Responses to persons with disabilities during the COVID-19 responses

Addressing Persons with Disabilities and those Working with them during the COVID-19 Emergency Situation

MENTAL HEALTH AND PSYCHOSOCIAL RESPONSES TO COVID-19

 

It is common knowledge that in times of emergencies, including health emergencies, persons with disabilities, among other groups who are vulnerable are usually affected differently. Their mental health is usually affected negatively. It is not only the mental health of persons with disabilities that is affected but that of their partners, support persons and families. Therefore, this article will Endeavour to focus on how the COVID-19 pandemic may affect the mental health of persons with disabilities and those who work around them.

 

It is essential to understand what “mental health” is because a mention of the term usually is received with negative feelings. Many people associate “mental health” as an equivalent of “mental illness” when it is not. According to the World Health Organisation (2015) mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

 

This is easy and straight forward. So, COVID-19 emergency responses and interventions may compromise or affect the state of mental well-being of persons with disabilities and those people working around them. It is therefore important for the government to realise this mental health issue in relation to the COVID-19 emergency responses and interventions. Persons with disabilities must be a priority, together with other vulnerable groups. But, public emergency responses usually tend to ignore them or attend to them as an afterthought. This, we have observed in our advocacy work especially when it comes to droughts, floods, cholera and so on. They are the first to forget and the last to remember. It is thus essential that persons with disabilities, through their representative organisations take proactive measures to strategically advocate for specific emergency, administrative, policy or legislative measures to have persons with disabilities prioritised during such emergency situations.

 

We are all aware that persons with disabilities, especially girls and women with disabilities, face several forms of stigma and discrimination that begin right from the families they live with, to the communities and society as a whole. In most cases, they live in seclusion or in designated segregated areas like rehabilitation centres or institutions.

 

It is not uncommon for persons with disabilities to exhibit fear of being discriminated in many spheres of human development. For instance, many persons with disabilities usually express some of the following:

1. avoiding visiting any health facility in fear of stigma and discrimination. This includes the fear to access sexual and reproductive health services, including HIV services because of the perception that they may be ‘asexual’ or not sexual active leading to non-protection.
2. fear of losing livelihood or employment as a result of perceived unwantedness from the society and employers;
3. fear of being isolated or secluded as a result of any form of impairment, especially psycho-social impairments;
4. fear of being socially excluded because of a previous admission or seclusion in a mental health institution;
5. feeling a sense of being stigmatized just because you are a care-giver or parent of a child with a disability;
6. feeling discomfort among peers just because you are in love or you a spouse to a person with a disability;
7. avoiding falling in love or any intimate relationships with other persons without disabilities in fear of rejection and scold and embarrassment;
8. regular and consistent feeling of helplessness, unwanted, bored and rejection due to their disability;
9. choosing to remain deliberately isolated or operating within a closed disability cluster in fear of failure of the other people not understanding they form or mode of communication or language;
10. fear of joining a career or profession related to disability, especially psycho-social disability, due to the existing stigma around disability.

 

Different categories of persons with disabilities express themselves differently due to their specific needs and accommodation requirements. Otherwise, the fears they express are almost similar.

 

The above expressions are real among persons with disabilities, their care-givers/parents and supporters. Persons with disabilities live with this experience on a daily basis. In many instances, these expressions or feelings change or oscillate from one degree of feeling to another depending on the situation or environment they find themselves in. Some environments are really hostile and depressing while certain environments are friendly and supportive. This is very essential to take note of in every situation where policy, legislative, administrative or emergency responses are being taken by the State and other key decision makers. If this aspect of the lives of different categories of persons with disabilities is missed, then all remains undone. Persons with disabilities will always continue to feel a sense of discrimination. This directly affects their mental well-being.

 

In any epidemic or pandemic like the current COVID-19, it is common for individuals to feel traumatised, stressed and worried. Just as indicated above on how persons with disabilities respond to different situations and environment, different people may respond to the COVID-19 pandemic differently. It is essential here to take note that the way persons with disabilities respond to their situations is similar to the way different people respond to a pandemic like COVID-19. Persons with disabilities, in addition to what they already experience and express themselves to as a result of their impairments, also express themselves the same as other people in times of pandemics. So, they face “double stress” therefore their fears are double.

 

At this point in time, let us look at the common responses people facing the COVID-19 pandemic in general face. The common responses or expressions people affected directly or indirectly by the COVID-19 pandemic may include:

1. Fear of falling ill and dying.
2. Avoiding approaching health facilities due to fear of becoming infected while in care.
3. Fear of losing livelihoods, not being able to work during isolation, and of being dismissed from work.
4. Fear of being socially excluded/placed in quarantine because of being associated with the disease (e.g. stigma against persons who are from, or perceived to be from, affected areas).
5. Feeling powerless in protecting loved ones and fear of losing loved ones because of the virus.
6. Fear of being separated from loved ones and caregivers due to quarantine regime.
7. Refusal to care for unaccompanied or separated minors, people with disabilities or the elderly due to fear of infection, because parents or caregivers have been taken into quarantine.
8. Feelings of helplessness, boredom, loneliness and depression due to being isolated.
9. Fear of reliving the experience of a previous epidemic.

(Adapted from the IASC Reference Group on Mental Health and Psychosocial Support in Emergency Settings: Interim Briefing Note – February 2020)

 

Persons with disabilities who find themselves in situations of a pandemic like the COVID-19 experience the same responses as persons without disabilities. As already stated, these responses are additional responses, or aggravating responses to the already disability related ones. Therefore, their mental well-being is affected more. This has to be realised during the emergency response and strategy planning and development stage. It should therefore be seen to be implemented during the actions of awareness raising, screening, testing, quarantine, tracing and tracking, treatment and discharge. This exhibits confidence-building and assurance interventions to the affected at pre-quarantine, in-quarantine and post-quarantine stages. This will build confidence in people and we shall not experience anyone running away or going into hiding on suspicion of being positive.

 

As already discussed above, emergencies are always stressful, but specific stressors particular to COVID-19 outbreak affect the population. Such stressors include:

1. Risk of being infected and infecting others, especially if the transmission mode of COVID-19 is not 100% clear.
2. Common symptoms of other health problems (e.g. a fever) can be mistaken for COVID-19 and lead to fear of being infected.
3. Caregivers may feel increasingly worried for their children being at home alone (due to school closures) without appropriate care and support. School closures may have a differential effect on women, who provide most of the informal care within families, with the consequences of limiting their work and economic opportunities.
4. Risk deterioration of physical and mental health of vulnerable individuals, for example older adults and persons with disabilities,  if caregivers are placed in quarantine if other care and support is not in place.
   (Adapted from the IASC Reference Group on Mental Health and Psychosocial Support in Emergency Settings: Interim Briefing Note – February 2020)
    
   While we were looking at the above expressions which seem to suggest that COVID-19 is fierce and should scare people from seeking health care, which includes quarantine, we are actually on the contrary saying there must be interventions to encourage people to voluntarily avail themselves to the health system because all the services, including quarantine are safe. We therefore support the continuous call by the Minister of Health to boldly state that the interventions are SAFE. What sometimes scare many people, including persons with disabilities is false news about COVID-19 and its related services. Already the extreme fear for COVID-19 services and procedures is already a mental health issue which can easily be avoided.

 

There is a lot of false news and messaging going on in our communities. This news does not spare persons with disabilities and those who support them or work with them. In this case, the Ministry of Health and its working partners must heighten the awareness raising efforts especially around the false news circulating around the communities. When it comes to the communities, in order to avoid all fake news, the best is to stick religiously to the information which is being given by the Ministry of Health and its working teams. Listen to nothing else! Remember, the Ministry of Health says:

1. Wash your hands frequently with soap and water. This is the usual soap we use for bathing in our day-to-day lives. There is no special soap for persons with disabilities.
2. Use an alcohol-based hand sanitizer if soap and water are not available. This does not refer to the alcohol people drink in order to get drunk or intoxicated. It is certified by health experts.
3. Avoid close contact with anyone showing signs and symptoms of respiratory illness such as coughing and/or sneezing. As persons with disabilities, this is also possible despite the challenge of always wanting to be close to persons who support us. Avoid those support persons with these symptoms and work with those others without symptoms. This does not mean that you have abandoned your beloved care-giver or favorite support person.
4. Avoid touching your eyes, nose, and mouth with unwashed hands. Always wash your hands regularly with soap and water before touching your face. Sometimes, the type of impairment you have requires that you touch your eyes, nose or mouth regularly.
5. When coughing or sneezing cover your mouth and nose with flexed elbow, handkerchief or tissue. On a serious note, what if you have been amputated from above your elbow? You are able to cough within the available space you have adapted to use when covering your mouth or nose.
6. Cook all your meat and meat products thoroughly before eating.
7. Avoid unprotected contact with live wild or farm animals.
8. Avoid spitting in public.
   (Adapted from the Ministry of Health Guidelines)
    
   The above guidelines are easy to follow but they must be availed to persons with disabilities in appropriate and accessible formats. Persons with disabilities and their representative civil society organisations must demand for this. It is a human rights issue.
    
   As we conclude, we should realise that mental well-being is for all despite disability. Zambia should be known as a nation that promotes both physical and mental well-being among all its people. It stands firm on the motto “leave no one behind”. Therefore the physical and most importantly the mental well-being of persons with disabilities in this time of the COVID-19 pandemic must be a priority. It is very important for the government to ensure that psychological first aid, emotional support and counseling services are in place and effective. Such services should include specific skills to tackle the double stress or trauma persons with disabilities face in this era of this deadly pandemic. Proactive psychological first aid, emotional support and counseling services should always be in place at all times, and not only be called for during stressful and traumatic periods like this one. No!
    
   There must be a strong and effective pre-quarantine, in-quarantine and post-quarantine counseling mechanism that must be targeted to those infected directly and are being quarantined and those affected because they are in close relationship with the infected persons. The above outlined expressions or stresses require psychological first aid, emotional support and counseling services. No doubt! But the big question is do we have such services targeting the COVID-19 infected and affected persons? It is obviously no. Then it is worse for persons with disabilities.
    
   But, where is the Mental Health Unit of the Ministry of Health? This is the time we should have seen and heard the Unit leading the mental health and psycho-social mitigation intervention arising from COVID-19. Is it about capacity to provide and/or coordinate such robust services? Or is it about placing little priority on mental health and psycho-social support services by the government? This is the time to examine ourselves as a people, through a critical introspection by our government.
    
   Other questions that require urgent answers include: when is the Ministry of Health going to establish the Mental Health Council of Zambia as provided for in the Mental Health Act of 2019? The Mental Health Council should have been essential in contributing in the coordination of the necessary mental health and psycho-social support services at this time of the COVID-19. We need action today!! As we make this call to action, we would like to emphasize the position that DRW is essentially part of the consensus built in the country to rally behind President Edgar Lungu’s call to concentrate on prevention to avoid burdening the health care system with clinical cases of COVID-19.
    

Note: Disability Rights Watch is providing information adopted or adapted from the Ministry of Health, World Health Organisation and their working teams or networks.

 

COVID-19 does not choose whether with or without a disability!

Stay Safe: Stay Health and Stay at Home!

STAY HOME!

 

Wamundila Waliuya,

Disability Rights Watch,

April, 2020.

different communication modes during covid pandemic

COVIC 19 versus Communication Modes and Language for Persons with Disabilities

 

This piece of writing depicts the real situation of different categories of persons with disabilities who remain at risk of being infected by the Corona virus. This is not only a threat to persons with disabilities but those care givers or parents or indeed support persons. Let us examine the demonstrations in the dialogue between Public Health Inspector (PHI) Kusalila and Disability Support Person (DSP) Bwino.

 

PHI Kusalila: Hey! Look at those two people. What they are doing is wrong in this time of social distancing under the COVIC 19 crisis.

DSP Bwino: Kusalila, what have the two done?

PHI Kusalila: they keep touching each other in their hands and on different parts of their bodies. Let me go and have them charged for breaking the SI 21 and SI 22. Of course also not complying to the directives given by His Excellence, President Edgar Chagwa Lungu. Look!

DSP Bwino: Hold on Kusalila. The problem with you is that you rush into conclusions before inquiring. Let me make you understand.

PHI Kusalila: there is no understanding when it comes to life or death Bwino. It is a Presidential directive and no one must break it. I am charging them under the Public Health Act. How do they keep on touching each other in public during this Corona Virus time.

DSP Bwino: Wait. Those three people are discussing a family matter. The gentleman in a blue shirt is deaf-blind. He cannot see, or speak and cannot hear at all. The lady he keeps touching with is his interpreter. She can speak hear and see. The other lady who seems to be speaking to the young lady touching him is actually speaking to him not her. She can see, speak and hear. She is his aunt.

PHI Kusalila: so! What do you mean? They speak by touching each other?

DSP Bwino: that is their alternative mode of communication. All that touching and writing on each other palms is all communication. You cannot stop them from communicating with each other in their own mode of communication.

PHI Kusalila: Now what do we do? COVIC 19 will catch them. They do not respect social distancing. They are touching and so on. We have the duty to correct the situation.

DSP Bwino: I would have asked that question to you. You are a public officer. Did you think of individuals who are deaf-blind in developing all those Sis, IEC materials and the rest of the interventions?

PHI Kusalila: Well! I do not know what to do. But they remain at risk.

DSP Bwino: It is you to blame. You left them behind despite your motto of “leave no one behind”. Good bye.

PHI Kusalila: Wait my friend Bwino! You are an expert of this field of persons with disabilities. You also have got the duty to educate me on any possible interventions that will ensure their full inclusion. Tell me what should I do to protect them?

DSP Bwino: Let us visit them and hear what should be done which is best for them. We should not make any decisions without them.

PHI Kusalila: But can I not give them hand gloves right aware since they continue to touch each other with bare hands?

DSP Bwino: No! That is not correct. Hand gloves are a barrier to their form of communication. The gloves will not allow them to receive the communication through their naked hands. They use the sense of feeling by the way.

PHI Kusalila: Oh! I see. What about face masks to cover their nose and mouth?

DSP Bwino: Come on Kusalila. You never know. I can see that the interpreter keeps looking at the moving lips of the person who is deaf-blind. She may be using a method called lip reading. So, the mask may be a barrier.

PHI Kusalila: Bwino, you are an expert, let us go and hear from them I think that is the best thing to do. Consultation. I should also educate my bosses…. It is important for us as a government to conduct wide consultation with everyone before we rush into some of the activities that affect our communities.

 

What is your thought?) Inclusion or exclusion?)

 

Dialogue two

 

PHI Kusalila: Bwino my friend look at the man coming over there. Do you know him?

DSP Bwino: Of course, I know him very well. He is Mr. Mabvuto. He is one of those persons with disabilities I have been working with for a long time.

PHI Kusalila: So he is coming for you. Can I leave the two of you to discuss. When you are through I will come over. I just want to check on how the distribution of the hand sanitizers is going on.

DSP Bwino: No my friend, Kusalila. Stay around. Maybe Mabvuto is looking for assistance from you. So, stay around and we talk to him together.

(Mabvuto arrives and presents his case to Kusalila instead of Bwino as was expected.)

PHI Kusalila: Bwino, have you heard his complaint. He says the team in the field has refused to give him some hand sanitizers. Please attend to him since you may understand your people better.

DSP Bwino: I have heard his complaint. He says your team has refused to give him some hand sanitizers because he does not have arms. So he does not need them. This is your matter Kusalila. I am not a Public Health Inspector. Neither do I work for the Ministry of Health. Resolve this.

PHI Kusalila: Bwino can I talk to you alone first before I deal with Him. Come over here.

(Move to the side leaving Mabvuto alone.)

PHI Kusalila: Bwino, why do you sometimes just want to be difficult. This man does not have hands really. Those are hand sanitizers. What does he need them for. Maybe he wants to distribute to his family. Advise me, please.

DSP Bwino: Kusalila, Kusalila, I always tell you to consult the person complaining. Go and talk to Mabvuto himself. I was not there when they refused to give him sanitizers. Talk to him.

PHI Kusalila: But…but Bwino, how? I may offend him. Talk to him and I will listen to whatever he says. I will be able to give him as many sanitizers as he wants for further distribution since he does not require them. Please….

DSP Bwino: It seems you are really stuck Mr. Inspector. Let us go I talk to him on your behalf.

(They get back and find Mabvuto gazing at Kusalila expecting an answer.)

DSP Bwino: Yes, Mabvuto, you said the team out there refused to give you hand sanitizers because you do not have hands or arms. I know your arms were amputated after an accident.

(Mabvuto explains. He even explains how he uses his legs/feet to do everything he does. He said he required the sanitizers to sterilise his feet which work as his hands.)

DSP Bwino: Kusalila, you have heard. I have seen Mabvuto using his feet for making door mats. Good door mats. He uses his toes to hold a pen and write. He also uses his toes to pick a table fork or spoon to feed himself.

PHI Kusalila: This is really surprising. God is great! God is really great! So…so…I….

DSP Bwino: Let us go and give him more sanitizers than these other people who use their hands. His feet are more vulnerable and susceptible to infections because he even steps on the ground. Come on let us go.

PHI Kusalila: He seems to be a good man. He is jovial and does not even seem to regret his loss of hands.

DSP Bwino: That is not important. He has got the right to receive  equal protection from this COVIC 19 pandemic just like any other person. The problem with you health workers is that you think you know it all. Consult the affected and they will tell you their requirements. Involve them in planning and implementation of the emergency responses and intervention to the pandemic. Then you will learn them more.

PHI Kusalila: I have learnt a lot. I learn a lot about persons with disabilities whenever I am with you. Mr. Mabvuto, my friend, let us go. I will give you the sanitizers you require. I will also register you on the list of those to carry out awareness raising on the Corona virus. Of cores we shall orient you. Let us go.

DSP Bwino: Kusalila, after you are done with him, let him take you to their office. He belongs to an association which advocates for the rights of persons with physical disabilities. Get more information from the association. Bye!

 

(Another interesting experience. Discrimination at face value – right?)

Wamundila Waliuya,

April, 2020,

Lusaka.

Inclusion of Women with Disabilities in Inclusive Sustainable Development

Wamundila Waliuya
Founding President
Disability Rights Watch 

The issue of full and effective participation of women in inclusive sustainable development has in the past 20 years been escalating to such an extent that today women have taken over most of the leadership positions especially in the education and business sectors. The myth of “women can not lead: they must remain in the kitchen” is quickly thinning down. It is in the past twenty years that we have witnessed the emergence of women Presidents; women Vice Presidents; women Managing Directors; women engineers; women farmers; women Police Commissioners and Inspector Generals; women pilots and so on. The list is inexhaustible. At the same time we have witnessed the emerging strong organisations like: Women for Change; Women in Mining; Women in Health; Women in Law; Women in Agriculture; Women in Business; Women in Education; Women in Politics; Women in Construction; Women with Influence; Women in Religion; Women in Manufacture ring; Women in Environment and so on. Again the list is long. Amazing! I did a search and never found ‘Women in the Kitchen’ or ‘Women in Marriage’.

I am truly impressed with this. This is not a shock. It has been as a result of robust strategic advocacy works by women themselves. Women stood and positioned their voice where it needed to be. I write this article as a contribution to the celebrations of the International Women’s Day 2017 which falls on 8^th March. The theme of this year’s day is “50:50 in the workplace” at global level. The theme is befitting.

The International Women's Day is a day of celebration globally, for the social, economic and political achievement of women. It is a day of reflection on the past and present achievements of women in the world. At the same time, the day is for mapping the future achievements of women. In view of this the challenge is to ensure that the women of the past are proud, the women of today are motivated and the women of tomorrow are focused.

As I thought through, my heart suddenly felt low! Seriously, I did not understand why I felt low! I spent time to reflect on this year’s day before putting my fingers to the keyboard. I just felt low after realising that one group of women was clearly missing on the long lists of “women…” or “women in …” I could not get to a reasonable conclusion on why this group of women was missing in the impressive development surrounding women. Where are the women with disabilities? I asked myself on whether they remain as “women meant for the kitchen”. Unfortunately they are missing even in the kitchen. They are missing in all sectors outlined above. I know they exist. But where are they?

Many international human rights instruments, particularly the UN Convention on the Rights of Persons with Disabilities, recognise the fact that women with disabilities face multiple-discrimination. This discrimination arises from their being women, in a world of gender imbalance; their being women with disabilities in a world of discrimination on the basis of disability; their low socio-economic status in a world of social stratification on the basis of socio-economic status. One other factor is that they remain in multiple-discrimination on the basis of their being silent on many matters that affect them both directly and indirectly. This may not be absolutely true but it contributes to their being left behind. This is an unfortunate situation which should be addressed. But who should take the lead in addressing this gap?

It should start with women with disabilities themselves. I feel so. I also believe so. Let us look at how liberation struggles started. The African liberation struggle from the colonial masters started with the Africans themselves. All African States which were in the powerful hands of the Europeans are now in the hands of Africans. Originally, Africans were considered illiterate; barbaric; primitive and ignorant. Today African leaders have got influence in the world. They lead all the former European colonies, the African nations.

In the United States, the Black Consciousness Movement was started by African Americans who were originally called by the derogative term “negroes”. They spoke, struggled and some were assassinated. But from somewhere, Barrack Obama emerged. He has been rated one of the best US Presidents. It is all because of the work of the affected black American communities. We still look forward to another real black American President. We also look forward to a female American President. The emergence of Hilary Clinton is all about the efforts of women ensuring that they are present.

I once worked in the field of HIV and AIDS. Unfortunately, I participated in designing HIV and AIDS awareness materials around 1988. HIV and AIDS were depicted with pictures of eagles, skeletons, graves and the ‘death-trap’. Everything about the people who were diagnosed positive was treated with serious stigma and discrimination. One or two persons who were diagnosed positive came out in the open and spoke about it aggressively. HIV and AIDS was originally a pure medical issue. After the affected and infected spoke about their rights consistently, it changed its socio-legal status to being a human rights issue. Today, discrimination of any person on the basis of their HIV or health status is prohibited. This is practical as we can see many persons who are HIV positive living happily and openly. They are taking up very high political, business and traditional leadership positions. It is because they came out of the self-discrimination shell and spoke out without fear. Currently, no one debates the rights of persons with HIV and AIDS conditions when it comes to exercise of their human rights and fundamental freedoms. Their inherent dignity is fully recognised and respected. Consistency and resilience in strategic advocacy is the key!

It all begins within the conscious of the affected. The affected groups referred to above remained conscious of their inherent dignity, human rights and fundamental freedoms. It does not help to remain in a shell for ever. In most African States and language there is a saying which means, “A baby who does not cry dies while in the back carrier of their mother”. This means that if women with disabilities do not aggressively speak out on the promotion and protection of their social, economic, cultural, political and civil rights, they will remain in the margins of society’s development. They will remain being considered instruments of philanthropy. This is not ideal in this era of inclusive development.

It is important that women with disabilities and their representative organisations stand today to look at situation in terms of effective participation and inclusion in sustainable development. This calls for bold stances by a selected group of women with disabilities to identify the real issues that affect them and need to be redressed. This requires a clear analysis of their problems. Without a clear and comprehensive analysis of their problems, women with disabilities may not be able to map a clear strategic advocacy plan for their inclusion in sustainable development. Of course the comprehensive analysis of their problems should include an analysis of their human rights situation in general. This may sound complicated for women with disabilities but there are a lot of organisation of women who have done this. Such organisations are usually willing to work with organisations of women with disabilities. One initial strategy is to network and affiliate themselves to alliances or federations of women organisations like the NGO Coordinating Council (NGOCC) in Zambia. Such networks exist in all African States.

It is also very important that women with disabilities and their representative organisation carry out strategic advocacy capacity assessments. This will help them clarify their organisational position in terms of their strengths, opportunities, weaknesses and threats. This is very essential because it assists in enhancing all the strength the organisations have. It will assist the organisations to ensure that they penetrate and utilize to the maximum all the opportunities existing outside their organisations. For instance, the opportunity for affiliation to women organisation alliances or federations or networks. A capacity assessment process also assists in determining the weaknesses of the women and their representative organisations in terms of their strategic advocacy skills, resource mobilisation skills and the general organisational development matters. Such an assessment for women with disabilities and their representative organisations will help in building the strategic advocacy capacities of their organisations.

Apart from the issues raised above, it is very critical to uphold good governance within the organisation of and for women with disabilities. Good governance means, in simple terms; accountability; transparency; rule of law; equal participation of women and men(despite the organisation being a women organisation); Participation of persons with disabilities who require more intensive support; Participation of children and youths with disabilities; contribution of the elderly persons with disabilities. Inclusion means the participation of persons without disabilities. Obviously, the active participation of women without disabilities would contribute to the effective inclusion of women with disabilities in sustainable development.

This obviously demands that women with disabilities and their representative organisations should reflect on the voices and the legacy of those women who founded the movement of women with disabilities. Apart from reflect on the voices and legacy, they should sound and amplify their voices and legacy today. This amplification of the voices and legacy includes the exercise and dissemination of the messages from the voices and legacy. Furthermore, the women with disabilities of today should transmit and transfer the voices and legacy of the gone women to the future women with disabilities. These are the girls and youths with disabilities. The current crop of women with disabilities should also transmit and transfer their vision to the girls and female youths with disabilities. They should transfer their successes, failures, challenges and opportunities for the future generation of women with disabilities.

Women with disabilities and their representative organisations should try by all means to document the successes of the past and current women with disabilities who have been successful or are currently successful. Their stories should be documented and published with world-wide publicity. This will contribute into motivating the current young crop and future group of women with disabilities. Every successful woman always has a story behind another successful woman who has been their inspiration and motivation. This is very essential among women with disabilities. Currently, this is absent! On the other hand, this is heavily prominent among women without disabilities. A lot of profiles, books, feature and documentaries exist to motivate and inspire girls and young women to be one of the ‘Women in…’ as outlined in my preamble, for instance ‘Women in Law’.

Women with disabilities should now begin to reflect on how they support each other. This requires a deliberate and voluntary effort of any of the women with a disability to pick up the ‘voice-shovel’ and start shoveling her experiences into other women’s minds. This is how revolutions begin! There is need for a revolutionary approach by women with disabilities towards the respect of their inherent dignity and recognition of their human rights and fundamental freedoms. This must be done or else…discrimination continues.

Factually, for the current generation of women with disabilities to transmit and transfer the voices of the past women and their own voices, they need to exhibit clear knowledge of the legal rights of persons with disabilities, and in particular, the rights of women with disabilities.

Girls, youths and women with disabilities should not only wait to be called upon to participate. They should be proactive in terms of visibility at all times. They should be specifically be visible during all  national and international celebrations like the Youth Day; International Labour Day; Africa Freedom Day; Heroes and Unity Day (where are the women heroes with disabilities?); Farmers’ Day (Women with Disabilities in Agriculture); Independence Day (Women with Disabilities in Politics). I still raise the question: where are women with disabilities?

While we debate the issue of multiple-discrimination for girls and women with disabilities, there is the untold story of girls and women with cerebral palsy; girls and women with mental and intellectual disabilities; girls and women with albinism; girls and women with deafblindness and girls with multiple disabilities. Where is their human rights space? Where is the protection of their inherent dignity as human beings? Deliberately, do women leaders with disabilities and the representative organisations really understand this situation. If so, what advocacy action have they been taking.

In my discussion, I have deliberately left out the role of the State in promoting and protecting the rights of women with disabilities. I have also deliberately left out the role of the women movement at large. I again have left out the important role of men. The purpose is simple: I want to engender a sense of strategic advocacy in the women with disabilities.

MENTAL DISORDERS ACT OF ZAMBIA MUST BE DECLARED NULL AND VOID

By Wamundila Waliuya,

Founding President - Disability Rights Watch

Many African countries are currently being governed using laws which were passed during the pre-independence period. Essentially, this means that countries are running using colonial rules and laws. Specifically, many countries have got mental health laws that are archaic. Zambia is not an exception. It has the Mental Disorders Act of 1951.

Thorough perusal of this Act clearly indicates that the law was meant to detain those people suspected of having mental problems in order to keep them away from society. Some observers say that the law was meant for and directed to Africans. The Act is very dehumanizing, demeaning, degrading and discriminatory. It is extremely a bad law when it comes to respect and promotion of human rights. Just from the onset, I feel the Mental Disorders Act of Zambia must, as soon as possible, be declared null and void by the courts of law. This can only be done if a petition is filed to the High Court demanding for the nullification of this old law.

People may ask me why I seem to rush for a petition rather than advocacy for the repealing of the law. All efforts have been done by different organisations working in the field of disability and mental health to have the law repealed but all such efforts stand at still having the law intact and valid. Where strategic advocacy has failed, the last resort is use of litigation. Therefore, strategic litigation in the circumstances of the Mental Disorders Act of Zambia is inevitable.

I know that many people in Africa have not yet embraced the culture of strategic litigation where social advocacy has failed when demanding for the respect, promotion and protection of human rights. It is worse with Disabled People’s Organisations and their members. Strategic litigation should not be viewed as an antagonistic approach to resolving matters of human rights. It works very well when well planned. The goodness of strategic litigation is that it establishes precedent that has an impact on the larger population. Positive rulings from the courts also establish case law that would be used across different jurisdictions. So, strategic litigation seeking the nullification of the Mental Health Act of Zambia is fully justifiable and it must commence! It must commence now!

What is the justification for this petition? The Mental Disorders Act is Cap 305 of the laws of Zambia. Therefore, it must comply with the provisions of the Constitution of Zambia. But, when you read the Act, it is explicitly violating the rights and fundamental freedoms of persons with mental disabilities. What quickly comes to the fore of my mind is how the Act describes persons with mental disabilities. It explicitly describes them as “idiot”, “imbecile”, “feeble-minded” and “moral imbecile”. Really, does such a law deserve space in a democratic country like Zambia which stands to promote human rights and dignity?

In carrying such derogative terminology, the Mental Disorders Act directly discriminates against persons with mental disabilities. Such descriptions violate the inherent dignity of persons with mental disabilities. The language is derogative and degrading in nature and perpetuates discrimination against them. Society naturally believes in what is written in law. So, society will believe in the use of the same language because it is legal. It is written in law and anyone who uses such descriptions against persons with mental disabilities is protected by law. I feel this should not be allowed. This can only be stopped by having the Mental Disorders Act declared null and void by the courts of law. A petition needs to be quickly filed demanding for the nullification!

Perusing through the Mental Disorders Act of Zambia, I find more violations. The Mental Disorders Act provides for the detention of persons with mental disabilities on suspicion of their mental disabilities. The law has established designated detention places or prisons where such persons with mental disabilities must be detained. This clearly violates the right to liberty and protection of the law of persons with mental disabilities. Furthermore, the Act gives extensive powers to the Police and members of the community to arrest and detain persons with mental disabilities without due regard to their right to liberty, legal capacity, and respect to constitutional protection of law. It is because of these provisions that persons with mental disabilities continue to suffer chaining, locking and detention. Persons with mental disabilities feel insecure in their own country. Anyone can call for their detention and the law allows this. Is this acceptable in this era? No! The Act must be declared null and void without delay.

The Constitution of Zambia, in its Bill of Rights provides for a wide range of protection of rights and fundamental freedoms. This includes protection from discrimination and protection of liberty and security of person. The Persons with Disabilities Act of Zambia also provides for the right to enjoy legal capacity in its section 8. It also prohibits discrimination on the basis of disability. Section 3 of the Persons with Disabilities Act of 2012 provides for the supremacy of the Act on all matters related to disability rights. It therefore, repeals the Mental Disorders Act. The Persons with Disabilities Act therefore prevails over the Mental Disorders Act. I therefore remain wondering why the law is still valid and being actively used. The law must not exist. It is an invalid law. But, it can only become invalid if the courts declare so. So, a petition should be filed immediately demanding for its invalidity and nullification. The time is now!

It should be noted that Zambia ratified the United Convention on the Rights of Persons with Disabilities (UNCRPD) in 2010. The Government of the Republic of Zambia further domesticated the UNCRPD through the enactment of the Persons with Disabilities of 2012. Therefore, the State has the obligation to abide by the provisions of the UNCRPD and its domestication law, which are the Persons with Disabilities Act of 2012.

The UNCRPD provides for the right to enjoy and exercise legal capacity on an equal basis with other persons in all aspects of life in its Article 12. This Article has been domesticated by section 8 of the Persons with Disabilities. This means that legal capacity for persons with mental disabilities is both internationally and domestically binding. With the persuasion of the UNCRPD together with the binding previsions of the Persons with Disabilities Act of 2012 and the Constitution of Zambia, the Mental Disorders Act of 1951 is found discriminatory; inconsistent with the Constitution of Zambia; inconsistent with the Persons with Disabilities Act of 2012. The Mental Disorders Act is inconsistent with international human rights standards. It is not compliant to the provisions of the UNCRPD. In view of this analysis, I am of the unreserved view that the Act must be declared null and void. This declaration of the Act being invalid and void should be done through an urgent petition to the High Court of Zambia.

30^th January, 2017.

Wamundila Waliuya

Promoting Psychological First aid to Reduce Psycho-social Problems

Mental Health Day

10^th October, 2016.

Promoting Psychological First aid to Reduce Psycho-social Problems

I realize that in many instances people have ignored the psycho-social conditions they find themselves in which they could lead to critical mental health problems. Almost everyone sometimes find themselves in stressful psycho-social situations. In many circumstances, they treat such situations lightly when they could be grave. In my many years of working around mental health rights and mental health law in Southern Africa I have interacted with persons with psycho-social disabilities, mental health practitioners, human rights activists around mental health and the rights of mental health users and of course public health policy makers. It is in view of this that my interest to contribute towards the development of quality mental health services that are comprehensive in nature, but at the same time sustainable and community-based. I write this article as a contribution to the Mental Health Day which falls on 10^th October, 2016. The theme of the Mental Health Day in 2016 is around “psychological first aid”.

World Mental Health Day is observed on 10 October every year, with the overall objective of raising awareness of mental health issues around the world and mobilizing efforts in support of mental health.

Just as a way of engendering critical introspection, I present the following simple questions: have you ever witnessed a fatal road traffic accident which affected your thought and psychological state for some time? Have you ever felt hopeless and neglected after a divorce and just break-off of a sexual relationship? Have you ever been overwhelmed by debt, but at the same time totally moneyless, while your family is all looking at you to provide? Have you ever felt abused and exploited by your spouse, but have remained silent with a ‘hot burning heart’? In general, have you ever found yourself in a stressful, frustrating and almost depressing situation where you thought suicide was a best solution? Have you felt lost, anxious and lonely when you have not taken any form of alcoholic or drug substance? Have you ever found yourself in situations when your sexual drive is overwhelming and you simply needed to find any other means of sexual relief and that this has been consistent? While on duty as a health professional, have you ever found yourself stressed or depressed by the death of any patient you needed to save and tie that to your failure? I may sound too simplistic but I am real!

I just gained interest in suicide cases in the Southern African countries and discovered that there are an increasing number of attempted and completed cases of suicide. I have been asking myself – why this increase in reported cases? My humble unverified opinion is that there is an absence of psycho-social services; inadequate policies and legislation on mental health; absence of suicide prevention strategies; absence of psychological breakdown and crisis management strategies; inadequate awareness raising on psychosocial conditions. I tend to realize that I understated the issue of strategies, policy, legislation and programmes. The true picture in Southern Africa is that there is absence of policy and legislation to promote psycho-social services and the protection of persons who are mental health users or survivors of psychiatry services of survivors of suicide. Worse still, countries do not have psycho-social strategies to capture community and individual level stress, trauma  and depression related conditions. This is in form of early identification and intervention of psycho-social problems. This is why there are high occurrences of suicide attempts and suicide. In view of this, I fully endorse the theme “psychological first aid”.

In my interaction with mental health professionals, activists and of course literature, I came across a concept called “psychological first aid”. From my own understanding of this concept, when providing any form of first aid, psychological first aid should be integrated. My opinion on this is psychological first aid is supposed to be provided to everyone found in a stressful condition after a traumatic or near to traumatic condition. For instance, when a motor vehicle has hit a pedestrian who as a result dies on the spot, there is need for psychological first aid for the person who was with the victim of the accident; there is need for psychological first aid for the driver who hit the person; and maybe psychological first aid for those who directly witnessed the accident. In many instance those who witness fatal road traffic accident normally describe the blood they have seen. This is both psychological and social. It is also cultural in most of the Southern African countries. The sight of a bleeding person causes stress!

I am deliberately narrowing the issue of psycho-social problems to a level where society have not yet explored. This is for the purpose of triggering thought to ensure individuals, communities, NGOs, State agencies, the private sector and international community start thinking of prevention of psycho-social problems. Apart from prevention, there is need for everyone to mitigate the occurrence of psycho-social problems in the community. I wish to be clear here that when I refer to the community, I mean a multi-sectoral or multi-disciplinary approach to community mental health services. While advocating for such community mental health based services, I would like to strictly emphasise the need for the full and effective participation of the directly affected. The persons who are directly affected are those with psycho-social disabilities. It is simply essential that they effectively participate in decision making towards development of regional, national and community protocols, legislation, policies and strategies on prevention, care and rehabilitation of psycho-social problems and persons affected by psycho-social problems respectively.

In Southern Africa, research has clearly indicated that many family and communities usually seek the intervention of traditional healers before they visit mental health institutions. This is where the awareness and knowledge on mental health conditions is crucially critical. Elderly persons with dementia are usually associated with witchcraft. This is because communities do not understand the causes and effects of psycho-social problems. This has led to a lot of stigma in diagnosis, care and community based rehabilitation. It has further led to denying persons with dementia and of course, those with psycho-social problems, and of course those with intellectual disabilities from enjoying and exercising the right to legal capacity.

Apart from the issue of the elderly persons, there is an increase of young women murdering, dumping or rejecting born infants on grounds not clear even to them; but usually as a result of rape, inability to support the child, fear of condemnation and many unexplained thoughts. Many of such young ladies have lived with traumatizing situations which communities and families have ignored. Communities and families need to be educated on matters of early identification of psycho-social problems in order to initiate psychological first aid at the right time.

In my own view, the need for psychological first aid needs to begin with the recognition of the person with a psycho-social disability as a person. Secondly, that such a person is recognised and should be protected as a person under the law. Furthermore, and key that all persons with mental problems are full and recognizable member of the family and community: and that they contribute effectively to community, national or regional development.

Countries in Southern Africa should endeavour to ensure the following:

1.     Development of policy and strategies that will address the issue of psychological first aid in their main mental health policies, legislation, programmes and strategies. Such measures should be clear on indicators and targets that will be effectively used to review implementation, progress and impact.

2.     Ensure all policies, legislation, programmes and strategies are in line with universal health coverage taking into consideration all forms of mental health issues affecting the children, youths, women, persons with disabilities, the elderly and those living in extreme humanitarian situations like internally displaced persons, refugees and migrants in general.

3.     World Health Organisation should ensure States or governments adopt the principles of psychological first aid, and that they incorporate them into their National Development Plans, policies, legislation, programmes and strategies. The WHO should ensure that it compels the State Parties to the WHO General Assembly to provide progress reports on implementation.

4.     Governments should ensure that persons with psycho-social problems have their human rights recognised, enjoyed and exercised on an equal basis with the rest of society.

5.     Governments should ensure that they recognise and support organisations or networks of persons with psycho-social problems.

6.     Governments should ensure that scientific research is carried on all aspects of psycho-social conditions including prevention, care, support and treatment.

7.     Governments, recognising that women may be disproportionately affected by psycho-social problems, both as directly affected or as carers, efforts to develop and implement public health responses towards psycho-social problems must be gender sensitive.

In view of all the above, deliberate efforts should be put in place to ensure a multi-disciplinary approach is taken towards achieving sustainable measures for psychological first aid. Efforts should further be made to ensure that the psychological first aid, is, whether deemed necessary, culminated into sustainable, medium or long term measures to provide psycho-social support.

 Wamundila Waliuya,

Executive President,

Disability Rights Watch.

October, 2016.