When Patrick Tuyishimire reached adolescence, he had to rely on his parents to accompany him when seeking medical services including those related to sexual and reproductive health (SRH), at the health center. Tuyishimire who has hearing impairment knew that seeking SRH services had to be a secret. And he preferred not to disclose it to anyone. ALSO READ: Persons with disabilities call for more facilitation and inclusion The member of Rwanda National Union of the Deaf (RNUD) also encountered difficulties when seeking services at the health centre on his own, the main obstacle being his inability to communicate directly with nurses there who could not use sign language. Tuyishimire is only one among many youths with disabilities who encounter various challenges particularly concerning communication and the stigma surrounding disability and SRH. Patience Gloria Babirye, a person with hearing impairment from Uganda, noted that when trying to access SRH services, often struggles to make healthcare providers understand her needs, as they may not immediately recognise her disability. This, she continued, leads to a lack of proper assistance. She often has carry a notebook or seek help from others to communicate effectively. ALSO READ: Why society needs more awareness on sexual and reproductive health Babirye called for inclusive information on SRH for people with hearing impairments given that she faces difficulties when trying to access digital content without captions or sign language interpretation. She emphasized the need for policy makers to make sensitive and general SRH information more inclusive for people with hearing impairments and other forms of disability. Babirye and Tuyishimire are actively involved in Make Way, a programme by the Netherlands-based organization, Liliane Fonds. The programme which operates in Rwanda, Uganda, Ethiopia, Kenya and Zambia, aims to ensure that young people are able to realise their sexual reproductive health rights and make informed decisions about relationships, their bodies, family planning, sexuality and wellbeing. ALSO READ: PWDs push for accessible public buildings Since joining the program, Tuyishimire had an opportunity to exchange ideas with peers from other countries on effective strategies for advocating and ensuring access to SRHR information and services for youth with disabilities. Babirye and her team currently reach other young people through advocacy, group discussions, community outreach, and social media. ‘Tackle misconceptions and stigma’ Speaking during a side event at the just concluded Women Deliver conference, which included a workshop on SRHR and disability, on July 21, Shrushti Mahamuni, the SRHR Advocacy Advisor through Make Way Program at Liliane Fonds, highlighted that in many societies, people with disabilities (PWDs) are marginalised, and their sexual and reproductive rights are often neglected. She said there is a prevalent misconception that these individuals do not have sexual desires or the need for reproductive health services, declaring that Liliana Fonds ttackles the issues and works towards breaking the barriers in health systems that prevent PWDs from accessing quality services. During the event, Liliana Fonds and partners organize sessions, games, and a marketplace to showcase their work on disability and SRHR, exchanged ideas, and increase awareness on intersectionality and inclusion. Ariane Dusenge, the Country Coordinator of Make Way, said that the challenges faced by persons with disabilities are compounded by inequities stemming from various factors, such as poverty, lack of education, and discrimination. She noted that in some cases, family members may even make decisions about their reproductive health without their consent. Women with disabilities also face issues like forced sterilization and limited access to abortion services, leaving them vulnerable and without bodily autonomy, Dusenge said, adding that there is a lack of tailored solutions for different categories of people with disabilities. Programs and initiatives are often generalized and may not address specific challenges faced by individuals from different contexts. Dusenge highlighted the importance of considering intersectionality in understanding the unique challenges faced by people with disabilities, declaring that by understanding the various identities and contexts of people with disabilities, tailored advocacy and solutions can be developed to address their needs effectively. The Make Way program, operating since 2021 in Rwanda, aims to address these issues through contextualized approaches, creating safe spaces for youth with compounded vulnerabilities to discuss their experiences and advocate for meaningful youth engagement. Dusenge said the program operates in five districts, and the experiences of the youth are used as the basis for advocacy efforts at the grassroots and national levels.
