The Need for Access: Is Nigeria failing persons living with disabilities?
“I want everyone to remember, to reflect, that they are one fall away from being a person with a disability. How would you want to be treated?” — Dr. Stella Iwuagwu, Executive Director, Centre to the Right for Health.
In January 2019, Blessing Mary Ocheido, Pharmacist and Founder of Ramp Up Nigeria wrote to a bank, sharing her experience while trying to visit one of their branches in Abuja. Below is an excerpt of what she wrote.
“I use a wheelchair and needed to make use of your MoneyGram services sometime last week and upon visiting one of your facilities, the closest to my work place in Kubwa, Abuja, I realised that there were no accessibility ramps to enable me enter the building. Even your doors are too small to fit a wheelchair. I asked your security personnel if there were other entrances into the bank that I could use instead and they replied that there were none. So I was left with the option of waiting under the sun while they went in to make inquiries on my behalf.
Upon his return, the security man said I would have to go into the bank to be attended to. And seeing as there was simply no way for me to do that, except maybe to be lifted up in his arms, I had to leave. There are over 20 million people with disabilities in Nigeria, a good number of whom make use of wheelchairs. So you can imagine the large demographic of people to whom you’ve shut out of accessing your banking services. You would agree with me that this is not right. I’m speaking out on behalf of people like me and kindly requesting that you build disability ramps in all your facilities and make your mantrap doors wheelchair-friendly.”
Ocheido and millions of Nigerians living with disabilities in Nigeria encounter barriers when accessing basic services and amenities. According to the World Health Organisation (WHO), over a billion people, about 15% of the world’s population has some form of disability. Persons with disabilities have higher rates of unmet health care needs compared to persons without disabilities. Ahead of the 2019 International Day of Persons with Disabilities (IDPD) marked on December 3rd, in an exclusive interview with Nigeria Health Watch, Dr. Stella Iwuagwu, Executive Director at the Centre to the Right for Health shared challenges that people living with disabilities face when accessing healthcare in Nigeria, and points out what they need from Nigeria’s health sector.
Barriers to healthcare
Have you ever thought of how a pregnant woman with impaired hearing attends antenatal classes? What happens when a patient cannot speak and has no relative or help around? Do our healthcare facilities have sign language interpreters? Many health facilities in Nigeria have no ramps for those in wheelchairs, poor signage, narrow doorways, internal steps, inadequate bathroom facilities and inaccessible parking areas for people living with disabilities. Health workers need to understand their patients’ concerns, especially women, and adjust their practice to incorporate the unique needs of persons with disabilities. At the 2019 Future of Health Conference, one of the panellists Patience Dickson said, “We need to train health workers on how to treat people with disabilities, especially women. They need to see us as human beings. We deserve quality healthcare too!”
Affordability of healthcare services
Access to health care, even in high-income countries, is often difficult for persons with disabilities, but in low-income countries, the challenges are worsened, both physically and financially. Persons with disabilities experience adverse socioeconomic outcomes such as poor education, low levels of employment, and high poverty rates. A large number of persons with disabilities are not employed, so they do not seek healthcare in health facilities because of a lack of funds. Should Nigeria consider options for reducing or removing out-of-pocket payments for people with disabilities who do not have other means of financing health care services? The National Health Insurance Scheme (NHIS) has a Physically Challenged Persons Social Health Insurance Programme (PCPSHIP) but how many people living with disabilities know about the programme?
The theme for this year’s IDPD is ‘Promoting the participation of persons with disabilities and their leadership: taking action on the 2030 Development Agenda’. In January 2018, President Muhammadu Buhari signed into law the Discrimination Against Persons with Disabilities (Prohibition) Act, 2018. The Act states that all employers of labour in public organisations shall, as much as possible, have persons with disabilities constituting at least 5% of their employment. Since the signing of the Act into law, how much has changed? Are private institutions proactive about recruiting staff who are persons with disabilities? Are our offices easily accessible spaces for persons with diabilities? These are hard questions we must ask ourselves.
The 2030 Agenda for Sustainable Development pledges to ‘leave no one behind’, but most people living with disabilities are being left behind in Nigeria. Persons with disabilities in Nigeria need to be treated with dignity and respect. The Nigerian Government needs to establish health care standards related to care for persons with disabilities and include in those standards a robust enforcement mechanism. Simple modifications such as providing health information in accessible formats such as Braille and building proper ramps would go a long way. People living with disabilities in Nigeria deserve better from the government and from fellow Nigerians. Would you like to be treated the way persons with disabilities are currently treated? If not, then the time to act is now. Inclusion can no longer be merely a buzzword, it is time to move beyond words to action.
In your workplace, place of worship, school or other public space, are the needs of persons with disabilities taken into account? If not, what are the obstacles? Please share your thoughts in the comments section below or via Twitter @nighealthwatch or Facebook @Nigeria Health Watch