SYLVIA GLORIA ADHIAMBO, 22

Accounting student –KCA

For Sylvia, a student at the Kisumu’s Kenya School of Accounting, being in perfect health provides her with the much needed concentration in her studies.

Since she was disabled from birth, getting the required health services in various facilities remains one of the biggest headaches.

Being a woman, access to various sexual reproductive health services has become a challenge both physical and mental, aggravating her condition even more.

 One of the challenges she highlighted was mobility and how she struggles when using public transport to get to the facilities.

“The vehicles we have in Kenya are not disability-friendly and therefore if I use a matatu and flag it by the roadside to board, I cannot get in if I do not get the front seat which is a bit spacious and can allow me to sit comfortably,” said Sylvia.

This sometimes delays her appointments with medics and sometimes she has to dig deeper into her pockets to get an alternative which would be a motorbike or hiring of taxi to the facilities.

Sylvia claims also that the touts sometimes ignore them when they flag down the vehicles to board, because they are not ready to ‘handle’ persons with disability or that they may not pay the fares.

When you finally get to the hospitals, infrastructural challenges are evident, since some facilities are not disability-friendly because they lack ramps, and if they have, it’s steep while others lack wheelchairs or the available ones, are not in good condition.

The staff also do not care about their conditions and therefore are made to queue for long hours just like other abled patients.

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“We sometimes queue for a very long time with some rogue medics even demanding bribes so that they could help us move ahead of the queue and access services we need. This sometimes makes us turn away and go without seeing the doctor,” says Sylvia.

For her the medics’ state of mind and attitude is key, for her to open up about some of the SRH issues affecting her such as menstruation, family planning and contraceptives.

Getting a sexual partner has also been difficult for PWDs as stated by Sylvia, saying some view them as a ‘burden’ that one is not ready to take care of for the rest of their lives.

She recalled how one days she took her pregnant relative to a facility for the usual prenatal care. Her aunt is also disabled.

The reaction and statement made by the medic was shocking.

“One of the medics asked in Swahili, ‘Nani amekufanya hivi? (Who has done this to you?” These people feel like people like us should not be sexually active or get pregnant. That was how my relative dropped clinic visits until she delivered,” says Sylvia.

She felt that trusting the health practitioner would be difficult because he or she would judge her due to her condition.

She also feels the messaging, if available, is not packaged with PWD in mind, since some writings are very tiny while there are no visually impaired aids to help patients in that condition understand what they should do.

“The government and manufacturers should rethink the packaging of these important items or drugs that help us when faced with sexual reproductive concerns. The writings should be bigger, pictures and graphics should be used to aid in illustration and use of braille for better understanding of the information on the product,” says Sylvia.

Going forward, the KCA Student felt that PWDs should be involved more in formulation of policies affecting them and not be treated like passive stakeholders waiting to be helped or given directives.

Sylvia proposes that medical practitioners be capacity built on SRHR so as to equip them with the required skill set and information to handle the PWD.

Hospitals should also be disability- friendly to ease access to various specialists.

MICHAEL OCHIENG OKUMU, 33

Businessman

We meet Michael on the pavements of Kisumu’s Jomo Kenyatta Highway selling his wares including sweets, biscuit, credit cards and doubling as an M-PESA agent.

For him, his business earns him a living and therefore he takes it seriously. However, it comes with challenges mostly bordering on mobility.

This is compounded by his struggle to access other services, whether sexual reproductive health, nutritional or sanitation.

Just like many Persons with Disability who are physically impaired, it is not easy for him to get to hospitals in good time.

When he does, he reveals that some either do not have elevators or lack ramps to make entry into the wards or consultancy rooms difficult.

He recalled having visited one hospital and was met with deflated wheelchairs.

With a cumbersome registration process in public hospitals, the long queues make it very tiring for him.

He stated that he was involved in an accident when a vehicle hit his tricycle from behind. A motorcycle operator was also injured in the accident and both were rushed to one of Kisumu’s referral hospitals at night.

“When we reached there, the boda boda guy was given the first priority as I lay there in pain. They felt that treating me would ignite another challenge and therefore they were afraid of attending to me,” Michael says.

It gets worse when the management assumes that they cannot foot the bill and are usually bombarded with questions which includes their next of kin, where they come from among others, which is usually not done to other patients.

The medics’ attitude gets worse with PWDs and this has made people like Michael shy away in revealing what ails them.

He revealed that there is a different way of questioning the nurses and doctors adopt with him as opposed to the abled lot.

“There was a time I had an SRH problem and went to see a doctor but he just looked at me and made a general diagnosis. He did not even run some tests on me that are the norm and I felt like the doctor assumed such problems do not affect us or that we are simply pretending and seeking sympathy,” says Michael.

He pointed out that at some point when some of his counterparts requested condoms, a nurse asked whether they can have sex, which to them was demeaning and discriminatory.

Michael wants access to health facilities improved right from the gate. He also believes that with capacity building, the medical practitioners can treat PWDs better. According to him, this should be entrenched right from colleges.

He also wishes to see facilities employ more personnel to help PWDs when they visit hospitals.

VILDA ATIENO, 23

Student- Social worker

Vilda’s prayer is one day everyone changes the perception they have of Persons with Disability because it all starts with mind.

For her, on many occasions, health workers view them as people who are not in need of some sexual reproductive health services and this he attributes to lack of awareness among medics and also PWDs.

As a youth, she feels she can only talk freely with her peers and share her concerns without fear of being victimized or judged.

“We do not have youth-friendly centres and in most facilities, those who are available to handle you are old folks who will judge you immediately if you raise any concern that borders on sex, abortion or STIs because of our age,” says Vilda.

As if queuing in public hospitals is not enough, she stated that while some health workers might want to help out of goodwill by coming to attend to them on the line, the fact that you will be sharing your issues while others are listening, makes it a major challenge.

“They want to help you but how do I start revealing what is bugging me with other parties standing around me? Confidentiality of many patients seeking SRH services which are personal, is compromised,” Vilda says.

When such issues continue, many like her keep off the facilities despite being in need of these crucial services.

The availability of enough facilities will also limit the cost of travelling to get contraceptives or drugs needed to deal with SRH issues affecting the PWDs.

Vilda says in an event that the county government cannot construct more disability and youth-friendly clinics to accommodate PWDs, they should collaborate with organizations who have activities in that line to help bridge the gap.

She also calls for meaningful engagement with all the stakeholders and applying intersectional lenses, saying these are key in unlocking the challenges PWDs face in accessing SRHR.