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Working for change

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

What women with disabilities can do

a woman in dark glasses speaking
Learn as much as possible about
health exams from this and other health books.

We can always ask to have breast and pelvic exams when we see a health worker. Also, we can get together as a group and study this and other health books to gather as much information as we can about the exams women should have. Then we can ask local health workers, and also hospital and clinic directors, to make these services available to us. As a group we can tell the Ministry of Health how important these exams are to women with disabilities.

People First makes easy-to-understand health booklets
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In 1997, several women with learning difficulties started a women's group, called People First Liverpool, so they could learn more about women's health care. They worked with a women's health clinic to produce several booklets that would make health exams easier to understand. To find out where to get these booklets, see Women's Health Information & Support Centre in our Other resources section.

Learning about sexuality and fertility
a health worker teaching a group of women about "Understanding your body."

Kranti and Sabala are health workers in one of the poorest communities in India, where most women, with and without disabilities, are unable to get any health care.

They have taught women how to examine and understand their own bodies. They have looked at problems, such as unusual vaginal discharge, and discussed fertility awareness and sexuality. They have focused on finding remedies to problems that the women can do themselves and that do not require lots of resources.

What families and caregivers can do

a woman speaking.
Offer to go with me to get the health exam and stay with me if I choose.

Friends and families of women with disabilities can help by talking with disabled women about how important it is for all women to get regular exams. Learn to describe what will happen during the exam and why the results are important to know. Encourage women with disabilities to share what they know about exams and the ways health workers can adapt the exams to their needs.

Also, talk about the barriers in clinics and hospitals that keep women with disabilities from getting exams, and what can be done to make getting exams easier.

a woman using sign language.
Many women are anxious or afraid the first time they have an exam, especially a pelvic exam.

As your disabled daughter grows from a girl into a woman, help her to not be afraid of exams. Together, you and your daughter can work to make sure clinics are accessible, health workers are trained, and transportation is available.

What health workers can do

Health workers can begin by talking with a woman before any exam. Explain what is going to happen, answer her questions, and tell her she can ask questions during the exam too.

Help women with disabilities understand why it is important for them to have health exams, including both pelvic and breast exams. You can explain why these exams are important for all women. Explain that a disabled woman can have these exams, even if it is hard for her to move her arms and legs. Explain that disabled women and their health workers have found many different positions women can use for these exams. Remember that the disabled woman understands her body better than anyone. So ask her to let you know how much she can move and if she will need another person to help.

Women are often taught not to touch their own bodies, and not to complain. Because of this, many women are uncomfortable doing the breast exam, or telling someone they have an unusual pain in the belly. Women are sometimes embarrassed to talk about sex or the sexual parts of the body. So it may be difficult for them to talk about a discharge from the vagina. Health workers can help by encouraging women in their communities to feel comfortable touching their bodies and talking about any problems they may have.

Always speak directly to the disabled woman and ask her about her health problem, even if there is someone else in the room assisting her. Talk with her as you do with other people, even if she has difficulty speaking with you.

When you examine a woman who is blind or cannot see well

a blind woman holding the arm of another woman.

For a blind woman, going to an unfamiliar place like a clinic can be confusing. She does not know where things are or where to go. Sometimes people treat blind women roughly or move them around. This is not very respectful.

When you guide a blind woman, do not take hold of her arm or hand. Many blind women rely on their hands to “see,” by touching. Instead, offer her your arm and let her hold your arm or rest her hand on yours. Tell her where things are and where you are going. Then she will learn how to get around the space better on her own and will feel more comfortable during the exam.

When you examine a woman who is deaf or cannot hear well

For deaf women, going to a clinic can be very frustrating when no one there can use sign language. Sometimes, a deaf woman will bring with her someone who can hear, and who knows her sign language
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and can interpret for her. If she does, make sure you look at the deaf woman and not at her interpreter when you speak to her and when she speaks to you. This includes when you listen to the interpreter. Look only at the deaf woman. The interpreter is there to help, but the deaf woman is the person who has come to you to receive health care.

When you examine a woman who has trouble learning or understanding

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Women who have trouble learning or understanding should still get information about their health and should help make decisions about their bodies. You may need to take more time to explain things to a woman who has trouble learning. Instead of just asking her if she understands, ask her to tell you in her own words what she has learned.

a health worker speaking.
I used to wait for disabled women to ask me about pelvic or breast exams. But most women with disabilities are surprised to find out they can have these exams, or they feel embarrassed to talk about them. Now I make sure to
ask if they know about the exams all women should have.