Sexual and reproductive health services are often inaccessible to women with disabilities for many reasons, including the attitude of health professionals and lack of physical access. In this story, a woman with a disability talks about her experience of giving birth and how it guides her activism today.
“No, no, no! We don’t want to take care of her! These were the words Coumba Ndiaye, of Dakar, Senegal, heard repeatedly as she sought assistance to deliver her baby. She went to four health centers, but they all turned her down, saying her disability (related to polio as a child) would make the birth “too complicated.”
Eventually she was sent to the hospital. But when she got there, a midwife abruptly told her, without examining her, that she was being taken to the operating room for a C-section. The midwife, Coumba said, had made her decision looking at her disability. “She saw my disability and automatically for her… disability means surgery. I was scared,” she said.
But behind the midwife, a voice reassured her: “Wait for me! I will help you give birth on a regular basis. He was a respectful caregiver, who later helped Coumba onto the delivery bed with a bench and then helped her have a vaginal birth, like most of the other mothers in the hospital.
About an hour after giving birth, a nurse came to take her to the rest room, but did not help her out of bed. Coumba fell and started bleeding. She passed out. Two days later, she woke up in a recovery room. “The baby was doing very well. Him but me? I had a hemorrhage. I didn’t know where you were,” she said.
Coumba, then just 22, was later told by the head midwife that she was not having another child. “At that moment, I cried,” he recalled, with a sigh.
Fighting for women with disabilities today
Today, 22 years later, Coumba is an activist and city councilor in Pikine, a suburb of Dakar, campaigning for disability inclusion. As chairman of the municipal commission for education, training and local languages, he ensures that children with disabilities study and have adequate teaching materials. As part of the city’s intercommittee, he ensures that disability is considered in his other committees, including health and living environment, and also advises on the care of women with disabilities.
Access to education was a problem for her when she was young. As a teenager, she had to walk holding her leg for over an hour to get to high school. “There was no bus. I had no crutches or prostheses. I was limping, I was holding my leg so as not to feel the pain, ”she recalled.
“I’ve had many experiences and that’s why I’m confident today. I can fight for disabled women. I also know that I can talk to the authorities,” she said, adding that she engages with women’s groups, the Senegalese midwives association, female lawyers and community groups.
His birth experience still drives his activism today. She raises the plight of disabled women who give birth when she can, and sometimes helps individual women with disabilities in their own capacity. “[If] someone calls me for the delivery of a disabled pregnant woman, I go to her house to offer my help for free,” she said.
In her previous work with a disability organization, she met many other women who had similar experiences to hers. “A woman in a wheelchair cannot climb [onto] a delivery bed for prenatal medical examinations. All these problems make women [with disability] scared of marrying someone and getting pregnant,” she said.
“See the person, not the disability”
Although inclusiveness is progressing in Senegal, there was still a need for change “from the bottom up of society,” he said. You called for the goal of providing access to health centers to all people with disabilities, without them facing problems. “Disabled people are afraid to go to the hospital. If they get sick, they stay at home and take the medicine they buy on the street. We have to make the hospital accessible”.
He believes that health professionals need better training on how to provide fair and respectful health services for people with disabilities. “Hopefully, the way they look at people with disabilities will change. You need to see the person, not the disability,” she said, adding that communicating with people with disabilities was very important.
“Step by step, society will include people with disabilities. My dream is to make all delivery rooms accessible to disabled women… [and] have qualified and kind medical personnel. When the delivery room will be available for disabled women, I’d say I’ve achieved my goal.”
A version of this story first appeared in the WHO Global Report on Health Equity for People with Disabilities.