Invisible Bruises: How Systems Continue to Fail Women with Disabilities in Kenya

When Josephine Mwende walked into a hospital in search of help during labour, all she expected was basic decency and medical care.

What she received instead was rejection and humiliation, a stark reminder of the prejudice that continues to shadow women with disabilities in Kenya.

“My pregnancy journey was very peaceful, with no challenges, until the day of delivery,” she recalls. “I went from one hospital to another, but none would admit me. At the second hospital, a female health worker looked at me and said, ‘We don’t handle such people.’ I hadn’t even been examined. My water had already broken. I was in pain.”

Josephine, a soft-spoken but determined woman born with cerebral palsy, is not just a mother. 

She is a rights advocate and a living testimony to the harsh realities faced by women with disabilities, particularly when it comes to healthcare access and gender-based violence (GBV).

According to the 2019 Kenya Population and Housing Census, persons with disabilities make up 2.2% of the population, about 0.9 million. Of these, 57% are women. The most common disabilities include mobility (42%), visual (36.4%), and cognitive (23.2%) challenges.

While Josephine has long experienced societal stigma, nothing prepared her for being rejected in her most vulnerable moment, when she was about to bring a life into the world.

“At that point, I felt useless and invisible. I was declared unworthy of care. We had to look for an alternative quickly to save my child,” she shares.

Being denied care isn’t just a physical risk, it’s an emotional and psychological blow.

“They may experience deep feelings of hopelessness and even suicidal ideation. It reinforces a sense of ‘I don’t belong,’ a dangerous spiral especially when someone is already dealing with stigma,” says Dr. Hamida Ahmed, a Consultant Psychologist who has worked with survivors for over 15 years.

Dr. Hamida Ahmed, a Consultant Psychologist

Josephine’s pain reflects what many women with disabilities silently endure. According to Lucy Mulombi, a grassroots disability-inclusive feminist, chair of Kakamega County Disability Caucus and a Policy Advocate says, “We still have service providers who handle women with disabilities with a lot of intimidation. You’ll still hear questions like, ‘Who made you pregnant?’ a comment that’s deeply hurtful. The stigma drives many to give birth at home or avoid care altogether.”

According to the National Institute of Health, women and girls with disabilities are at significantly higher risk of gender-based violence (GBV), especially when response services fail to accommodate their needs.

Invisible Bruises of Discrimination

Josephine’s story reflects a form of GBV that is subtle yet devastating, a cruel blend of discrimination, ableism, and neglect. It exposes a silent form of violence that women with disabilities endure not just in hospitals, but in homes and public spaces. Often, their existence as mothers is questioned, and their right to care is denied.

Lucy says, “It’s very common today to even see a woman with a disability just crawling in the hospital because there’s no standby wheelchair to support. Even hospital pathways are often too narrow for wheelchair users.”

Outside hospitals, discrimination persists in more hidden and harmful ways.

“Sometimes, it comes from people close to us, caregivers, partners, even family,” Josephine says. “Because we depend on them for basic things, we become vulnerable. You can end up being sexually abused or mistreated, but fear speaking out because you’re scared of being abandoned.”

This fear keeps many cases unreported. Society remains largely unaware of the hidden abuse women with disabilities face, and the emotional scars they carry.

Despite the trauma, Josephine is quick to acknowledge the support she received from her family, especially her mother.

“My mom stayed with me for two months after delivery. She helped me breastfeed, bathe the baby, and settle into a routine, support that saved me from postpartum depression,” she says.

Had she been alone, Josephine believes she would not have coped. “The pain of rejection, coupled with delivery stress and baby care would have been too much.”

Though she did not seek mental health services, she knows how critical they are for survivors. “Many don’t seek therapy because it’s unaffordable, inaccessible, or not designed with us in mind,” she notes.

Family Support Matters, But It's Not Enough

As the world marked the International Day of Families on May 15, Nguvu Change Leader Valerie Aura intensified her call for better support systems for GBV survivors. Her message: while emotional support from families is important, survivors also need professional, accessible, and inclusive mental health care.

“Strengthening family units leads to stronger communities,” Valerie says. “GBV often happens behind closed doors, and survivors are silenced to protect family honour or out of fear. That must change. Families must not only speak up but push for accessible services, especially mental health care.”

Nguvu Change Leader Valerie Aura

Valerie’s online campaign, ‘Provide Free Mental Health Support for GBV Survivors in Kisumu County,’ is inspired by her own journey of healing after leaving an abusive home. She is pushing for integration of mental health care into primary health centers, complete with trained personnel, regular hours, and private spaces for survivors to seek help without judgment.

She argues that while Kenya has progressive laws on paper, the gap between policy and practice is alarming. “What’s needed now is not just political will, but measurable action, budget allocations, staffing, and monitoring. We’re losing too many GBV survivors to suicide, and that should concern us all.”

Even collecting meaningful data that could improve services for women like Josephine remains a challenge.

“Facilities talk about how women are accessing services, but they don’t have data on women with disabilities, let alone disaggregated data by disability type,” Lucy explains.

To break this cycle, Lucy believes it’s time to invest in inclusive health budgeting, integrate basic sign language into nursing curricula, and ensure that women with disabilities are included in all stages of policymaking.

“Let the women with disabilities be at the table to discuss mental health, gender-based violence and maternal services so their needs are amplified,” she urges.

Giving an example of Kakamega County where she is a resident, she says that there is progress as women with disabilities are now part of the policy boards and hosting committees, “When women with disabilities are in these boards, they advocate for inclusive services right from the facilities themselves.”   

Turning Pain into Purpose

Instead of letting trauma consume her, Josephine transformed it into advocacy. “I told myself, I won’t let other women with disabilities go through what I experienced.”

She founded AbleRise Africa Society, a community-based organization championing the rights of women and girls with disabilities. Through the Nguvu Collective’s Change Leader program, she runs digital campaigns focused on disability inclusion, reproductive rights, and mental wellness.

“I mentor others, speak at forums, and use my story to advocate. I remind people that we, women with disabilities, are human. We deserve care, respect, and dignity.”

Cerebral palsy is one of the most common physical disabilities, yet it remains widely misunderstood. “Some people think it’s contagious, or that we can’t have families or make decisions,” Josephine says.

She urges healthcare workers to challenge these myths. “It’s painful when discrimination comes from professionals we trust with our lives.”

When Home Isn’t Safe

Josephine also highlights a painful truth; home isn’t always a safe haven.

“Relatives, siblings, and even partners can be abusers. In our homes, triggers are everywhere. Sometimes your pain is dismissed. That’s why survivors need safe spaces to heal, physically and emotionally inclusive environments where they are believed, protected, and supported,” she says.

To caregivers, she offers a reminder: “Being a caregiver is not a license to mistreat. Behind every disability is a person with dreams, emotions, and boundaries. We deserve autonomy and dignity.”

On gender-based violence, Dr. Hamida adds that survivors with disabilities face a double burden, stigma and inaccessibility, “Some can’t even report their abuse because the perpetrators are their caregiver.” 

“We must invest in inclusive mental health services, train our professionals better, and offer accessible therapy options. Otherwise, we’re leaving behind a whole group of women who need help most,” urges Dr. Hamida

Josephine’s story is one of pain, yes, but also of power. In speaking out, she stands for countless other women silenced by systems not built for them. It’s time those systems listen.