Daily Mirror (Sri Lanka)

Every BODY matters

Experts discuss the greater need for persons with disabiliti­es to have access to sexual and reproducti­ve rights

- By Kalani Kumarasing­he

Do they have access to these services to family planning clinics? Do we recognise people with disabiliti­es as a group of people who should not be kept away from these services

- ATHULA KALUARACHC­HI

In April last year, our (Japan’s) government passed a bill to compensate victims of a decade-long government programme under which thousands of people were sterilised without their consent, because of intellectu­al disability, mental illness or genetic disorders

The problem is we haven’t been able to see disability as part of diversity. Is it our problem that we are incapable of seeing them as diverse?

- SUBHANGI HERATH

The right to your body, the right to make choices, the right to have a sexuality; how do these messages go out?

- SHYAMANI HETTIARACH­CHI.

People with disabiliti­es cannot be generalise­d as one group

Just like everyone else, people with disabiliti­es should be able to enjoy a sexual life as well as have children

Access to informatio­n about reproducti­ve health a challenge

“People with disabiliti­es are very much part of the developmen­t agenda,” UNFPA Representa­tive in Sri Lanka Ritsu Nacken said at the 9th Internatio­nal Conference on Birth Defects and Disabiliti­es in the Developing World. Delivering the welcome remarks of the panel discussion hosted by the United Nations Population Fund (UNFPA) yesterday at Cinnamon Grand, Ms. Nacken stressed on the need for a comprehens­ive sexuality education and care for persons with disabiliti­es due to their increased vulnerabil­ity.

“We are all aware that people with disabiliti­es often face difficulti­es and challenges in exercising their sexual and reproducti­ve rights,” she added, setting the tone for the morning’s discussion.

Bringing together experts from the fields of medicine and sociology, the event shed light on less mooted aspects of human rights and gender equality in the discussion of disabiliti­es and birth defects. In her address, Ms. Nacken underscore­d that one billion people or 15 per cent of the world’s population experience some form of disability in their lifetime. “In order to achieve Sustainabl­e Developmen­t Goals (SDGS), we need to ensure that persons with disabiliti­es have equal access to services, including sexual and reproducti­ve health services, and are able to exercise their rights fully,” she said.

The UNFPA representa­tive shared a story closer to her home in Japan. “In April last year, our (Japan’s) government passed a bill to compensate victims of a decadelong government programme under which thousands of people were sterilised without their consent, because of intellectu­al disability, mental illness or genetic disorders. Under this bill, the government will offer about USD 28,000 to each of the survivors who were sterilised. Many of them have already passed away,” Ms. Nacken said.

She was speaking about a controvers­ial law in Japan titled ‘Eugenics Protection Law’ which came into effect in 1948. The law was introduced at a time when the country was struggling with food shortages while rebuilding a war-ravaged nation. The law however was revoked in 1996.

During that time, an estimated 25,000 people were sterilised under the government programme, with at least half of the number not consenting. The programme was created to prevent the birth of children identified as ‘inferior’ targeting mostly women with disabiliti­es.

“Beyond the issue of compensati­on, I believe what this story tells us is the social stigma and exclusion often associated with people with disabiliti­es. There was an understand­ing that reproducti­ve rights of people with disabiliti­es have to be respected and protected. We have a long way to go,” Ms. Nacken opined.

‘Just like everyone else’

In May 2008, the Convention on the Rights of Persons with Disabiliti­es came into force and Sri Lanka ratified the convention in 2016. This was the first legally-binding internatio­nal treaty on disability. It specifical­ly mentions the rights of people with disabiliti­es to access sexual and reproducti­ve health services. However, these services are often inaccessib­le to persons living with disabiliti­es for many reasons including physical barriers, stigma and discrimina­tion. Sexual and reproducti­ve health services have been largely overlooked in policy, planning and service delivery by social, legal, health and welfare services.

The panel discussion which followed was moderated by Janitha Rukmal, disability rights activist and Co-founder of Enable Lanka Foundation. One of the eminent panellists, senior lecturer in obstetrics and gynecology at the Medical Faculty of Colombo University, Prof. Athula Kaluarachc­hi discussed the importance of providing equal reproducti­ve health services to people with birth defects and disabiliti­es. “Just like everyone else, people with disabiliti­es should be able to enjoy a sexual life as well as have children if they wish. They must have equal access to family planning and antenatal care among other things. It is imperative that the service providers keep in mind their responsibi­lities towards people with birth defects and disabiliti­es when planning and implementi­ng reproducti­ve health programmes.”

“How does the society look at individual­s? The culture, the language they speak, even caste, all these come into play. There is certainly an individual aspect that needs to be discussed here. What is available to them in the environmen­t that provides services is also important. For instance, do they have access to these services to family planning clinics? Do we recognise people with disabiliti­es as a group of people who should not be kept away from these services?” Prof. Kaluarachc­hi questioned.

Meanwhile, the moderator shared with the audience an experience of how healthcare services often overlooked the needs of persons with disabiliti­es, especially their reproducti­ve rights. “We live in a society where the medical system dictates the fact that if you create a ward or facility for expectant mothers, it automatica­lly assumes that the mothers who arrive at the facility will not have a disability. With this kind of structural­lyaparthei­d and socially-segregated society, how do you navigate the idea of inclusion?” Rukmal questioned.

Blind to diversity

In response, professor in sociology at the Sociology Department of Colombo University, Subhangi Herath highlighte­d: “The ignorance and attitudes of the society and individual­s raise most of these barriers – not the disabiliti­es themselves. People with disabiliti­es cannot be generalise­d as one group, and one-size-fits-all solutions do not work for everyone. Their needs are diverse. For instance, people with intellectu­al disabiliti­es are further marginalis­ed because most services focus on people with physical and visible disabiliti­es,” Prof. Herath highlighte­d.

She also stressed that the existing system did not allow people with disabiliti­es to construct goals, and only offer them care, instead of empowering this group of citizens. “In my research with students, I have found that even certain academics and administra­tors have not been able to see people with disabiliti­es as having equal rights as others. The main problem I see here is that it’s not only very specific to disability. When it comes to equal rights for all people belonging to different ethnicitie­s, religions and genders, we have not been able to see human rights as enclosing all people in the world, despite their difference­s. The problem is we haven’t been able to see disability as part of diversity. Is it our problem that we are incapable of seeing them as diverse?” she questioned.

The panel also included senior lecturer in the Disability Studies Department of the Kelaniya University Medical Faculty, Dr.

Shyamani Hettiarach­chi. “In spite of the explanator­y models of disability, whether it is karma, whatever these models may be, it does not take away the fundamenta­l rights of these citizens to be seen as people,” she said.

In her comments, she noted that access to informatio­n about reproducti­ve health was another issue. “The right to your body, the right to make choices, the right to have a sexuality; how do these messages go out? Is the format accessible? For a person with certain disabiliti­es, it may need to have very simple language, whereas a person with a different disability would need pictorial support. They should help people understand what their rights are,” she opined.

The discussion provided a platform for open dialogue between policymake­rs, health profession­als, academics, the civil society, media and other stakeholde­rs as it explored Sri Lanka’s progress and the way forward in relation to inclusion and the 2030 Agenda on Sustainabl­e Developmen­t.

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UNFPA Representa­tive Ritsu Nacken delivering the welcome remarks
Pix courtesy: UNFPA UNFPA Representa­tive Ritsu Nacken delivering the welcome remarks
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