WUNRN
ARMENIA - DISABLED WOMEN STRUGGLE TO
ACCESS ANTENATAL SERVICES
Healthcare
infrastructure not equipped for expectant mothers with mobility difficulties.
By
Gayane Mkrtchyan - 23 July 2013
Tamar Tashchyan, a 40-year-old Armenian
immigrant from Lebanon who arrived with her husband two years ago, walks with
difficulty and normally uses a wheelchair. She gave birth to triplets a month
ago.
Disabled women in Armenia say they are
prevented from getting proper antenatal care because hospitals lack the
equipment and access facilities they need. Some say the poor provision reflects
enduring Soviet-era attitudes to disability.
“I had a caesarean section to give birth to
the children,” she said. “I was basically unable to use the birthing couch.
During my pregnancy, on my regular visits for medical check-ups, it was
problematic getting onto the couch. To get up the three steps and then lie on
the couch, I needed help from my husband and the nurse. I just couldn’t manage
it on my own.”
Zaruhi Batoyan, a disability specialist with
Bridge of Hope, an NGO which works with disabled children and young people,
confirmed that women with mobility, hearing or sight problems faced various
obstacles during pregnancy.
“The gynaecological couches are standard ones
that can’t be raised or lowered for people with restricted capacity. They can’t
even lower the three steps that women have to climb to get up onto the couch,”
she said.
More than 184,000 Armenians are registered as
disabled, and they frequently complain about the difficulty of accessing
medical facilities, which are often upstairs or otherwise hard to get to.
Christine Aghanyan, a psychologist from the
Agate centre which helps women with special needs in the city of Gyumri, said
that in Soviet times, disability was treated as a disease, and it was taking a
long time to change public perceptions.
Nelly Nahapetyan, a gynaecologist and
lecturer at Yerevan State Medical University, said there was not a single
medical institution in Armenia that was completely geared up to receive and
treat disabled women.
“You don’t get the amenities that women in
wheelchairs require to get around easily, especially when they’re pregnant,”
she said.
Batoyan said she had personal experience of
trying to enter and move around a hospital in a wheelchair.
“The people who should have been there to
help me weren’t around,” she said. “There were only women at reception, and
they wouldn’t have been able to lift a heavy weight. The doors were narrow, and
it was hard getting into the lift. Maybe the problem is that I went to the
hospital on my own without anyone with me. But at the end of the day, the
environment should adapt to us, not the other way round.”
Batoyan argues that the government needs a
whole new programme to make buildings accessible to disabled people, in
accordance with the United Nations Convention on the Rights of Persons with
Disabilities, which Armenia ratified in 2010.
Nahapetyan said medical staff were as keen as
anyone else for disabled women to have full access to healthcare facilities. At
the moment, she said, “doctors and nurses have to cross from one medical department
to another to ensure a disabled patient doesn’t face difficulties. The doctors
do what they can, but all this moving about from one floor to another and from
one ward to another don’t make sense and create a load of problems.”
Armenia is moving towards a new approach to
disability and benefits, with a law that has been in the pipeline since 2009
but has yet to be passed. The Soviet-era method of placing people in one of
three categories ranked by severity of disability will be dropped and replaced by
a fairer, more nuanced classification based on ability to work. (For a report
on the planned changes, see Armenia Reforms Disability Rules.)
“I welcome this new law if it’s going to
bring reforms that mean that in future, facilities will become more convenient
and accessible for women with disabilities,” Nahapetyan said.
Health ministry official Anna Hakobyan said
that although the new law would not apply retrospectively to hospital design,
“it does prescribe that in a few years’ time, there will be ramps and doors
everywhere, and it will be compulsory for all buildings and roads to be
modified to suit the needs of people of restricted capacity”.
She added, “It wouldn’t be right to say we’ve
done everything, but we’re on the right track.”
Aghanyan, the psychologist, disagreed with
this view, arguing that conventions and laws adopted by government actually
made little difference on the ground.
“As for problems around maternity and
reproductive health, these matters are raised only rarely, even at state
level,” she added.
Tigranuhi Minasyan works for the Bridge of
Hope group, and has limited mobility because of cerebral palsy. She says living
in Armenia involves a constant battle against a world not designed for the
disabled.
“When I was studying at the Agrarian
University, I wouldn’t eat anything all day so that I wouldn’t have to go to
the toilet, as I was just not capable of getting there,” she recalled. “I
recently spent a few days in hospital and the room was so uncomfortable that I
resolved to return to hospital only when it was time to die.”