More than 1.7 million people in Malawi live with a disability, and the lack of a hospital system for them means they face humiliation and worse. (Photo by Anthony ASAEL/Gamma-Rapho, Getty Images)
Malawian Christian Tsibisa visited a local health facility before giving birth, but was left confused and frustrated. She was non-verbal and there was no sign language interpreter available at the Limbe Health Center in Blantyre.
“I tried to explain how abnormal I felt, but I was ignored. The nurse on duty did a physical examination, filled out a health passport, and sent me on my way.”
She shared her experience with continent Through a sign language interpreter while breastfeeding a 9-month-old baby girl.
Chibisa took safety precautions by asking her sister to accompany her to the facility to deliver the baby.
“She helped me communicate.”
Communicating with the nurses proved important as Ms. Chibisa did not recover well after giving birth and needed a referral to a larger facility.
when continent I visited three of Blantyre's most important medical facilities – Limbe, Queen Elizabeth Central Hospital and Zinwangwa Health Center – but no interpreters were available at any of them. There were no toilets or ambulances available anywhere for people with mobility issues. The height of the delivery table and examination table could not be adjusted.
“For us, the labor ward is almost inaccessible,” says disability rights activist Laineth Manduwa.
These restrictions are occurring across Malawi's public hospitals, forcing adult patients like Tsibisa to rely on “guardians” to act as translators and assistants when using the toilets and other amenities. These restrictions are even more severe in rural Malawi and have been in place for decades.
When Fanny Maremia suffered an ectopic pregnancy in 2018, her life was at risk due to the lack of a sign language interpreter. Her life-threatening condition was not treated at Zinwangwa Health Center. Her husband was also unable to speak and was unable to convey her pain to the nurse.
Maremia underwent surgery after the pastor's wife agreed to accompany him to Queen Elizabeth. The delay and doctors not giving her enough information left Malemia worried that she would not be able to conceive again.
“I endured a double psychological war. This also affected my relationship with my husband until I became pregnant again a year later,” Maremia said through a sign language interpreter.
Bias among medical professionals can sometimes make the humiliation even worse.
“Recently, one of the women was slapped while giving birth because the nurse and patient were unable to communicate,” said Bryson Chimenya, president of the Malawi National Association of the Deaf. continent In July.
This situation has been going on for decades. Mandwa said that when she gave birth to her baby in 1992, nurses confronted her husband about impregnating a disabled woman.
Formal training for health workers in Malawi rarely covers caring for people with disabilities. Christopher Namagowa, registrar at Kamuzu University of Health Sciences, Malawi's main medical training institution, said the four-year nursing program includes only a cursory content on disability care.
The government seems to be much better at talking about disability than actually helping people with disabilities.
The country is party to progressive international treaties such as the United Nations Convention on the Rights of Persons with Disabilities and the African Disability Protocol.
The Americans with Disabilities Act was passed in 2012 and improved this year. However, a review last year of the implementation of the UN Convention found that Malawi has only 10 qualified sign language interpreters.
Most work as on-screen news interpreters. In critical areas such as hospitals, interpreting is left to unqualified friends and family, if any.
Doreen Ali, Malawi's head of reproductive health services, acknowledged that inaccessible infrastructure and poorly trained health workers lead to poor treatment of women with disabilities. But she said the department has plans to improve staff training through the pre-service curriculum.
The government has a poor track record of implementing established plans. The 2018 Five-Year National Strategy for Improving Disability Services included the goal of “the highest attainable standard of health for persons with disabilities”.
When it expired last year, there was little to show for it.
Recognizing the government's dismal track record, independent campaigners are instead working with allies such as Sightsavers and UK Aidmatch to train health workers.
This article was supported by the Pulitzer Center through its “Underreported Stories in Africa” project.
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