Joanne Crawford Triple jeopardy-crawford-ACFID-uts-2013[1]
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This document summarizes key findings from research on the experiences of women with disabilities in Cambodia. The research found that women with disabilities face high levels of gender-based violence and limited autonomy due to barriers related to their gender and disability status. Women with disabilities experienced much higher rates of partner violence but were less likely to report it than women without disabilities. The research also highlighted the importance of including women with disabilities in the research process and disability organizations to ensure their voices are represented. The document describes various tools and resources developed based on the research findings, including reports, briefs, and training materials, to help inform policies and practices around disability and gender inclusion.
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Joanne Crawford Triple jeopardy-crawford-ACFID-uts-2013[1]
- 1. Triple Jeopardy: practice implications for addressing gender-based violence for women with disabilities Triple Jeopardy Research Jo Crawford, IWDA, Development Futures Conference, November 2013 CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 2. Triple Jeopardy Research It’s easy to miss something you’re not looking for CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 3. Triple Disability, gender & development Jeopardy Research Link between disability and vulnerability to violence Substantial diversity among people with disabilities in terms of vulnerability to interpersonal violence But, robust studies for most regions, and particularly low- and middle-income countries, were absent (Hughes et al. 2012). Women with disabilities (WWDs) face multiple disadvantages from interplay of gender, disability & developing world status. Challenges such as poverty, GBV, barriers to sexual & reproductive health care are magnified by disability & gender. CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 4. Disability, gender & development Triple Jeopardy Research Social model of disability: the barrier is not the disability but how society responds & accommodates – Which is deeply connected to gendered social norms & attitudes – When gender already limits a girl or woman’s access to education or mobility, adding disability can result in profound constraints on her ability to participate & contribute, earn & support herself CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 5. Disability, gender & development in Cambodia Triple Jeopardy Research Accurate statistics on disability in Cambodia not available, but estimated at 15% People with disabilities are among the most vulnerable groups in Cambodia One of the few studies in Cambodia (ADB 1995) suggests an absence of WWD ‘voices’ within disability and women’s service sectors – informants say little has changed CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 6. Women with disabilities in development WWDs particularly marginalised from development WWDs are less likely to be decision makers in DPOs – which influences organisational priorities DPOs tend to focus on issues of common interest – not on the gendered experience of disability or the unique barriers faced by WWDs Needs of WWDs not well reflected by women’s orgs Limited awareness of rights, programs, services, resources among WWDs
- 7. Triple Jeopardy Research CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 8. Globally high levels of psychological distress 10.8% of WWDs had tried to kill themselves (vs 4.5% non-disabled women)
- 9. WWDs have more limited autonomy WWDs Without Both Insists on knowing where 62.2% 28.0% you are at all times Expects you to ask his 71.1% 49.2% permission before seeking health care for yourself Shows the limitations of averages! 36.7% And why collecting data 54.8% on, & disaggregating for, disability is critical “I have never gone to the hospital even when I’ve been sick. When my wheelchair broke, I had a cart to help me travel to the central hospital when I was pregnant. Once when I was sick I asked my husband to take me to the hospital but he refused and tied up my cart so that I couldn’t go.” (IDI 3)
- 10. How will you know? Most women with disabilities (68%) did not tell anyone about their experience of partner violence. If they did, it was someone close to them, not an NGO By comparison, 44% of women without disabilities disclosed For family violence, 55% of women participants with a disability did not tell anyone – if they did, it was someone close to them, not an NGO 92% of WWD (vs 66% non-disabled) said household violence had affected their mental health 49% of perpetrators of household violence were parents What does this mean for how you work?
- 11. Nothing about us without us Gender + disability: too many issues to think about? Triple Jeopardy shows why taking account of gender and disability matters and how it can be done Not rocket science, but does need intentional, systematic, consistent & coherent action, time, budget, and awareness & commitment to integrate gender & disability in a way that genuinely enables participation
- 12. Women with disabilities as researchers Access a core criteria for office location, training and workshop venues Pairs of researchers, to maximize safety & increase understanding b/w CDPO & Banteay Srei re GBV & disability Maximising opportunities for WWDs & female carers of girls with disabilities as research implementers, tool developers, training facilitators Valuing the experience of field researchers not just their ‘data’ Field testing of tools Inclusion in practice
- 13. Inclusion matters Involving women with lived experience of disability and gender inequality as researchers and people with expertise is key to good research and development outcomes – especially where there is limited specialist expertise Having women with disabilities as researchers helped ensure that participants with disabilities felt safe to talk about their experiences Employing WWD as researchers challenged stereotypes re gender and disability
- 14. Language – a first step towards inclusionTriple ‘People with disabilities’ has its limitations Jeopardy Research – Suggests a single group from whom disability brings shared interests – and whose interests can be fully represented by a ‘disability’ organisation & addressed by ‘disability’ policies & programs – But how women, men, girls, boys experience their disability, & how it impacts on their lives, is deeply influenced by other factors including gender, age, ethnicity, rural/urban context Inclusive development requires sensitivity to difference, as well as attention to commonalities – And to the specific barriers and challenges experienced by women and men, not just those that they have in common Language brings visibility CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 15. What does meaningful inclusion look like? Triple Jeopardy Research Real inclusion requires involvement in setting the agenda & the rules by which the agenda is determined – Not being invited to play in a sandpit whose boundaries are determined by others – Real inclusion brings with it the potential for transforming the agenda – not just adding to it Participation of those with most at stake helps in understanding the issues & priorities & tracking progress – & supports accountability that promotes change CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 16. Tools to inform policy & practice Research report Policy brief Pamphlet for service providers Poster Community training tool – All in English & Khmer Aims: to get research out and used to transform discriminatory attitudes of service providers and community Triple Jeopardy Research CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
- 17. Community training tool Module 1 Module 2 Module 3 Day 1: 8:15 – 4:00pm Introduction and pre-training test Introduce the workshop; set ground rules; use a warmup activity to help participants feel comfortable; test existing knowledge about disability and gender. Break Disability Participants understand what disability is; how disability is caused and common myths about disability; and that women with disabilities should be included in the community equally with everyone else. Lunch Gender Participants understand: what is gender; that women experience certain kinds of violence and discrimination because they are women; and that we can change this. 1h 20 mins 8:15 – 9:35 15 mins 2h 10 mins 9:35 – 9:50 9:50 – 12:00 1h 30 mins 2h 30 mins (including break) 12:00 – 1:30 1:30 – 4:00
- 20. Triple More information email: Jeopardy banteaysrei_research@online.com.kh iwda@iwda.org.au Research Or visit: http://www.iwda.org.au/research/triple-jeopardy/ CBM Australia-Monash University-IWDA-Banteay Srei-CDPO with funding support from AusAID
Editor's Notes
- A number of studies indicate a clear link between disability and vulnerability to violence (Barrett et al. 2009). – those with mental illnesses or intellectual disability could be particularly vulnerable. The intersection of barriers and sources of discriminations such as disability and gender deepens marginalisation, in a way that is more exponential than addidtive. This has significant implications for development priorities and approaches (ie what we do and how we do it)
- Eg, if women are valued for their beauty, a visible disability can be particularly stigmatising, especially if there is a belief that it will be passed on to her children It is not possible to understand the impact and implications of disability on life choices without understanding how those choices are shaped and mediated by gender gender influences expected social and economic roles, responsibilities and opportunities and often rights available to women and men in every country and in turn how disability is experienced
- (WHO estimates average prevalence in developing countries at 10–12%) Women with disabilities equal access to education, training and employment. This constant lack of opportunity alienates them from fully participating in their communities. While many workers with disabilities have considerable skills, many have not had the opportunity to develop their potential.
- WWD are often not counted in research, difficulties accessing services, more vulnerable to discrimination and violence in families and communities GBV and sexual and reproductive health needs are not often addressed in disability-specific programming
- Triple Jeopardy also shows that the intersection of gender and disability changed the nature of the violence experienced by women, not just the extent of it In particular, they are more likely to experience family violence than IPV, at a rate that is significantly higher than that of women without disabilities. WWD & non-disabled women experience similar prevalence of physical or sexual partner violence, but less likely to partner Women with disabilities up to 4.2 times more likely to experience controlling behaviour from partners Significant differences in prevalence of family violence: more than half ‑ 52.5% ‑ of WWDs who participated in the survey reported emotional abuse, 25.4% reported physical violence and 5.7% reported sexual violence from family members, in addition to an array of controlling and coercive behaviour including having to seek permission before accessing health care for oneself.
- The mean SRQ scores in this study show that even women who did not have a disability and had never experienced partner violence, had a higher SRQ score (10.5, sd=5.2) than the highest mean scores documented in every country in the WHO study. The lowest mean SRQ score for women who reported any type of partner violence in the WHO Multi Country study on Women's Health and Domestic Violence was 2.7 (Ethiopia, provincial). The highest mean score was 9.8 (Peru, provincial). In other words, the levels of psychological distress for Cambodian women are high and especially so for women suffering the double burden of disability and violence. These women reported that they experienced an exceptionally high level of distress, responding to 15 out of a possible 20 symptoms of psychological distress on the SRQ. This exceptionally high level of psychological distress is cause for concern and response.
- Household violence 0% of WWD told doctor / health worker vs. 12% 3% had told local leader None had told Priests, Counsellors, NGO, DPO or Women’s organisation
- It’s easy to miss what you’re not looking for ‑ and what you find when you go looking changes what you focus on in future The ‘benchmark’ approach to researching violence against women, used in the WHO multi-country study on violence, cannot currently be disaggregated for disability. The Triple jeopardy research began with two organisations sensitive to the intersections of gender and disability, concerned about how this would play out in relation to that stark expression of gender inequality and rights violations, violence, and about the lack of evidence to inform action. Inclusion was there at inception We drew in local partners – a women’s organisation and disabled persons’ organisation with local knowledge of gender and disability discrimination and policy respectively, and ongoing missions to represent and address issues and interests. CDPO and BS also helped ensured that local understandings of disability and gender were integrated in the research plan and methodology Inclusion was reflected in the partnership And in the methodology – this was action research, focused on understanding for change All partners contributed to shaping the problem identification and situation analysis, making visible the benefits of seeing priorities through someone else’s eyes, and the experience, knowledge and understandings they brought We shaped our approach around the idea of ‘nothing about us without us’ This influenced how we worked Participatory analysis of networks, stakeholders, needs & priorities with partners and others. Hired women with disabilities as researchers Intensive training on gender, disability, gender-based violence and research methods with Cambodian partners and research team, including experiential learning about disability and access. Researchers worked in pairs, to maximize the safety & increase understanding between CDPO field researchers (women with lived experience of disability) and the Banteay Srei field researchers (women with expertise in GBV) about the overlapping issues of GBV and disability. male drivers assisted with field security Wherever possible opportunities were provided for women with disabilities and female carers of girls with disabilities to participate as research implementers, tool developers, and training facilitators. The experience of field researchers was valued, not just the data they collected Value of partnership between research institutions and NGOs with an ongoing focus on the rights and interests of participants And uses results to inform practical tools that support change Hearing directly from women and men, girls and boys with lived experience of disability is part of what is required to understand how disability intersects with other factors to shape opportunities and options. Meaningful participation requires actively reaching out, addressing barriers, recognising power inequities
- Reflection discussions with WWDs documented insights after 6+ months in the field re how to improve the situation for WWDs who experience violence
- Reflection discussions documented their insights from over six months in the field conducting the research, about how to improve the situation for WWDs who experience violenceIt influenced recommendations and priorities.... It influenced what we heard and the demonstration value of the research itself Having women with disabilities as researchers helped ensure that women with disabilities felt safe to talk about their experiences – they would be understood Having women with disabilities in professional roles as researchers challenged stereotypes re gender and disability And our understanding of the limits of the research By the end of the research process, we also more clearly recognised the limitations of the research – who wasn’t included (deaf women, those with intellectual/cognitive disability) It influenced recommendations and priorities, outputs and tools.... translation of findings into a practical Community training tool to address discriminatory attitudes of community Information aimed at service providers translation of materials into Khmer It influenced next steps ALA Fellowship – developing inclusion guidelines with disability and gender advocates and policy makers eg. systematic, consistent and coherent action, time, awareness, budget, expertise and commitment to integrate gender and disability in a way that genuinely enables participation Highlights the importance of process for achieving a good outcome It is not possible to understand the impact and implications of disability on opportunities and choices without understanding how those these are shaped and mediated by gender. Gender influences expected social and economic roles, responsibilities and opportunities and often rights available to women and men in every country, and in turn how disability is experienced Action research involving WWD can provide a better understanding of the situation for WWD, barriers & enablers and identify practical ways to improve access & services, challenge discrimination & model possibilities
- Eg anti-violence services – if the focus is on partner violence, and you are a woman with a disability experiencing violence from a family member, and you did not know you have rights, and you have been told you are worthless and a burden, would you see the service as relevant to you?
- The research provides understanding of what is ‘adequate’ inclusion. For example, in a presentation and discussion of the research findings and their implications, an AusAID staff member suggested that adding ‘a question’ on disability to the WHO survey on violence against women VAW would be sufficient to integrate disability and act on the Triple Jeopardy results. Both the disability adviser in Cambodia and IWDA argued strongly that this was not adequate And it shifted our understanding of what meaningful participation requires
- Discriminatory attitudes won’t go away by themselves – they need to be actively challenged, within a rights framework.
- Discriminatory attitudes against women and women and men with disabilities are often so deep in cultures that they are normalised / naturalised.
- Supporting people to unpack myths & stereotypes, to put themselves in the shoes of a woman or man with a disability – to imagine what life would be like if they suddenly experienced a disabling injury – is particularly important to improving access and opportunities for women with disabilities given the role of families as carers and gatekeepers and the prevalence of family violence against women with disabilities
- Women with disabilities are largely hidden from and ignored by NGOs and services that could and should be acting in their interests Discriminatory attitudes of community members, authorities and community services staff against women with disabilities condone and perpetuate violence against women with disabilities. Such attitudes must be challenged and transformed if women with disabilities are to access services, realise rights etc. Violence programs (and surveys) need to focus on household violence, not just IPV Donor and others supporting violence prevention and response services must take active steps to reach and enable access for women with disabilities