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Working for change

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HealthWiki > A Health Handbook for Women with Disabilities > Chapter 2: Organizing for disability-friendly health care > Working for change

Here are some suggestions you can use to work together with health workers to improve health care services. These activities can be used to:

  • raise awareness about accessibility, availability, and the attitudes that make it hard for disabled women to find and get good health care.
  • identify actions that can improve health care for disabled women.

Meeting in a group to share personal experiences of health care barriers can build each woman's confidence.

STEP 1. Everyone has something to offer

To help everyone feel comfortable, and to show how each person has a contribution to make, you can ask each woman to tell about something she does well or that she is proud of. (No one has to talk about herself if she does not want to.) For instance:

WWD Ch2 Page 44-1.png

Kranti is
a good cook.

WWD Ch2 Page 44-2.png

Maria keeps the peace
between her sisters.

WWD Ch2 Page 44-3.png

Rania is a skilled
midwife and has
hundreds of

WWD Ch2 Page 44-4.png

Adetoun is a good storyteller.
The children in her family and
neighborhood love to listen to her.

STEP 2. Share experiences about health care access

Ask each person to tell about something she has seen or experienced that has prevented a woman with a disability from getting good health care. Make a list, in no particular order, of the difficulties the women describe.

a woman writing on a large sheet of paper while speaking to a group of disabled women.
Let's list some of the experiences you have had so we can start to think about how we can make changes.
- no one knows sign language
- no handrails or ramps
- health centers too far away
- transport will not take me
(even when I can afford it)
Training in nursing school does not include anything about disability.
Health workers confuse my sickness with my disability.
They do not believe I need family planning or information about sexual health.
There is no information in Braille.
Our health center does not have the money to get accessible equipment.

STEP 3. Role plays to learn about barriers to good health care

a woman speaking.

People can switch roles — a health worker acting as a disabled woman, and a disabled woman acting as a health worker.

Use role plays to deepen everyone's understanding of the difficulties they have listed. Divide the group into several teams that include both health workers and women with disabilities. Ask each team to spend a few minutes preparing a role play about a disabled woman who has trouble getting good health care. Encourage everyone to participate.

Role play possibilities

Here are some role plays you can suggest if the group has trouble coming up with ideas of its own:

Role play 1. A woman with cerebral palsy wakes up one day with a fever, chills, and diarrhea. She is the fourth person in her family to get sick like this. She goes to the local health center where a health worker asks her lots of questions about her disability, but nothing about her sickness. Role play 2. A deaf woman cannot get anyone at a clinic to understand what she wants. Role play 3. A woman in a wheelchair cannot get a taxi or bus to take her to a health center.

After each role play, ask the "actors" to return to the group. Invite the group to ask each other questions about the role plays that will help deepen their understanding of the problems disabled women have in getting good health care.

STEP 4. Visit a health center

a disabled woman speaking.
A group will be taken more seriously than an individual. Decide ahead of time who will speak for the group and what that person will say. You may need to get permission ahead of time to make your visit.

After the group has identified some general barriers to good health care access, they can visit local health centers to take a closer look at things that can cause problems for a woman with a disability. Divide the group into 2, if there are enough people, with at least one health worker in each group, and visit one or more health centers. (If possible, do not send a group to visit a health center where the health workers in that group work.) Ask 1 or 2 women in the group to write down or make note of any problems and obstacles they find. Also ask them to note anything they find that is helpful for women with disabilities.

The trip to the health center can also be used as an example of how women can help each other and work together to use each other's strengths to overcome problems. For example, wheelchair riders can guide blind women, and blind women can support women who need help with walking.

STEP 5. What did you find at the health center?

When you return from the visits, have each group describe the problems they found and things that were helpful to women with disabilities. Also ask each group to describe how they were treated by the director of the health center and the staff. You can make a list or draw a map of the problems they found.

a map of a health center.
- stairs at entrance
to clinic
- no sign language
- narrow doorways
- no knowledge
about disabilities
6 stairs at front
of building
far from
no one knows
sign language
doorway too
narrow for
health workers
have no knowledge
about disability
beds too
high, and
on wheels
Compare the experiences at the different health centers. Did the groups see the same problems?

STEP 6. Which problems are the most important?

WWD Ch2 Page 48-1.png

Discuss the problems seen during the health center visits and ask the women to decide which ones they think are the most important to change, or that they would like to change first. Making improvements to health care services can take planning and time. Your group may want to study the list to see which things you can change quickly, and which may take longer to change. Ask them to talk about why the problems they have chosen are important to work on, and what their hopes and wishes are for the change they may bring if these problems are improved.

STEP 7. An action plan for improvements

Once the group has chosen 1 or 2 problems that make it difficult for women with disabilities to get good health care, they can work on a plan to solve these problems. Ask the group to discuss different ways they can solve each problem, and ask them to think about other people who can help them make these improvements. Work out the steps that will be needed to make these improvements and decide who will be responsible for which step. Then, take action!

a group of 4 women talking.
Amina, your brother is a carpenter. He built a good wheelchair ramp at your house. He could show the staff at the hospital how easy it would be to build ramps and handrails there.
My uncle is a taxi driver. I will ask him to speak with the other taxi drivers about stopping to give us rides.
Namita, you know sign language. You could teach it to some of the health workers.
I will speak with the other health workers at the health center where I work. I will show them how we can easily make the exam tables and the beds lower and safer.