Double disability - physically handicapped and female

Every morning is a strain for Awa as passengers help to hoist her wheelchair and then herself into one of the multi-coloured mini-buses that ply the dusty roads of the Senegalese capital. Skinny Awa, who is in her mid-20s, lost the use of her legs due to a badly delivered injection in childhood. Every day she takes a long ride in a rickety and overcrowded bus to go begging in downtown Dakar, with her one-year-old daughter sitting on her lap. Senegal has at least 200,000 physically disabled people among its population of 10 million, according to non-governmental organisation Handicap International (HI), although some experts believe there may be five times as many. Awa's husband is also confined to a wheelchair. But while he stays at home, she rolls from one car to another, pleading for a few coins. Awa says the pittance she earns by begging from car drivers held up in heavy traffic is always “insufficient to feed the children”. When Mariam lost the use of her legs after giving birth to her third child, she was afraid that she too would have to beg for a living. However, she manages to make a modest living from selling vegetables at a roadside stall in one of Dakar's up and coming residential neighbourhoods. “My husband supports me and my family help me in my daily tasks,” said Mariam, who is still able to walk with the help of crutches, but finds it increasingly difficult to do so. “I’m very lucky, thank God. I wouldn’t have wanted to be like those women begging in the street," she told IRIN. Miriam's daughter, who is 10, provides precious support, running for change when needed, as her mother chats with customers and weighs up tomatoes. Double disability “Physically handicapped women face a double disability - they are women and they are physically handicapped,” said Dague Gueye Ndeye, an assertive middle-aged woman who heads the women's section of the National Association of Physically Handicapped People of Senegal (ANHMS). Ndeye said handicapped women face greater social stigma than their male counterparts. "Women suffer greater prejudice," she told IRIN Ndeye, who has a degree in education, knows all about that. She suffered polio as a girl and is now forced to hobble around on crutches. She pointed out that handicapped women often struggle to get an education and find a marriage partner. And those that do marry face greater dangers and difficulties in childbirth. Ndeye, who has two children of her own, noted that many physically handicapped women require extra prenatal care and must give birth by caesarean section, an operation that frightens many expectant mothers. And since children are central to the idea of marriage in Senegal, the common belief that a disabled woman cannot deliver a healthy baby repels potential husbands, she added. But Ndeye's difficulties have not stopped her from fighting for the rights of other handicapped women The women's section of ANHMS was set up in 1998 and now operates a special training centre in Dakar, where an increasing number of handicapped women learn skills that will ultimately give them a job and financial independence. Kept away from school The stigmatisation of the handicapped in Senegal starts in early childhood and often plagues an individual for life. “Parents here are ashamed to give birth to a handicapped child. They often believe it is the result of a bad spell being cast upon them,” said Pape Assenbeye, a social worker for Handicap International, one of the few NGOs to provide services for the disabled in Senegal. All too often, Assenbeye said, children with disabilities are kept at home, away from community life, and are prevented from attending school. According to UNICEF, the literacy rate in Senegal is 47 percent for men and 28 percent for women, reflecting the fact that parents often prefer to send their sons to school, while keeping their daughters at home to help with the housework. This gender imbalance makes life especially difficult for handicapped girls. Haram Diakhate, for example, was lame from birth. As a result she spent most of her childhood and teenage years at home doing the housework while her siblings went to school. “I couldn’t follow the other kids because I was handicapped,” she said. But now Diakhate, 23, is learning how to sew and make traditional batik cloth at the training centre established by the women's section of ANHMS. On the ground floor of the building in a vibrant working-class neighbourhood of Dakar is a member-run internet café. And soon, women in the area will be able to pretty up at a beauty salon run by a group of handicapped women. “If they help the family they become autonomous and don’t feel the handicap,” said Ndeye. “One shouldn’t live as an outsider. We must open up so that our problems become every woman’s concern.” Condemned to beg HI’s medical consultant, Jean-Louis Ndiaye, said it was vital to ensure that handicapped children go to school, just like other kids. “In an underprivileged milieu where education is a sacrifice for the entire family, parents will most of the time focus all of their limited resources on the healthy child,” he told IRIN “But no basic education means no diplomas and later no work. So begging ends up being the only solution for the handicapped.” In this 95 percent Muslim nation, where charity is a duty recommended by the Koran, the public supports begging. Many of the beggars who work Dakar’s roundabouts and intersections find that the activity pays well enough to be worth the effort and the deluge of abuse that it often brings. “Women are insulted and called names. It takes courage to beg,” said Coudia Seck, who was paralysed by an accident at work. But behind the struggle to physically survive is the fight within, said HI consultant Ndiaye. “What I have realized as a doctor is that they are estranged to themselves,” he said. “They do not fully understand what is happening to them, what they are feeling.” Botched injections, accidents and heart disease For many years, poliomyelitis was the main cause of people losing the use of their legs in Senegal. The illness generally struck during childhood and many of its victims ended up as beggars. Vaccination campaigns have successfully got rid of polio. However, a host of new problems, notably poorly administered injections, accidents at work and on the road and heart disease, contiue to swell the ranks of the lame and the crippled. “Polio was officially eradicated in Senegal in 2003, yet I have never seen so many people in such a poor state,” said polio specialist Olivier Dizien. According to the UN World Health Organisation (WHO), badly delivered intra-muscular injections became the main reason for children in Sub-Saharan Africa suffering problems with their legs in the 1980s and the 1990s. Poor sterilisation, the use of expired medicines and faulty injection techniques were all responsible. The good news is that the introduction of more vaccines, which can be taken orally in the form of drops or tablets, has helped to contain this problem. Dizien said that nowadays “an increasing number of people lose their mobility in road accidents or due to heart failure.” Ndeye admits that her association for handicapped people has only managed to scratch the surface of the problem. "Prejudices remain. There is still a lot to do," she said.