Kazakstan: Disability Still Seen as Bar to Motherhood

Disabled women in Kazakstan face many obstacles in fighting for their rights, not least when it comes to accessing reproductive health services in the state sector.

Alima Beysenbaeva is deputy chair of the Shyrak Association of Disabled Women, and was confined to a wheelchair following a car crash more than 20 years ago.

Now 42, she can talk from personal experience about the difficulty of simply seeing a doctor for a check-up.

"When I went to see a gynaecologist, she looked at me with near-bewilderment, as if to ask why I'd come to see her," she recalled. "It was so humiliating."

Beysenbaeva said some doctors believe disabled women should not have children.

The Shyrak group commissioned a report last year that focused specifically on disabled women in Almaty, Kazakstan's biggest city. Of the 300 women interviewed, six out of ten said their rights had been harmed in some way by hospitals and clinics. This included disrespectful and downright rude treatment by medical staff.

Some reported that when they became pregnant, they were refused permission to register with maternity services and were referred for abortions instead.

A 2010 survey by Kazakstan's Public Opinion Research Centre found that most of the 1,500 visually impaired and hard of hearing people it canvassed had limited access to information on reproductive and sexual health. Those seeking to have children were unaware of options that might be open to them, while the lack of family planning information led to a high incidence of abortion.

Saida Abdrahmanova, a doctor at the municipal health centre in Almaty, acknowledged that some of her colleagues held negative attitudes towards people with disabilities.

Particularly among the older generation who worked in the Soviet medical health system, there are some medics who see no need to offer a good service, provide a high standard of care and respect patients' rights, she said.

Abdrahmanova insisted that rather than persuading disabled women not to bear children, the role of doctors was to provide the right advice to inform their decisions.

Kazakstan has laws setting out the state's obligations to support disabled people, including legislation on social benefits and home care provision.

As Shyrak has pointed out, the current legislative framework is limited to ensuring that the disabled get the basic essentials, but ignores other needs that they share with everyone else.

Shyrak has organised training sessions for medical staff to improve access to reproductive and sexual health services for disabled women. In June, it held the first in a series of workshops which focused on encouraging health and social workers to offer the right kinds of treatment to disabled women, and to use the correct terminology when speaking to them.

Doctors like Abdrahmanova argue that with the best will in the world, some disabled women are not up to having children.
Viktoria Kuznetsova, 45, proves how wrong such attitudes can be.

A resident of Almalybak, a small town near Almaty, she has used a wheelchair since an operation to remove a tumour on her spine that she attributes to years of volleyball training.

Her doctor supported her decision to have a child; and she gave birth by caesarean section. Things got harder when her husband died before the baby was born.

"No one helped me so I looked after the baby virtually on my own," she recalled, adding that her mother, who does not live nearby, would visit just to take the child out for some fresh air.

When her daughter Sofia was 18 months old, a ramp was fitted to allow Kuznetsova to take her daughter outside on her own. Before that, she said, "it was physically impossible for me to get downstairs and go outside".

Sofia is now eight. Alongside coping with single parenthood, Kuznetsova has won Kazakstan's disabled table tennis championship several times, and recently took up archery.