the same sexual needs as anyone else.”
Mr Mangope said nurses even advised the termination of pregnancies because of misconceptions that people with disabilities are not fit to carry pregnancies to full term and have children.
He attributed the misconceptions and consequent violations of disabled persons’ sexual reproductive health rights to the government’s failure to mainstream health disability issues in health training and provision of services.
To address these challenges, the LNLVIP has joined forces with the African Union of the Blind (AFUB) and officially launched the African Disability Protocol.
The protocol seeks to eliminate all sorts of forms of discrimination against people with disabilities. It was launched two months ago.
“Our organisation has made it a priority to sensitise nurses and other health professionals and policy makers to understand that the disabled also have a right to sexual reproductive health services. There shouldn’t be any obstacles to disabled persons accessing sexual reproductive health services at health facilities,” Mr Mangope said.
Contacted for comment, the health ministry’s Sexual Reproductive and Health Services Manager, Motsoanku Mefane, said it was unfortunate that there were healthcare services providers who still practiced discrimination when the guidelines for the provision of sexual reproductive health services were “very clear and inclusive” of the disabled community.
“The guidelines are very clear and inclusive of the disabled community. A health professional should not choose a contraceptive method for anyone including the disabled. The health worker is obliged to inform a client of all the available methods and teach them about the methods. It is then up to the client to make an informed choice about which contraceptive method to use.
“Nurses and other healthcare workers should stick to the guidelines,” Ms Mefane said, adding they were constantly engaging in capacity building to eliminate stigma and ensure everyone, including persons with disabilities, fully enjoyed their sexual reproductive health rights.
According to the last Lesotho Demographic Health Survey conducted in 2014, the contraceptive prevalence rate (CPR) is 60 percent. Modern contraceptive use by married women has steadily increased over the last decade, growing from 35 percent in 2004 to 46 percent in 2009 and 60 percent in 2014.
However, the survey has not categorised the disabled community in its reporting, meaning that they have been generalised and not classified as key populations in the survey findings.