Reproductive health and the fight against GBV in Senegal: Sokhna’s campaign for the inclusion of people with disabilities
Gender-based violence (GBV), which is of concern in the Senegalese context, takes on an even more alarming dimension when it affects adolescent girls living with disabilities. Often relegated to the margins of society, these young girls face physical and emotional obstacles, which are further exacerbated by the weight of socio-cultural norms that hinder their access to adequate reproductive health services.
In the cool of a Saturday morning in Thiès, Senegal, the rising sun bathes the earth in its golden light, illuminating the dust that rises in the shadow of a small house. The resilient spirit of its residents is palpable. Among them is Sokhna Mbène Dianka. Suffering from an illness since the age of nine, she understands that her life journey would be out of the ordinary. “The world wanted me to be just a shadow, but I decided to be a light,” she revealed years later.
In Senegal, access to information and services for adolescent reproductive health (ARH) is a significant challenge. It is even more so for people living with disabilities, who often face discrimination, stigmatization and marginalization. Many obstacles stand in their way, including a lack of disability-friendly facilities in health centres, a shortage of communication supports for those with hearing or visual impairments and insufficient skilled health professionals to meet their specific needs.
These barriers are exacerbated by certain socio-cultural norms, rooted in traditional perceptions which still tend to marginalize or stigmatize adolescents living with different abilities. This has the effect of depriving them of sexuality education and limiting their access to essential reproductive health services. The complex dynamics between age, gender and disability also influence the approach to this issue.
Once stigmatized and marginalized due to her physical disability, Sokhna today fights against these prejudices and discriminatory practices to prove that change is possible and urgently needed.
Beyond disability: a double vulnerability
According to the UN, children and adolescents living with disabilities are three to four times more likely to experience physical and sexual violence and neglect than children without disabilities. And the Special Rapporteur on the Rights of Persons with Disabilities warns, “ … the risk is systematically higher in the case of deaf, blind and autistic girls, girls with psycho-social and intellectual disabilities, and girls with multiple disabilities.”
Access to health centres is often complicated for adolescent girls living with disabilities because of the distance to the centres and the lack of suitable and affordable means of transport. Additionally, most of these centres are not equipped, for example, with ramps for people with reduced mobility or Braille resources for the visually impaired. This further restricts the possibility of receiving appropriate care in complete confidentiality for adolescent girls living with disabilities.
The obstacles Sokhna faced throughout her life reflect the daily trials of many adolescent girls living with disabilities. “When we talk about reproductive health, the rights of adolescents with disabilities to reproductive health are neither respected, nor protected, nor guaranteed,” laments Sokhna.
In Senegal, a study by the African Child Policy Forum reveals that in some cases, stigma stemming from socio-cultural norms has pushed some families to hide their children living with disabilities or exclude them from formal education and life in the community. The myths and misinformation about the sexuality of adolescent girls living with disabilities call for concrete action based on evidence about how to remedy this injustice.
The response to exclusion
Sokhna began her fight at the Mamadou Dia school in Thiès which, like most schools, is poorly adapted to the needs of students with disabilities. Transforming rejection and stigma into a momentum for change, she was able to mobilize her peers to combat the exclusions suffered by children with disabilities.
Determined, Sokhna insists, “We are not asking for pity, but equity of opportunity, to take care of our health and well-being. Reproductive health education and services must be accessible to all, regardless of our disability.”
There is now a pressing need for data and programmatic approaches to understand the scale of this problem and respond effectively. It is in this context that the “Better reproductive health for adolescent girls in Senegal” (ADOS) program, supported by IDRC and Global Affairs Canada (GAC), has initiated the beginning of a palpable change.
Focused on strengthening the capacities of adolescents to claim their rights to better reproductive health, raising awareness among political decision-makers of their needs and the fight against GBV, ADOS aims to make evidence available on the interactions between ARH and GBV. This helps to influence the decision-making process and the implementation of specific policies and programs regarding ARH and the protection of adolescent girls.
The program also provided training for health professionals on the importance of an inclusive approach. This makes them more sensitive in considering the specific needs of adolescent girls with disabilities. Thus, rather than limiting itself to the simple provision of services, ADOS actively works to deconstruct the stereotypes associated with the reproductive health of vulnerable people.
A voice for change
“Every individual, whether they have a disability or not, has the right to information, protection and dignity in matters of reproductive health,” insists Sokhna. ADOS is committed to the Youth, Population and Development Network of Senegal (RESOPOPDEV) — which aims to facilitate access to reproductive health services, education, training, youth leadership as well as entrepreneurship as an alternative solution to migration — and it has been strengthened thanks to the relationship between the two organizations.
Indeed, the visibility offered by the program has made it possible to amplify the voices of adolescents and raise their advocacy to a higher level. Sokhna, for her part, is increasing her inspiring interventions in the media and meetings with political decision-makers and health professionals with a view to promoting this cause. Awareness campaigns, carried out in collaboration with local partners, have also played a crucial role in increasing recognition of the rights of people with disabilities to adequate reproductive health.
Additionally, ADOS served as a catalyst for the transformation of a once-marginalized girl into an influential leader for the cause of those whose reproductive health rights are violated. The Program provided opportunities and platforms for her to share her story and advocate for inclusion. Today, Sokhna and her peers are no longer mere spectators; they have become actors in their own change.
They advocate for a downward trend in GBV and the integration of program results into the formulation of public accessibility policies, particularly at the local level. The ultimate outcome would be increased availability of ARH services as well as the provision of health infrastructure adapted to the needs of people living with disabilities in educational establishments.
Toward a more inclusive society
Sokhna's strong commitment highlights the essential challenges relating to GBV and the reproductive health of adolescents with disabilities. However, beyond access to health services, she leads a fight for fundamental rights, dignity and equity for all.
“I dream of a Senegal where the presence of a disability does not build walls but encourages each of us to build bridges towards inclusion in access to reproductive health services,” Sokhna declares in emphasizing the need for universal accessibility. Her vision reminds us that these issues, too often relegated to the background, deserve awareness and concrete action.
Thanks to the support of IDRC and GAC, RESOPOPDEV has carried out remarkable work in the field. In particular, it played a key role in the transformation of social norms in Senegal, while increasing public awareness of these issues. The significant changes initiated by ADOS are undeniable. The ultimate objective remains: to guarantee every individual, regardless of their disability, equitable access to quality reproductive health services and to strengthen protection against GBV.