ARMENIA: DISABLED WOMEN STRUGGLE TO ACCESS ANTENATAL SERVICES
Institute for War and Peace Reporting, UK
IWPR Caucasus Reporting #695
July 23 2013
Healthcare infrastructure not equipped for expectant mothers with
mobility difficulties.
By Gayane Lazarian – Caucasus
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.
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.
“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.”
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