By JECKONIA OTIENO
Kenya: When Client Mary gave birth to twins at the Nairobi Women’s Hospital recently, she became part of the growing number of abused mentally-challenged mothers. Her children may never know their father since their mother was a victim of several months of sexual abuse by different men.
The UN Convention on the rights of people with disability notes that women and girls with disabilities are particularly vulnerable to sexual abuse.? About 25 per cent of women with intellectual disabilities have been raped and six per cent forcibly sterilised.
The Kenya Society for the Mentally Handicapped puts the number of mentally challenged people in Kenya at 3.6 million.?
Mary is one of these people. Apart from these twins, she has three older children all whom she got from her previous marriage to a man in Limuru before her mental health took a turn for worse.
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She was then thrown out of her matrimonial home where her children now live with their grandmother.
Mary’s case brings out a complicated web of linked issues affecting women with mental challenges; their social life, violence against women, sexually transmitted infections, including HIV and Aids, and maternal health.
According to the Gender Violence Recovery Centre’s (GVRC) report for 2011/2012, there were 1,126 cases of violence against women reported within 12 months at a time when 1,167 girls were violated.
Grace Wangechi, the executive director of GVRC, says there are more cases of violence which go unreported.
“Some of these cases are like this one that we are now handling. Client Mary (name coined up to protect her identity) has endured months of sexual abuse,” says Wangechi.
From the increased number of survivors whose cases are reported, there are two possibilities; either more people are coming out to speak about violence meted out on them or the numbers are generally increasing.
Between 2001 and 2003 there were only 326 reported cases of gender-based violence, but nine years later, this number has grown almost 10 fold to 2,954.
Cases involving mentally challenged women have not been properly documented owing to societal attitudes which in most instances regard people with mental problems as a curse to their families.
“Since they are regarded as a bad omen, it is quite difficult for those who mind them to report any violence that these women may experience,” says Wangechi.
Going by these statistics, it is quite probable that cases of sexual violence against women with mental challenges has also gone up.
About 86 per cent of reported cases are sexual, while the remaining cases involve physical violence. Therefore, Wangechi says, women with mental problems are likely to suffer more sexual violence than physical violence.
Mary’s case falls in the group of cases where perpetrators of violence are unknown. But it becomes more intricate since it is not clear how many men took advantage of her situation to rape her.
GVRC documents that in the last two years alone, 1,897 perpetrators were known to their victims, 328 were known but not mentioned by their victims, while 729 were unknown to their victims.
Low income areas lead in violence cases. In Nairobi, there were 1,284 reported cases in the slums as compared to? 661 in middle income areas, with 215 being recorded in up market areas.
HIV and Aids is also an issue in cases involving women with mental problems. Since there may be no means of quick response to instances of violence, the risk of sexually transmitted infections is higher for these women.
Prof Alloys Orago, the director of the National Aids Control Council, says people living with mental disabilities are more vulnerable to abuse, therefore, intervention programmes should be better funded.
“It is unfortunate that we started funding these needs late, only in 2008, but we deal with groups which reach these special needs,” says Prof Orago.
The United Nations Population Fund (UNFPA) notes that about 800 women die daily due to pregnancy or childbirth-related complications.
Evidence further suggests that infants whose mothers die are more likely to die before their second birthday. This places children whose mothers are mentally challenged and neglected in a perilous position.
The UN agency says 90 per cent of women who die during pregnancy live in Africa and Asia —they die from severe bleeding, infections, eclampsia, obstructed labour as well as unsafe abortions.
The director of reproductive health services at Kenyatta National Hospital, Dr John Ong’ech, says special attention needs to be given to maternal health for mentally challenged patients.
“Most of the cases that we deal with border on abuse of these women with special needs; they need special care which is different from normal people,” he says.
Nurses and minders who handle these patients also require specialised training. But these interventions can only be pushed at a government policy level.
Nairobi County Women’s Representative Rachel Shebesh notes that there needs to be legislation that will ensure the needs of such women are taken care of.
She is saddened that it took the intervention of a Good Samaritan to bring Mary to hospital.
“It is sad that it took a good neighbour, and not the government, to bring this 37-year-old lady to hospital to deliver safely,” she says.
“But the question should be how many are out there who still cannot access such services as Mary here.”
Shebesh says she will push for a Mental Health Bill once the National Assembly gets down to business, and adds that people with mental health problems should not be stigmatised.
She rues the fact that like Mary, many more mentally challenged people who are unaccounted for are out there facing violence and abuse.
A Nairobi philanthropist, Susan Mboya, says that a number of crosscutting issues need to be addressed to ensure that mentally challenged people are safe.
Improving security is one of the most immediate challenges, says Mboya, wife of Nairobi governor Evans Kidero.
The lack of proper medical facilities is also a major problem in Nairobi.
However, the restoration of 60 health facilities in Nairobi County has started. This is expected to ease the pressure on Kenyatta National Hospital.
Mentally challenged women are susceptible to infections from the numerous sexual partners who take advantage of them, says Wangechi.
So for them, life is a double tragedy.