International Women’s Day is an annual opportunity to celebrate progress made towards equality for women. But it is also a reminder of how far we still are from this goal – particularly for women with disabilities who are experiencing violence around the world.
Violence against women and girls has been described as a ‘global pandemic.’ And it is easy to see why. 1 in 3 women has experienced physical or sexual violence in their lifetime. Women with disabilities are even more likely to face violence, experience it for a longer period and are less able to escape or access justice.
Globally, adults with disabilities are 1.5 times more likely to be victims of violence and for adults with mental health conditions this rises to a staggering 4 times more.
Men with disabilities are also at a much higher risk of experiencing violence and, although there is very little research, this violence is likely to be driven by many of the factors that cause violence against women. While the numbers are likely to be smaller than women, this is still a significant problem which is rarely discussed.
Why does violence happen?
Largely, women with disabilities are victims of violence for many of the same reasons as women without disabilities. Violence against women is often a result of gender relations and gender norms and the unequal power relations between men and women. This is amplified for women with disabilities who experience more discrimination and marginalisation and are much less likely to be viewed as equals – either in their households or communities. This increased level of discrimination means that their risk of experiencing violence is also amplified.
Having a disability also brings additional risk factors – such as living in an institution or being dependent (either for care, mobility or finance) on a family or a partner.
Low levels of reporting
The problem doesn’t just end with the high number of women with disabilities facing violence. Globally reporting of violence is low, especially when this violence is committed by a partner or family member. Women with disabilities are also less likely to report violence and even if they do they are less likely to be able to access justice.
Many of the reasons that women without disabilities don’t report violence or can’t access justice are the same as for other women. For example, they may be afraid of the consequences of reporting, may feel that nothing will be done or not know who to talk to. For women with disabilities the multiple discriminations that they face make them even less likely to report. Many more women with disabilities do not work and so they are more likely to be financially dependent on family or a partner – and so the consequences of reporting could be more severe.
Women often do not tell anyone because they feel that they won’t be believed – this is particularly an issue for women with intellectual disabilities or mental health issues who are less likely to be seen as credible witnesses. As one woman in our research in Cambodia put it “I have never told other people because they will not think it is true, and since my father-in-law is the vice chief, most people in the community respect him. They are afraid that they will not be invited to participate in the community or receive gifts.”
And so what can be done?
In recent years violence against women and girls has risen up the agenda as a development issue, including high level political commitment from the UK and inclusion in the new Sustainable Development Goals. If organisations are serious about tackling violence against women and girls – they must reach women with disabilities.
The Department for International Development commissioned a really interesting piece of research looking at ‘What works’ to tackle violence against women and girls – and we were really pleased to see that it included a paper on disability. Unfortunately there was so little out there documenting what works that the paper was hardly able to come to any conclusions.
It is vital for us to build more evidence on what work to tackle violence against women and girls with disabilities. Programmes addressing violence must make sure that they understand the specific barriers that women may face in accessing their programmes and look to overcome these. We need to make sure that data on violence against women and girls is being disaggregated by disability – otherwise we won’t know who is affected and who is being reached by prevention efforts.It is also important that wider work to tackle discrimination and stigma against women with disabilities continues, to reduce the underlying causes of violence.
The discrimination that women with disabilities face may in some cases make them harder to reach – but that doesn’t mean they aren’t worth reaching.
Today we are celebrating International Day of Persons with Disabilities. This day, which happens every year on the 3 December, is an opportunity to raise awareness of the importance of including people with disabilities in all areas of society. Each year the United Nations sets a theme, this year it is Inclusion matters: access and empowerment for people of all abilities.
We talk about access a lot, and it is hugely important. People with disabilities need to be able to access all the same services and opportunities as people without – they need to be able to go to school, access health care and earn an income. They may also need access to specific services – such as rehabilitation or assistive devices, such as wheelchairs.
What is meant by empowerment is less obvious. But it is equally, if not more, important. Empowerment is about people being able to have a voice and take control of their own lives and futures. All people, whether they have a disability or not, need to be involved in the decisions that affect their lives.
People with disabilities know best what barriers they face, and they are able to identify what they need to overcome them. If people with disabilities aren’t involved in the development of programmes and policies then the likelihood is that they will continue to be excluded from them. People with disabilities need to be able to participate in decision making at all levels – from community to global decision making, so that they are not passive recipients of aid, but included in their own development.
I recently got back from the Philippines, where I spent some time with members of local Disabled People’s Organisations who were receiving support from CBM and partners. Here I saw how important empowerment is to unlock the potential of people with disabilities and to deliver real change.
Being part of a Disabled Person’s Organisation had transformed many of their lives. Before being involved in these groups, some of them were isolated in their communities, but now they have an increased awareness of their rights and the opportunities available to them and have become key members of their communities.
One group has been counting the number of people with disabilities in their district, with this information they can go to their government and demand that they meet their needs. Someone else told us about how after one of their group was killed by a police officer, they came together and made sure that the police officer was arrested and charged. Others were making sure that schools in their area had the right policies in place – so that children with disabilities were able to receive an education.
By having a voice and being able to take control of their own lives – they have not only been able to change their own lives – but also the lives of others.
In less than a month, the Sustainable Development Goals, which were agreed by world leaders in September, will come into action. They commit countries to eradicating poverty, fighting inequality and reducing the impact of climate change by 2030. Crucially for CBM, and for the one billion people with disabilities globally, this new agenda pledges to ‘Leave no one behind.’
As part of their training in the Philippines, participants learnt about the Sustainable Development Goals and linked them to issues that affect their everyday lives. They now have the information they need to go their government as say ‘you signed up to this, so this is the action you need to take.’
The Sustainable Development Goals are a once in a generation opportunity to create an equal and inclusive society where people with disabilities have the same access to opportunities as those without. If people with disabilities are able to raise their voice and demand their rights – the impact could be truly transformative.
This week to celebrate International day for Persons with Disabilities, we will be sharing ten stories of people with disability from around the world. To read these stories, please click here.
October 10th is World Mental Health Day. This year we address a key issue facing people living with psychosocial disabilities (disabilities caused by mental illness): dignity.
The theme chosen for October 10, 2015 is “Dignity in mental health”. The word ‘dignity’ comes from the Latin word meaning worthiness. It is the idea that everyone has the right to be valued and respected. But taking it one step further, dignity is also about how people feel: treating someone in a way that they feel valued and feel respected. When people are living with dignity, they feel confident and they are able to make decisions for themselves.
Worldwide, high levels of stigma and discrimination strip people with psychosocial disabilities of dignity and prevent them from the experience of living as, and being treated as, equal members of society.
At CBM, we believe that all people with disabilities deserve to live in a world that treats them with dignity. Here are 3 ways that we believe can promote the dignity of people with psychosocial disabilities:
1) Creating accessible, people-centred care following a humanitarian emergency
Knowing that disasters can negatively influence the mental health of a population, CBM sees humanitarian emergencies as an opportunity to ‘build back better.’ In Sierra Leone, for example, the Ebola virus disease outbreak impacted the mental health of the country in many ways. Not one person was excluded from the experience of stress, fear and loss. CBM used this opportunity to mobilize resources and establish, with other partners, 14 mental health units across the country. Previous to the outbreak, mental health care was only available at the Psychiatric Hospital and in a couple of health units outside of the capital city. Similarly, in the Philippines, following Typhoon Haiyan, CBM used the opportunity to establish mental health units with trained staff who could visit and support people with psychosocial disabilities in their communities.
Creating accessible mental health care following an emergency seeks to reduce the long term psychological impacts of a disaster. However, it also brings care closer to people with psychosocial disabilities, allowing them to rebuild their lives with dignity: close to their homes and families with trained staff who treat them with respect.
2) Supporting opportunities for voices to be heard
An important part of dignity is providing people with the opportunity to make choices and to have control in their lives. It is not enough to speak on behalf of people with psychosocial disabilities. Instead, what is needed is environments that offer support and build confidence, so that people with psychosocial disabilities can find and use their voices.
Maya Angelou put it best when she defined dignity: “Dignity. It means a belief in oneself, that one is worthy of the best. It means that what I have to say is important, and I will say it when it’s important for me to say it. Dignity really means that I deserve the best treatment I can receive. And that I have the responsibility to give the best treatment I can to other people.”
Since 2008, CBM has supported the Presbyterian Community Based Rehabilitation (PCBR) programme based in Northern Ghana, to establish self-help groups (SHGs) with the aim of providing mutual support, and enabling people to re-enter the community, both socially and economically. Now, with over 23 SHGs throughout the upper east region, the groups provide an important source of support to people with psychosocial disabilities and their families. Through the groups, members have been able to challenge discrimination, share support and advice, and attain financial security in a resource poor setting.
3) Advocating for change in global priorities
While local developments, such as the establishment of services and self-help groups, are necessary to promote dignity, progress on a global level is equally important.
In September, 2015, the Sustainable Development Goals (SDGs) were launched. The SDGs build on the Millennium Development Goals (MDGs) and clearly state the priorities for governments and development agencies over the next 15 years. During the drafting process, FundaMentalSDG was formed: an alliance of organizations who believe in a common vision of seeing the SDGs consider the needs of people with psychosocial disabilities.
When the UN adopted the SDGs in September this year, we saw the exciting inclusion of mental health and well-being in the document. This success is in part due to the work of FundaMentalSDG, of which CBM is a founding member.
Mental health was not mentioned in the MDGs. Therefore, the inclusion of mental health and well-being in the SDGs indicates an increased respect for people with psychosocial disabilities on a global level. Equally important, we anticipate a greater investment in interventions that will lead to less human rights abuses against people with psychosocial disabilities.
On World Mental Health Day 2015, we are promoting the value and worth of people living with psychosocial disabilities. Whether we invest in improving access to care, the establishment of self-help groups or changing global priorities …it should all be done in the name of dignity.
“Things have a price and can be for sale but people have a dignity that is priceless and worth far more than things.” – Pope Francis
This week in New York, the Sustainable Development Goals will be finalised. This is a historic moment for CBM and other civil society organisations as world leaders come together to agree on 17 goals and 169 targets that aim to transform the world we live in over the next 15 years.
The SDGs replace the Millennium Development Goals (MDGs) which were agreed in 2000 and come to an end this year.
The SDGs mark a huge shift from the MDGs in a number of ways. The MDGs were largely designed by a small number of individuals from high income countries. Discussions on the SDGs have included governments from low, middle and high income countries, civil society and more than 8 million people from 194 countries have had a say through online and face to face surveys. The MDGs only applied to low and middle income countries, while the SDGs are universal and apply to everyone.
In most cases the MDGs were about getting half way, for example halving the number of people living in extreme poverty. The SDGs are much more ambitious, they are about ending extreme poverty – finishing the job.
The other major difference is that disability wasn’t mentioned in the MDGs, which has led to people with disabilities being excluded from their progress. The number of children going to primary school for example has increased dramatically, but children with disabilities are much less likely to attend than their non-disabled peers. In Nepal for example, 85% of children who are out of school have a disability.
For several years CBM and our partners have been advocating for the SDGs to address this exclusion and to be inclusive of people with disabilities.
So we are therefore really pleased that SDGs promise to ‘Leave no one behind’ and to reach the furthest behind first. Disability is referenced 11 times in the new document. This includes making sure that all children can get an education, that people with disabilities have equal access to decent jobs and that they can participate on an equal basis with others in society. Many of the targets are also universal – which means that they have to be met for everyone, including people with disabilities.
Sometimes the discussions that happen between world leaders in New York can seem a million miles away from our everyday lives or the work we do. But reality is that the SDGs have the potential to have a huge impact on people’s lives around the world. They will determine what governments at both a national and local level prioritise, and where they spend their money.
We need to see the SDGs as a huge opportunity to change people’s lives for the better. They can get people and governments talking seriously about reducing inequalities and promoting social justice. They are a chance to make governments realise the importance of including people with disabilities in their policies and planning. They are also an important advocacy tool for people living with disabilities – who can take the document to their governments and argue for their inclusion.
When the goals are agreed at the end of this week a new challenge will begin; translating their ambition into action. CBM and our partners will continue working to make sure this ambition is realised. If we can grab the opportunities that the SDGs give us then we should all, including people with disabilities, be living in a much better world by 2030.
By Andrea Brandt von Lindau, CBM UK’s Trachoma and Eye Health Programme Officer.
Trachoma is the world’s leading cause of preventable blindness. 6 million people have lost their sight to Trachoma. If it is not effectively treated, the eye infection causes constant pain and will eventually lead to blindness. CBM is working with partners in the wider context of the Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative which supports efforts to eliminate Trachoma in eleven Commonwealth countries.
CBM is active in Uganda, Kenya and Malawi, where we conduct TT (Trachoma Trichiasis) surgery. This is one of the four elements of the SAFE Strategy (Surgery, Antibiotics, Facial Cleanliness, Environmental Improvements) which has been endorsed by the World Health Organisation as an effective and comprehensive way to eliminate Trachoma. TT Surgery addresses the advanced, blinding stages of the disease, saving people from further visual loss and from going completely blind.
TT surgery is often conducted at outreach camps in districts which have a high Trachoma prevalence. This allows us to reach remote, and often very poor, populations – people who would not otherwise have the money to travel to a hospital or even to their local health clinic or to pay for treatment or medication. CBM has been running Trachoma outreach camps in Uganda since October last year. I recently had the opportunity to visit a CBM Trachoma outreach camp in Uganda.
The camp lasted for one week and clearly involved a great deal of planning and preparation. Staff from CBM’s local partner organisation, the Benedictine Eye Hospital, based in Tororo, spent each day in a different local health centre in the target sub-district, where they set up an operating theatre for the day. TT surgeons from the local district, who were trained by our programme, operated all of the Trachoma patients who attended the camp each day. Patients returned the following day to have their bandages removed and to be given eye drops with instructions of how to look after their eyes. Surgery patients were also given antibiotics to prevent reoccurrence of the infection.
One major logistical challenge during these outreach camps is patient mobilisation, not only in terms of finding patients and encouraging them to seek help, but also transporting them to the outreach site and back home. CBM uses radio adverts and the ‘town crier’, a car with loudspeakers which drives around the villages and makes public announcements to make people aware of an upcoming Trachoma camp. In addition, CBM has started using so-called ‘case finders’, a method which has proved extremely successful. In Uganda, case finders are usually members of existing Village Health Teams, who are trained to inform people about different health issues and possibilities for treatment and/or prevention.
CBM’s Trachoma programme has trained a number of case finders to make an initial Trachoma diagnosis and counsel people to encourage them to seek treatment. The latter can be extremely challenging because people are often suspicious or fearful of undergoing surgery. However, now that the Trachoma outreach programme has been running successfully for some time, people hear more and more success stories from former patients. As a result, more new patients are now coming forward for surgery. All patients will also receive counselling at the camp itself where they are being told about what the surgery entails and where they can ask questions. Some people will still refuse surgery at the camp, but this is usually a small minority. CBM also provides transport for patients who live too far from the health centre to walk there and who can’t afford transport, which again increases patient numbers.
The outreach camps also see a large number of patients who do not have Trachoma but all kinds of other eye problems. Some issues, e.g. allergies, can be treated with eye drops; however, many other patients require further treatment such as Cataract surgery. This has created a significant need to complement the trachoma camps with Cataract surgery camps. Currently, Cataract patients’ details are recorded so they can be notified the next time a Cataract camp is held. In future, Trachoma and Cataract camps could be organised concurrently, meaning that Cataract patients would no longer have to wait for treatment. In any case, the treatment of other eye diseases is of course extremely important, not only to help as many people as possible, but also to maintain people’s trust in the programme and ensure that patients keep attending. The saddest thing to see is when patients attend the camp who have already suffered irreversible sight loss through diseases like Glaucoma and who have to be told that they cannot be helped. These patients are also referred to the counsellor who will explain the difference between their problem and those of other patients who can be helped.
Something else that struck me is how many people had other disabilities, in addition to Trachoma. This could be other eye issues like Cataract or physical disabilities. One elderly man whose bandages were removed following his Trachoma surgery told us he still couldn’t see anything, due to Cataract. He will now be added to the list of patients who will be alerted the next time CBM will hold a Cataract outreach camp in the area which could be several months later. Benyamen, an Ophthalmic Assistant who screened patients at the camp, talked about meeting a number of elderly women from some remote villages at a recent Cataract camp, who, in addition to having Cataracts, were unable to walk, and had never accessed health services before.
At the Trachoma camp, we met Joyce who is unable to walk and therefore very reliant on her daughter in her every-day life. Her daughter had found out about the camp from a local case finder and the camp vehicle picked Joyce up from her home. It is good to know that she has now received the surgery which will save her from going blind, as this would have made her mobility issues even worse; however, as a disability organisation, I feel that CBM should be providing support for her physical disability too, and was glad to hear that our project team is currently sourcing a wheelchair for Joyce.
CBM will continue to conduct TT surgery in Uganda. This work is complemented by the distribution of antibiotics which prevent the infection and other organisations working to improve water and hygiene standards. The ultimate aim is to eliminate Trachoma in Uganda.
Watch Joyce’s story here:
The ability to read and write is hugely powerful. Women who can read have fewer children later in life, and the children they do have are much more likely to survive. Being literate helps people to find jobs, access information and make decisions about their lives.
Today, on International Literacy Day (8th September), we think about the 781 million adults who cannot read, write or count, and about what needs to be done to make sure that they have the opportunities to gain these valuable skills.
While the data is poor, we know that people with disabilities often have lower levels of literacy than people without disabilities. This is hardly surprising when you consider that in developing countries, as many as 9 out of 10 children with disabilities do not go to school.
In the last 15 years there has been a huge global effort to get more children enrolled in primary school. This has led to a drop in the number of children out of school from 100 million in 2000 to 57 million today. While this progress is huge, many children with disabilities have been left behind. In many low and middle income countries, having a disability more than doubles the chance of a child not going to school. In Nepal for example, 85% of children out of school have a disability.
If they do attend school, children living with disabilities are often more likely to drop out and leave school early. They are also less likely to be able to learn – because schools are not correctly equipped, teachers are not trained or because they are discriminated against. Often getting children in to school and making sure they have the opportunity to learn vital skills such as reading and writing involves small changes; in teaching methods, in physical accessibility or even just in attitude.
Illiteracy among adults with disabilities is even more prevalent than among children, because those who are adults today were less likely to attend school that today’s children. To address this, adult literacy programmes need to be inclusive of people with disabilities. More broadly, we need to make sure that information is provided in alternative formats so that those who are unable to read can still access it.
Goal 4 in the new Sustainable Development Goals recognises the importance of inclusive education and promotes learning for all, including lifelong learning. This is a huge step forward and an important opportunity to ensure that people with disabilities have the same chance to become literate as their non-disabled peers. CBM is advocating that in the indicators that measure the new goals school enrolment is broken down by disability. Because only when we have good data about how many children with disabilities are not in school will we really be able to reach them all. We are also advocating for an indicator on the number of trained teachers to teach children with special educational needs; because getting children into school is not enough.
We often talk about the cycle of poverty and disability, the fact that disability causes poverty, and poverty causes disability. Literacy is one way of breaking this cycle – because when people learn to read and write they are more able to participate in society and have the power to change their own lives.
It could have been me: Anne Wafula Strike responds to BBC3 documentary “Worst Place to be Disabled?”
CBM Ambassador Anne Wafula Strike gives a personal response to Worst Place to be Disabled?, a documentary about disability in Ghana shown as part of BBC3′s recent Defying the Label season.
I sat with my son, overwhelmed with tears, as I watched a so-called “healer” talk about how he kills children with disability, because they have a curse. We were watching “Worst Place to be Disabled”, a BBC 3 documentary in which British journalist Sophie Morgan, a wheelchair user, uncovers the stories of abuse and discrimination faced by people with disabilities in Ghana.
When I was growing up in Kenya this was what was meant to happen to me. My parents were told to feed me poison, abandon me and leave me to die. If my mother and father had listened to them, then I wouldn’t be here to tell the story today.
Our neighbours were afraid that my “curse”, in fact paralysis caused by polio, would spread to others, would affect the babies of pregnant mothers. If my parents refused to “send me back where I came from”, they threatened to burn our house down. So our family had to flee the village.
It saddens me to see how families are still going through the same thing even now. That there is still such prejudice, such lack of knowledge and education; even now, people believe that having a disabled child is a curse, caused by some fault of their own. And worst of all, that people can murder a child without anyone lifting an eyebrow.
But sadly I know that serious abuse towards people with disability is still happening in Kenya, even in the village I was bought up in. I know of cases where disabled children have been locked up in animal pens, viewed as a liability, their disability something shameful. Children with autism or intellectual disabilities locked away because they “make too much noise”. When I was in Haiti filming footage about disability, we were spat on in the street. It underlined for me to me that the views held by society are much more disabling than my own impairment.
The stories of horrendous abuse and discrimination experienced by disabled people around the world need to be told, which is why I am so glad that Sophie Morgan and BBC 3 were able to make this documentary. But now it’s time for action – the Government of Ghana should be ensuring that murderers and criminals are detained and that local people are educated about disability; the UN should be investigating these breaches of the UN Convention on the Rights of People with Disabilities.
It also struck me that the documentary did not tell the whole story. As with so much coverage of Africa, nearly all of the focus was on the negative, the most extreme examples. Understandable, perhaps, in this type of documentary, and undoubtedly true – but not the whole truth. We did see a couple of the organisations doing good work in Ghana, for example the Orthopaedic Centre where the child Blessing had her prosthetic leg fitted. But there are also many more positive stories about disability in Ghana that were not told – inspiring Paralympians, great work being done by NGOs, self-help groups which enable people with disabilities to challenge negative attitudes, like the ones supported by CBM.
There’s so much amazing work being doing in Africa by and for people with disabilities, including by my Olympia-Wafula Foundation and NGOs like AbleChild Africa and CBM, to provide practical support and change attitudes in some of the poorest communities.
While we must uncover and talk about the atrocities that the documentary uncovered, we also shouldn’t ignore those people with disabilities who are running businesses, raising children, being teachers, campaigning for their rights. We need to show the stories of those brave and loving parents who are supporting their disabled children in spite of the stigma that surrounds them, as my mother and father supported me.
I’d like to see a follow up documentary exploring the possible solutions to this. I’d like to sit down with these families who would be prepared to abandon their children or have them killed, to find out what drove them to do this. Is it their neighbours, tradition, lack of knowledge, fear?
Most of all, I’d like to tell those families my story and show them what a girl from a village in Kenya can achieve. They need to understand that they can still have dreams for a child who is disabled. They could be killing a future Paralympian, a professor, a teacher, a parent, the next President of Ghana. This is the message we need to get across to families and communities, and to disabled people themselves.
The stories we saw from Ghana are shocking, this type of abuse should never be allowed to happen in any part of the world. But we also need to remember that disabled people face prejudice and barriers in every country, including our own. In the UK, benefits cuts are causing great suffering for disabled people. A UK politician has stated that children who are likely to be born with autism or other disabilities should be aborted. So children with disabilities don’t even have the right to be born. Stigma is still real, even here with the NHS and education system, we can’t build a level playing field. So how far can we judge parents of children living in poverty, with no free wheelchairs or medical care, no social security, no free state education?
I’m very glad that this documentary was made – Sophie Morgan and the documentary makers did a fantastic job – but I hope that it is the beginning and not the end of discussion about disability in Africa. We need more documentaries, more discussion and more action. Attitudes to disability can and must change, and people in the UK can help that happen by supporting organisations like CBM, AbleChild Africa or the Olympia-Wafula Foundation. But most of all, we need to show families in Ghana – and across the world – that children with disabilities are not a curse or a liability, that they can grow up to be mothers, teachers, business owners or paralympians. That is the most important story that we need to tell.