Ingrid Van Der Heijden, Senior Researcher – Gender and Health, African Medical Research Council
Violence against women with disabilities is a human rights issue. On Human Rights Day, 10 December 2018, we reflected on the #16 Days of Activism campaign and considered how violence can happen to any woman, regardless of age, place, economic status, culture, or disability status.
Despite freedom from violence being enshrined in the Convention on the Rights of Persons with Disabilities, the rights of persons with disabilities remain unrealized. While the International Day of Disability, commemorated on the 3rd December 2018, highlighted the marginalization and human rights violations of people with disabilities worldwide, the #16 Days campaign did not fully shine the spotlight on the lives and violence experiences of women and girls with disabilities, and/or what is being done to protect them.
We know that women and girls with disabilities are marginalized and at greater risk of violence because of their gender as well as their disability. Perceptions of women with disabilities as passive, weak, and defenseless exaggerates their risk. They also experience many more barriers to help-seeking and resources for protection and justice, than women without disabilities.
Data of increased risk for women and girls with disabilities is largely based on research from developed country contexts, but little is known about the violence prevalence and experiences of those living in developing countries, or what we can do to prevent violence. Understanding that 80% of women with disabilities live in low and middle-income countries (LMICs) (World Bank, 2011), the What Works programme is the first global violence prevention initiative with a focus on women and girls with disabilities across multiple settings in LMICs (see link at the end of the article).
Over the past five years, the UKAID funded What Works programme conducted global research with over 6,000 women with disabilities who were living in poor, under-resourced communities across multiple countries in Africa, the Middle East and Asia, and who were participating in a range of different mainstream violence prevention interventions.
The inclusion of disability questions in the What Works research enabled What Works to track the participation of women with disabilities in its interventions, assess their risk of intimate partner violence and non-partner sexual violence, and assess the barriers and enablers of their participation in violence prevention efforts.
Three key findings have emerged from this research, that women with disabilities in LMICs are:
- FOUR times more likely to experience intimate partner violence (IPV) than women without disabilities (age adjusted).
- Twice more likely to experience non-partner sexual violence.
- Severity of disability is associated with an increased risk of experiencing violence (IPV & non-partner sexual violence).
What Works’ research also revealed that stigma and prejudice around their disability status underpinned many women’s accounts of IPV:
Emotional IPV: [My husband] does not call me by my name, he calls me lame. He calls me lame every day. I cry and feel sad. (Tajikistan, woman living with a disability)
Neglect and physical IPV: My husband saw that I was ailing and would not look after me. He would not take me to hospital…he began beating me, and calling me sick… He ruptured my eardrum, I was all in blood when I came up, and had to stay for ten days in the hospital. (Tajikistan, woman living with a disability)
Abandonment and physical IPV: My husband’s attitude changed toward me, when I became sick, he brought and left me here alone. He would not visit me. I remember when he beat me so hard. (Tajikistan, woman living with a disability)
IPV leads to further injury and impairment, and resulted in shame, depression, and anger amongst female participants, highlighting how IPV impacts on mental health:
He tells me he doesn’t want to live with a sick person. He insults and tells me I am a dirty woman. That my disabled fingers look like an animal and that he is ashamed to walk with me. When he says that I also get angry (Ghana, woman living with a disability).
Do Violence Against Women and Girls (VAWG) prevention interventions differentially impact women and girls with disabilities?
Reflecting on the emerging evidence from What Works, there were no statistically significant differences in programme benefit, suggesting that existing mainstream interventions may benefit all women, regardless of disability status.
What are the barriers for women living with disabilities to access VAWG prevention interventions? Participants with disabilities explained how lack of outreach to people with disabilities, lack of specialised transport, physical access issues, disability-related stigma, and shame about their impairments meant they could not participate equally in the intervention. Lack of self-esteem and feeling embarrassed about their impairments undermined their confidence to actively participate in the interventions:
I participated in all sessions, but I did not participate in the scenes because my lip stretched, and I was ashamed…I would have participated if not ashamed (Tajikistan, woman living with a disability).
What are the benefits to women living with disabilities who participate in VAWG prevention interventions?
For some participants, their inclusion in the interventions increased their self-esteem, increased their access to social support, and helped raise awareness and challenged social norms around disability. For those participating in income-generating interventions, the benefits of economic empowerment allowed them to contribute to the household and toward the purchase of assistive devices.
People started treating us differently. (Tajikistan, woman with a disability)
They taught us that though we are disabled, no one has the right to commit violence against us. (Ghana, woman with a disability)
How can we start to build inclusive programmes to prevent violence against women and girls with disabilities?
Disability inclusion means that people living with disabilities are accommodated and given opportunities to participate in all aspects of life, including interventions and strategies that could protect them from violence.
- Service providers and programming staff must commit to understanding the unique ways that women and girls with different disabilities experience IPV. This understanding is a critical first step to being able to adapt and develop programmes that effectively serve women and girls with disabilities.
- GBV prevention programmes should facilitate appropriate disability-sensitive selection, outreach (such as home visits), and ensure physically accessible and supportive programming that addresses the unique risks and needs for a range of women with disabilities.
- Social norms change: Programming should be both gender and disability transformative in terms of challenging stigma and discrimination related to both identities. Prevention of violence against women and girls with disabilities should not focus on functioning difficulties, but rather challenge disability-related stigma and social norms associated with being a woman with a disability.
- Raising awareness: Programming should incorporate disability awareness training among participants with disabilities, programme staff, community members and service providers.
- Economic empowerment: Programmes should foster resilience, capabilities, and economic empowerment of women with disabilities.
- Safe spaces: Program staff must identify accessible places of safety that can accommodate the needs of women with disabilities.
- Couples: Couples programming where one of the partners has a disability can help foster healthy and safe relationships.
- Inclusive materials: Programming materials and approaches should be designed in collaboration with women with disabilities and disabled peoples’ organisations and advocates, to complement existing guidelines, protocols, and tools for VAWG prevention and response.
For violence prevention to be inclusive, input is required from people with disabilities and those organisations that represent them.
- Monitoring: Programmes should monitor inclusion of and accessibility to people with disabilities, and make adjustments based on lessons from monitoring data.
- Evaluation: evaluate programmes to see how, and if, they effectively serve women and girls with disabilities
- Funding: Donors should prioritize disability inclusive VAWG programming and provide funding opportunities for disability-inclusive programme development, costing, provider training, implementation, monitoring, evaluation and scale up.
We have reached the end of this year’s #16 Days of Activism campaign, and if we truly want to prevent violence against women and girls and leave no one behind, we should meaningfully explore and understand the lives of women and girls with disabilities globally. What Works is a unique opportunity to ask questions and build evidence that will have a meaningful impact on our understanding around how to effectively include women and girls with disabilities in LMICs in violence prevention and ensure they benefit.