Healthcare access still a struggle for women with disabilities

Standing in a long queue for over two and a half hours at Bangladesh Medical University with severe leg pain, 33-year-old Sanjida Akter, a physically challenged woman from Badda, realised once again that seeking healthcare is no easy task for people like her. 

Sanjida, who works at an NGO, said, when she goes to the hospital, she needs someone to accompany her. The facilities lack basic accessibility– there are no ramps for wheelchairs, and she cannot even see the help desk as she is only 4 feet 6 inches tall. 

There are no clear signals or guides for visually impaired people, and those with speech or hearing disabilities can barely communicate with doctors.

"It would be a miracle if I ever received treatment without hassle," she told The Business Standard. 

Even when hospitals like the National Institute of Ophthalmology have separate counters for elderly and disabled patients, they are often closed. "I've never seen the special counter open," Sanjida added. 

From doctor consultations to medical tests and collecting medicine from the social service wing, everything involves long queues and mental stress.

Many physically and neurologically disabled individuals don't even get the opportunity to see a doctor. Shahriar Salim, father of physically and neurologically disabled Jannat (14 years old) from Keshabpur, Jessore, told TBS, Jannat has been taking the same medicine prescribed four years ago by a Dhaka-based doctor. 

"It's nearly impossible to treat a disabled child outside Dhaka. There are no pediatric neurologists or even necessary medicines available at district levels," he said.

Access is a major barrier. Government hospitals in Dhaka offer very limited disability-friendly infrastructure, and the situation is far worse in rural areas. Most hospitals are not built with persons with disabilities in mind. For example, hearing-impaired patients struggle because healthcare staff often cannot understand sign language, and patients can't express their symptoms effectively.

"One disabled person usually needs two others to accompany them to the hospital, and many buildings don't even have elevators or ramps," added Shahriar.

Ujjala Bonik, a visually impaired person and General Secretary of the Satarkul Disability Development Organisation, recently had a dispute with staff at a private hospital in Dhaka while waiting long hours for diabetes treatment. 

"Most hospital staff don't even know that persons with disabilities are supposed to be given priority," she said. "Hospitals need to be monitored to ensure they comply with disability rights."

According to the social welfare ministry, Bangladesh has 36,32,652 people with various disabilities – including physical, mental, visual, speech, hearing, cerebral palsy, autism, and Down syndrome – of whom 1,435,943 are women.

Bangladesh Bureau of Statistics (BBS) National Survey on Persons with Disabilities (NSPD) 2021 revealed that only 26.73% of people with disabilities had received care from public healthcare facilities, compared to 22.81% of the general population.

BBS stated that people with disabilities often have more complex healthcare needs—both general and impairment-related– and thus suffer more severely when care is inadequate or inaccessible.

The World Health Organization (WHO) echoed this, saying that people with disabilities face systemic barriers across the health system, including discriminatory attitudes among healthcare workers, inaccessible infrastructure, lack of disability-related data, and poor communication systems.

The Women's Reform Commission has recommended ensuring accessibility for persons with disabilities in healthcare services and creating targeted rehabilitation opportunities.

Speaking to The Business Standard, Dr Halida Hanum, a women's health expert and Member of the Women Reform Commission, explained, "Marginalised groups, particularly women with disabilities experience different unique challenges to accessing health and SRH (sexual and reproductive health) services due to barriers including social stigma and taboos, information and communication barriers, attitudinal barriers, transportation barriers, infrastructure barriers etc. 

"These barriers are compounded particularly for women and youth with disabilities, who experience intersecting forms of discrimination– based on gender, socioeconomic status, ethnicity, religion, or geographic location."

She added that health service providers have no/limited capacity to provide quality care to women and girls with disabilities. Pregnant women with disabilities don't receive any maternal allowance if they receive the disability allowance. 

"The disability allowance is needed to cover the additional costs people with disabilities face in accessing services, and is not sufficient to cover the costs related to maternity/ANC.

"This system discriminates against pregnant women with disabilities as the maternal allowance should be available for all women to ensure the best outcomes for all mothers and children," Halida Hanum said.

"For example, due to not receiving this benefit, pregnant women with disabilities are often unable to ensure proper nutrition/proper ANC," she added..

When asked about the government's efforts, Dr Md Moinul Ahsan, Director of Hospitals and Clinics, Directorate General of Health Services, said: "We provide free treatment for persons with disabilities in public hospitals. In women's and children's wards, two beds are reserved for them. While not bound by law, many hospitals prioritise patients with disabilities out of humanitarian concern. Ramps are being added, and we are working towards making disabled-friendly washrooms available."

Professor Dr Sayedur Rahman, special assistant at the Ministry of Health, told TBS, "Our new healthcare plan includes specific focus on the elderly, women and persons with disabilities. They will be given priority in any queue. Major public hospitals will provide separate services for the elderly and women.

Meanwhile with financial support from the European Union, the "Expanding Civic Space through Active CSO Participation and Strengthened Governance System in Bangladesh (ECSAP)" project is working to raise awareness and build the capacity of organizations to uphold the rights of marginalized communities.

This project is being implemented by Christian Aid, AMRAI PARI (Alliance to End Domestic Violence), and Manusher Jonno Foundation.