Sexual and reproductive rights of women with disabilities are neglected in shelters

25 March 2021

The sexual and reproductive rights of girls and women with disabilities in residential care are often neglected or even denied.

The sexual and reproductive rights of girls and women with disabilities in residential care are often neglected or even denied. Many of them have no knowledge of minimum life skills and would not be able to provide for themselves independently. These are the findings of a 2020 report by the Institute for Human Rights in Moldova (IDOM). The warnings come as Moldova has pledged to deinstitutionalise around a thousand people with intellectual and psychosocial disabilities by 2026. Once in the community, these beneficiaries should have the capacity to live independently, including being able to start a family. In the absence of sexual and reproductive health education, these people may find it difficult to adapt once they leave care. The study by the Institute for Human Rights in Moldova highlighted the critical situations in residential institutions and psychiatric hospitals in our country. The author of the research, lawyer Doina Ioana Străisteanu, found that women and girls in temporary placement centres for people with disabilities lack the necessary knowledge about their sexual and reproductive health. "They are not taught how to use contraceptives and often suffer consequences after taking them. Similarly, they don't know how to carry a menstrual calendar. Hygiene products for women are kept at the medical sisters and are issued on request. Medical staff in these institutions are not sufficiently trained on sexual and reproductive rights, stereotypical attitudes prevail that women with disabilities do not need sexual and reproductive education because they do not have sex, which is wrong. There are also prejudices about their ability to be parents," says the lawyer. Deinstitutionalisation also involves empowerment with life skills In 2018, the Moldovan government approved the National Programme for the deinstitutionalisation of people with intellectual and psychosocial disabilities in residential institutions managed by the National Social Assistance Agency (ANAS) for 2018-2026. According to this programme, by 2026, more than a thousand beneficiaries are expected to leave residential homes and end up in communities. The programme envisages reforming the residential care system for beneficiaries by developing community social services and ensuring the right to independent living in the community for these people. "To deinstitutionalize means to return people to society, including providing them with housing, employment and minimum life skills. A lot of people in these centres don't know how to count, they can't read, they can't manage their money, because they don't learn anything there. Minimum life skills include knowledge about your body. For a woman, and still with disabilities, it is even harder. She needs to know her own body, how to protect herself, how to enter a relationship and be safe, but also how to decide whether she wants children or not, etc.", says Doina Ioana Străisteanu. For his part, human rights expert Dumitru Russu, programme coordinator at IDOM, points out that by ratifying the UN Convention on the Rights of Persons with Disabilities, the Republic of Moldova has committed itself to ensuring access to health services for people with disabilities. "There is a need for strategic measures that would anticipate the problems and risks to which these people will be exposed after deinstitutionalisation. Beneficiaries as well as employees of these centres need to be trained on the sexual and reproductive rights and responsibilities, including parenthood, of people with disabilities. Similarly, professional socio-medical services must be developed. The state must guarantee respect for human rights and international standards in this area. Last but not least, information campaigns are needed to reduce stereotypes about people with disabilities," says the expert. By ratifying the UN Convention in 2010, our country undertook to ensure equal access to health services for people with disabilities, including sexual and reproductive health services based on informed and freely expressed consent. The Convention protects the rights of persons with disabilities to non-discrimination within the family, in marriage, in partnership and in the parent-child relationship. The IDOM report and recommendations were submitted to the Ministry of Health, Labour and Social Protection and the National Social Assistance Agency, which is responsible for implementing the National Deinstitutionalisation Programme. Irina Banova, director of ANAS, confirms that she has seen the report's conclusions, but gives assurances that the authorities are making an effort to educate these categories of people. She says there are no deviations from the de-institutionalisation programme approved by the government. "It is good that we are being shown where we have certain problems and what steps need to be taken to improve the quality of services in residential institutions. And if there are such problems, we will solve them", Irina Banova told us. According to her, 167 people were deinstitutionalised last year. Alina was born with infantile cerebral palsy and uses a wheelchair. She came to the Balti placement centre in 2004 on her own initiative, where she met Nichita, the man with whom she started a family, a few years later. In 2017, she became pregnant and decided to leave the placement centre. They now live in their house in Alina's home village, Hăsnășenii Mari, Drochia district, got married and have two children. The young people were helped by the Keystone Moldova Association to prepare the paperwork for deinstitutionalisation and living in the community. Alina says she feels very well with her husband and children. "The child has to stay with mom and dad, that's why we decided to move in together. At first we were afraid that we wouldn't make it, but now we're doing it all. I cook by myself, I wash, I look after the children and my husband helps me. I am independent and can decide for myself. I urge women with disabilities to be brave and not be afraid to leave the shelters. Once you get out, you become more responsible and independent," says Alina. There are six residential institutions in Moldova, managed by ANAS: four temporary placement centres for adults with disabilities, located in Balti municipality, Cocieri commune in Dubasari district, Bădiceni commune in Soroca district and Brânzeni village in Edineț district, and two temporary placement centres for children with disabilities, located in Orhei (for boys) and Hâncești (for girls). As of 1 January 2021, there were more than 1800 people with intellectual and psychosocial disabilities in these institutions, including 30 girls up to the age of 18 and 852 women over the age of 18. Mariana Jacot, Independent Press Association