Hesperian Health Guides

Chapter 6: Health exams

Every day 20,000 people visit the HealthWiki for lifesaving health information. A gift of just $5 helps make this possible!

Make a giftMake a gift to support this essential health information people depend on.

HealthWiki > A Health Handbook for Women with Disabilities > Chapter 6: Health Exams

a woman using crutches outside a health clinic.

Women with disabilities need health exams

Many people think a disabled woman’s only health concern is her disability and that she needs no other health examinations. But this is not true. Checkups with a health worker every 2 to 3 years, even if you feel fine, are an important way for a woman to find health problems early, when they can best be treated.

Women with disabilities often have a hard time getting exams. You may not want to get exams because you have grown up feeling ashamed of your body. Or you may not want anyone to touch your body. Or you may already have had so many exams and operations that you do not want to see another health worker.

But because regular exams are just as important for women with disabilities as they are for all women, learn as much as possible about them from this book and other resources. Then you can ask local health workers—and demand of hospital directors and ministers of health—to make these services available to you and other women with disabilities.

This chapter has information about breast exams and pelvic exams. Getting these 2 exams is important for any woman to stay healthy. See information on other exams to stay healthy.

What regular health exams can tell you

There are many health problems that regular health checkups can find. Sometimes a person can be sick and not realize it until the problem has become very serious and difficult to treat or cure. Some of the health problems that can be helped if they are found early are: anemia (weak blood), tuberculosis (TB), HIV/AIDS and other sexually transmitted infections, malaria, some cancers, high blood pressure, worms and other intestinal parasites, and diabetes. Any woman, whether or not she has a disability, can have these problems.

Bringing health exams to the community
a group of disabled women sitting together.

Lizzie Longshaw knew that most disabled women in her community in Zimbabwe never got pelvic or breast exams. Clinics that were accessible were too far away and too expensive for disabled women. But she knew how important these exams were for women with disabilities. Because exams were not easy to get, many women did not learn about their health problems until it was too late and many died from cancer.

Lizzie, who is herself disabled, called together a group of women with disabilities. Together, they learned as much as they could about cancer and other health problems, and about how exams can help all women by finding problems early. The group then persuaded a representative from the Ministry of Health to meet with them about the health problems disabled women face. They explained how disabled women had trouble traveling to clinics and paying for health services. The representative was so impressed with how much the women had learned, he arranged for the government to provide a free, mobile clinic once a month to provide cancer screening and family planning services for disabled women in that community.

Two of the most important regular exams a woman should get are breast exams and pelvic exams. Two common cancers women develop are in their breasts and cervix, and these tests can help identify and treat them early.

How to prepare for breast and pelvic exams

You can prepare for a breast or pelvic exam by knowing ahead of time what is going to happen. Ask the health worker to talk about each step of the exam and to explain anything you do not understand. It may help to think in advance of questions to ask her.

a woman with a prosthetic arm speaking to a health worker.
Will you please
tell me how you will examine my breasts?

As a woman with a disability, you may have different needs during the exams. If possible, take a friend or family member who can stay with you the whole time. Talk with the health worker about your specific needs before the exam so she can do them in a way that is safer and easier for you.

If you are deaf or cannot hear well, bring a friend with you who can use sign language to help you communicate with the health worker.

If you are blind or cannot see well, bring a friend to explain and describe the exams. Ask the health worker to carefully explain what she is doing and what you cannot see.

If you have a mobility-related disability or cannot walk well, bring a friend, or plan ahead how to enter the clinic or health center.

If you have trouble understanding or learning, and the breast or pelvic exam makes you frightened, nervous, or uncomfortable, ask for someone you trust to stay with you during the exam.

Family members and caregivers can help women who have disabilities that affect learning or understanding:

WWD Ch6 Page 127-2.png
  • Talk about the exams in advance. A family member or friend can explain the exams to a woman who has trouble learning. Help her understand that these exams are important for her to be healthy. Describe what will happen during the exams and answer her questions. If you can, tell her who will do the exams.
  • Visit the clinic before the exams, if possible. The day before the exams, try to go with her to the place where the exams will be done.
  • Have someone she trusts go with her. If she wants, a friend or family member can stay with her during the exams. If the health worker who does the exams is a man, make sure a woman she trusts stays with her the whole time.

Health workers can help:
  • Explain the exams again right before. Explain what will happen before starting the exams and ask if she has any questions. She will probably be less afraid if she can ask questions before the exams start.
a speculum.
  • Show her any instruments you will use, such as the speculum. Make sure she knows what the speculum is before the pelvic exam so that it does not surprise her, and let her touch it if she wants to.
  • Talk to her during the exams. Explain what is happening at each step. Tell her what you need to do next. Ask her if she is ready and wait for her to agree. That way she has control over what happens.