By John Ogulei
Joan Ameso, a disabled woman with a six months’ pregnancy has little hopes of delivering her baby while not feeling segregated and traumatized by the health workers because the nurses are unkind to her.
“The nurse shouted at me and used derogatory language. They say I should not express my pain because I accepted to get pregnant when I knew I had a disability,” said Ameso.
According to Ameso, access to proper maternal care has become difficult as nurses do shout at her to climb up on her bed, asking how she managed to climb on a bed to get pregnant if she was not able to climb onto a hospital bed.
Disabled pregnant women in Uganda have a hard time accessing public health care because of nurses’ negative attitude toward them. This is worsened to the lack of ramps, doorways and beds designed to accommodate their needs.
Private hospitals offer better services and facilities, but staff acknowledge that many disabled women cannot afford to deliver at their facilities.
On average, at least five disabled women deliver in government hospitals daily.
In Uganda, 12.4% of Uganda’s population exists with some form of disability. Sex difference reveals that disability is higher among women (14.5%) compared to men (10.0%) and the disability prevalence rate was higher among those living in urban areas (15.0%) compared to those in the rural areas (12.0%).
Uganda’s 2009 national health policy and 2010 health sector strategic investment plan state that the government should ensure high-quality health services are available and accessible to all, including vulnerable and marginalized populations such as people with disabilities.
Ameso adds that the facilities do not have ramps to ease movement for pregnant women in wheelchairs.
She noted that, Women who use wheelchairs must have to crawl into bathrooms because the doorways are so narrow. In addition, the beds are too high for disabled mothers, she says.
John Bosco Ojur, the In-charge Soroti West Health Centre, acknowledges that maternal health care facilities at the hospital were made for general patients and do not accommodate the needs of special groups such as people with disabilities.
“Here in Soroti West Health Centre III and in other government health facilities, we have normal beds, so the disabled women have to climb up or are helped by a caretaker, usually a relative, to get to the bed,” said Ojur.
He also noted with concern that, Staff at the hospitals are not trained to communicate with mothers who are deaf.
“We have communication problems. We depend on relatives and attendants to communicate,” He said. While admitting that, some staff members at the hospital have a negative attitude toward disabled mothers as they use unfriendly language and avoid attending to them. But considers this a personality issue and assures that not all health workers are like that. Some are kind and helpful to all patients.
“If it is true, it is unfortunate and regrettable,” he said. “The patients should help alert us, and we discipline them.”
Uganda’s 1995 Constitution provides that the State shall ensure fair representation of marginalized groups including persons with disabilities on all government bodies.
He also added that, as a facility, they are working with the National Union of Women with Disabilities of Uganda through the Ministry of Health to ensure that people with disabilities can use restrooms in public health centers.
“We are proposing that if a health facility has at least three latrines, one should be reserved for disabled people,” he said.
Geoffrey Ewatu, the Deputy Speaker, Soroti East Division also blamed most government health workers for ignoring the disabled in accessing Covid-19 vaccine.
He said some PWDs in Soroti have not been given priority in vaccination against Covid-19 and yet they are as vulnerable as any other Ugandan.
He noted that whereas they have put efforts as local leaders to talk to the leadership of vaccination centers, their efforts have yielded little.
“We are trying to talk to them but our people are still being given lesser attention,” he said.
But the Soroti District Health Officer, Dr. Charles Okhadi, disputes the allegations saying they give equal treatment irrespective of whether one is a PWD or not.
Joshua Edogu, the Soroti City Mayor in an interview said as a city they are proposing to have all health facilities have access for the disabled.
“We are proposing to have ramps in all facilities within the city to help PWDs,” Edogu said.
Recently Aidah Lukwago, a program officer in charge of advocacy and networking at the National Union of Women with Disabilities of Uganda during an interview with the media said that women with physical disabilities have challenges accessing maternal health care at various public health facilities.
“Imagine a crawling mother in a dirty toilet,” she said.
Lukwago also revealed that nurses are rude to disabled mothers because they do not expect them to get pregnant.
“They think being disabled means everything is dysfunctional. They think these disabled women are nonsexual. Because of this mistreatment, some disabled mothers resort to delivering at home or with the assistance of traditional birth attendants,” She added.
Simon Peter Edoru, the Soroti District Chairperson on the other hand admits that facilities in public hospitals pose barriers to maternity patients with disabilities.