Every step is a struggle
Low-rise urinals with grab bars. Doors with lever-action locks. Bright colour-bands on edges of stairs. Ramps with the right slope. This is part of the wish list for making access in hospitals easy for people with disabilities.
But are these things really necessary, and is it even practically and financially possible to provide them in hospitals?
“We are not demanding something special and impossible,” shoots back Anjlee Agarwal, consultant at Samarthyam, an NGO working to provide accessible environments for the disabled.
“As per Article 9 of the United Nations Convention on the Rights of People with Disabilities, India is obligated to provide architecturally accessible buildings for the disabled. India should not have signed it if it was not possible,” says Agarwal, a wheelchair user herself.
According to the 2001 Census, 2.1 per cent of Indians are facing some kind of disability. And right from architectural barriers in hospital buildings to inaccessible medical equipment, from insensitive doctors to negligent authorities, access to healthcare facilities for this huge invisible population in the capital is abysmally difficult.
“It is a myth that design in hospitals costs a lot of money. If planning and strategising is done at the blueprint stage of a construction, the extra cost is 0.1 per cent. Even if modifications are done after construction, the expenditure goes up by just two per cent,” says Agarwal, adding that the suggested incorporations can be made at least in phases. “But over the last six-seven years, despite us providing the access audits, they have done nothing.”
Agarwal says the government washes off its hands by just providing ramps at the entrance of hospitals and some other areas of the hospital.
“One of my colleagues was at Deen Dayal Upadhyay hospital a few years ago to conduct an access audit. Even while he was being wheeled inside, his wheelchair tilted and he fell. In the name of ramps, rocket launchers are provided at the hospital,” she says.
An accessible hospital is not just about entering the building. Disabled persons should also be able to exit it with their dignity intact, with the hospital caring about their safety and convenience.
Agarwal says the architectural changes are also necessary because they will benefit the whole population one day or the other. “Everyone is going to age. Everyone is going to be disabled someday,” she says.
While the lack of empathy comes as no surprise in government hospitals, the private hospitals, despite being marginally better, too fall short.
Dr Satendra Singh, coordinator of the enabling unit at University College of Medical Sciences (UCMS), says a leading private hospital in the city he visited recently appeared to be totally accessible till he went to its ICU lobby and auditorium, which had just stairs and no ramps.
“I lodged a complaint and the hospital authorities were quick to look into the matter and conduct an access audit there. But such a response is unthinkable from a government hospital,” says Singh, who suffers from a disability.
In fact, not just the multi-speciality hospitals, even basic facilities like pathology labs are inaccessible.
“Have you ever seen a pathology lab with ramps? Most of them are located in the basement or on an elevated platform. In either case, there are only stairs available,” says Agarwal. This discourages the disabled from approaching such centres – and they shell out extra money to have the tests done at home and the reports delivered.
The medical equipment is not designed keeping the disabled in mind either. No hospital in Delhi, whether public or private, has a mammography machine which can examine a patient sitting on a wheelchair.
“I called a super-speciality hospital in the city and asked them if their mammography machine is designed for women using wheelchairs. They replied in the negative and said that their staff would lift me and get me examined,” says Abha Khetarpal, founder of Cross the Hurdles, an NGO working for the disabled.
“It is embarrassing for us. We have our dignity,” she adds.
Even machines as basic as a weighing machine are not designed for the disabled.
“Barring the Indian Spinal Injuries Centre, no other hospital in Delhi has a weighing
machine that can be used by a person on wheelchair. This means a disabled person can never check their weight,” says Agarwal.
Even the dentist's chairs are not designed to suit people with disabilities, she says.
Khetarpal says it takes very little effort to install hydraulic chairs which can be adjusted.
“A little bit of empathy could make life so much easier for us and make us feel normal.”
Further highlighting the attitudinal barriers, she says doctors in the city do not even recommend the papanicolaou test for cervical cancer for women with disabilities. “Disabled females are seen as asexual creatures.”
Even education institutes are not barrier-free for the disabled. Dr Satendra Singh says inaccessible libraries, lecture halls and hospital campuses dissuade people with disabilities from taking admission in medical colleges despite the three per cent reservations for them.
Singh was relentless in his pursuit for accessible facilities for the disabled in medical institutions and hospitals. He advocated this to the Central government's Chief Commissioner for Persons with Disabilities.
The chief commissioner in turn sent reminders to the Medical Council of India (MCI) which dashed off letters to all medical colleges to submit compliance reports on this.
“It came as little success because though the MCI found the issue important, it did not make it mandatory for the institutes to provide accessible facilities for the disabled. Unless it is made compulsory, we are not going to see much change,” says Singh.
Since the government provides financial assistance under Scheme for Implementation of Persons with Disabilities Act, there should be no excuse for government medical colleges not to make their campus barrier-free, he adds.
Despite the scheme offering up to Rs 50,000 to every institute for accessible buildings and up to Rs 15 lakh for making their websites accessible for the visually challenged and the hearing-impaired, not too many medical institutes have applied for it for over a year.
“This has also happened because people with disabilities themselves have not raised their voice and do not know about the prevailing schemes which they can benefit from,” says Singh.
The absence of many people with disabilities in access audit teams too is hampering the creation of an accessible environment. Agarwal says only a person with disability will know what is lacking in hospital buildings. Nothing less than proper representation on them of the disabled people will help improve the situation.