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 Sexual and Reproductive
Health of Adolescents with
Disabilities
Edited by
Tafadzwa Rugoho
France Maphosa
Sexual and Reproductive Health of Adolescents
with Disabilities
Tafadzwa Rugoho • France Maphosa
Editors

Sexual and
Reproductive Health
of Adolescents with
Disabilities
Editors
Tafadzwa Rugoho France Maphosa
Athena Institute Department of Sociology
Vrije Universiteit University of Botswana
Amsterdam, The Netherlands Gaborone, Botswana

ISBN 978-981-15-7913-4    ISBN 978-981-15-7914-1 (eBook)

https://doi.org/10.1007/978-981-15-7914-1

© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Singapore
Pte Ltd. 2021
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
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illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and
­transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
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The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
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The publisher, the authors and the editors are safe to assume that the advice and information in this book
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The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
 Contents

1 Introduction: Locating Sexual and Reproductive Rights

for Adolescents with Disabilities  1
Tafadzwa Rugoho and France Maphosa

Part I International Perspective   9

2 Availability of Training Programmes on Sexuality for

Adolescents with Severe Disabilities: A Review 11
Kirsty Bastable, Shakila Dada, Refilwe Elizabeth Morwane, and
Parimala Raghavendra

3 Sexual and Reproductive Health Among Adolescent Girls

with Disabilities: A Vicious Circle of Womanhood 45
Gilliet Chigunwe

4 Promoting Sexual and Reproductive Health of

Adolescents with Disability: A Synthesis of Global
Evidence and Possible Solutions for India 61
Seema Sharma and Muthusamy Sivakami

v
vi Contents

5 Menstruation and the Girl with Visual Impairment 85

Alimata Abdul Karimu

Part II Country Studies 101

6 The Role of Teachers and Caregivers in Adolescent Girls

with Disabilities’ Sex Education in the Lakes Region of
Kenya103
Mark T. Carew, Ola Abualghaib, Nora Groce, and Maria Kett

7 Teachers’ and Students with Disabilities’ Perception of

Sexual and Reproductive Health Education in Secondary
Schools in Tanzania125
Paul Mtasigazya

8 Access to Sexual and Reproductive Health Services:

Insights to Experiences of Sexually Active Persons with
Disabilities in South Africa147
Sibusisiwe Siphelele Mavuso

9 Policy Issues and Challenges in Teaching Sexual and

Reproductive Health to Adolescent Girls with Mental
Disabilities in Nigeria: The Way Forward167
Olayinka Adeniyi and Omolade Olomola

10 Educating Adolescents with Visual Impairments on Sexual

Reproductive Health and Rights in Resource-Poor
Environments an Uphill Struggle: A Case Study of
Practices from the Field in Zimbabwe191
Nqobani Dube

11 Social Media as a Platform for Participating in Sexual

and Reproductive Issues for People with Disabilities211
Tafadzwa Rugoho
 Notes on Contributors

Ola Abualghaib (PhD) was appointed Manager of the Technical

Secretariat of the UN Partnership of Persons with Disabilities at UNDP
in August 2019. Ola has over 20 years of experience working in gender
and disability in development including in fragile and crisis-affected set-
tings in the Arab States, Africa and Asia. Previous to her appointment in
UNDP, she has been the Director for Global Influencing and Research at
Leonard Cheshire Disability in London, UK. During the last 20 years she
has worked with the UN system at global, regional and country level to
support disability-inclusive policies and programmes. She also served as
the Vice Chair of the International Disability and Development
Consortium (IDDC) and a board member of the Disability Rights
Funds. Ola was recently featured in the Gender Equality Top 100 list of
most influential people in global policy in 2019. She has a PhD in Social
Protection from the University of East Anglia, UK.
Olayinka Adeniyi is a researcher, an advocate and a barrister of the
Supreme Court of Nigeria. She is presently an OpenAIR/QEScholar
Researcher with the Center for Intellectual Property and Information
Technology Law (CIPIT), Strathmore University, Nairobi, Kenya. She has a
doctoral degree in Law from the University of Pretoria, South Africa, and
obtained her masters and first degree from the Obafemi Awolowo University,
Osun State, Nigeria. She is a 2018/2019 Research Fellow of the International

vii
viii Notes on Contributors

Centre for Women’s Research of Coady International Institute, Antigonish,

Nova Scotia, Canada. Adeniyi has certificates in Women’s Human Rights on
UN CEDAW for Change, Women Leadership for Community
Development, Action Research for Citizen Led Change, Children’s Rights,
Student Support and Academic Development and a certificate in Social
Entrepreneurship. She has several years of experience in legal practice
(Nigeria), research, lecturing and community development for the protec-
tion of women and the girl child. She has authored book chapters in the
academics and papers in accredited journals. She is the author of many secu-
lar books and has presented papers in local and international conferences
and workshops. Adeniyi is the CEO and founder of Women on the Watch
(WOW) Society Initiative, a not-for-profit registered in South Africa. Her
present research interest is the rights of vulnerable persons, particularly
women and children, in the emergence of developed technology.
Kirsty Bastable (PhD) is a postdoctoral fellow at the Centre for
Augmentative and Alternative Communication at the University of
Pretoria. She is a speech-language pathologist with extensive experience
in working with people who are severely disabled and who may require
AAC. She was the teacher-in-residence at the Bridge School in 2009
(Hillsborough, CA) and has postgraduate training in working with AAC
and people with severe disabilities. Her research and publications con-
cern engagement and participation of people with severe disabilities.
Mark T. Carew (PhD) is a research fellow at the Leonard Cheshire
Research Centre. His experience and research interests lie in tackling
problematic issues and barriers that affect people with disabilities glob-
ally, including exclusion from sexual health. Recent publications include
the book Disability and Sexual Health (Routledge, 2018).
Gilliet Chigunwe (PhD) is a senior lecturer at Zimbabwe Open
University, Department of Disability Studies and Special Needs
Education, Mashonaland Central Regional Campus, Zimbabwe. She is
also the founder and Director of Ruvimbo School for children with dis-
abilities. Besides PhD, she holds the following qualifications: M.Sc.
Special Needs Education; M.Ed. Psychology; B.Ed. Hearing Impairment;
B.Sc. Special Needs Education. Gilliet Chigunwe’s area of interest is
 Notes on Contributors ix

inclusion of persons with disabilities; she has authored more than 28

publications in reputable journals and presented papers on disability
issues both locally and at international forum.
Shakila Dada (PhD) is an associate professor at the Centre for
Augmentative and Alternative Communication at the University of
Pretoria. She is a speech-language pathologist and has many years’ experi-
ence in training and implementing AAC in the South African context as
well as postgraduate training in AAC implementation. Her research and
publications concern augmentative and alternative communication inter-
ventions with a particular focus on the role of graphic symbols in lan-
guage learning and facilitating participation of persons with disabilities.
Nqobani Dube completed his Master of Arts in development and human
rights at Swansea University in 2017 with the thesis on land reform and
livelihoods of people with disabilities in Africa. In the past 12 years he has
extensively worked in different roles around southern Africa for various dis-
ability organizations and the government of Zimbabwe. This further sup-
ported his research and work which revolves mostly around the intersections
of disability inclusion with development and humanitarian interventions.
Epitomized by his forthcoming publication on social media-powered dis-
ability rights activism, Nqobani continues to pursue his desire to champion
the centrality of disability issues in development. He remains interested in
representations of disability rights activism in popular culture and radical
pedagogy. In addition to graduate studies, Nqobani has a background in
community development, a commitment to grassroots activism and a love
for disruptive social media and other forms of alternative new media.
Nora Groce (PhD) is an anthropologist and Director of the UCL
International Disability Research Centre at University College London.
Professor Groce received a PhD from Brown University and then served
as Research Fellow at Harvard before joining the Yale School of Public
Health faculty in 1990. In 2008 she was appointed to the Leonard
Cheshire Chair at UCL. She is best known for her work in global health
and international development with vulnerable populations and particu-
larly for her work on people with disabilities. Groce has done applied
research on poverty, domestic violence, the impact of the HIV/AIDS and
access to health care for people with disabilities.
x Notes on Contributors

Alimata Abdul Karimu is an independent researcher and rights activist

writing and publishing on issues affecting women and persons with dis-
abilities in peer-reviewed journals. She has over ten years of experience in
rights advocacy with the African Union of the Blind, Vision Australia,
Ghana Federation of Disability Organisations, Ghana Blind Union,
among others. Some of her authored works on the sexual and reproduc-
tive health and rights of persons with disabilities are published on Taylor
and Francis Online. Alimata has a background in Educational Psychology
and holds MPhil in Guidance and Counselling from the University of
Cape Coast, Ghana, and has taught at Accra College of Education for six
years before moving into rights advocacy.
Maria Kett is an honorary reader in Disability and International
Development at University College London (UCL). Maria has expertise in
global health, human rights, climate change, poverty alleviation and the
consequences of social exclusion. She has undertaken research in countries
across Africa and Asia, leading to a number of research programmes on dis-
ability and international development and is an author of over 90 publica-
tions. She regularly serves as a consultant for numerous bilateral and
multilateral donors, including the UK Department for International
Development (DFID), the World Bank, the Australian Department of
Finance and Trade (DFAT) and the United Nations. Maria also has a strong
research expertise in conflict and disaster-affected countries and has under-
taken policy-­ focused work on inclusive humanitarian responses. This
includes her work as the Global Focal Point for Disability in the 2010 revi-
sion of the Sphere Handbook on Minimum Standards in Disaster Response.
France Maphosa (PhD) is a Professor of Sociology and Anthropology at
the University of Botswana. Maphosa’s research interests include the soci-
ology of organizations, participation, disability, rural livelihoods, labour
studies and alternative dispute resolution (ADR). He has been awarded
several research grants including the ORREA Senior Scholars Research
Grant, CODESRIA Advanced Research Fellowship Grant and the
CODESRIA National Working Group Research Grant. He has more
than 15 years’ experience of university teaching. He has taught at both
undergraduate and graduate levels. He has so far successfully supervised
three PhD thesis and several Masters’ dissertations. Maphosa has written
 Notes on Contributors xi

extensively. He has a number of books and papers to his name. Maphosa

has been a chief editor of a number of journals.
Sibusisiwe Siphelele Mavuso holds a Masters in Population Studies
from the University of KwaZulu-Natal and Masters in International
Development Studies from Radboud University Nijmegen, the
Netherlands. She is a PhD student at the Centre for Researching
Education and Labour, School of Education, University of the
Witwatersrand.
Refilwe Elizabeth Morwane is a PhD candidate and lecturer at the
Centre for Augmentative and Alternative Communication at the University
of Pretoria. She is a qualified speech-language therapist and audiologist
with a Master’s degree in Augmentative and Alternative Communication
(AAC), both completed at the University of Pretoria. In addition to her
involvement in academic and research activities, she also trains profession-
als such as educators and therapists working with children with severe dis-
ability in AAC implementation. She is enrolled for her PhD studies.
Paul Mtasigazya is a lecturer at the Mwalimu Nyerere Memorial
Academy, Karume Campus, Zanzibar, Tanzania. Mtasigazya holds a
Doctor of Philosophy in Public Administration from The University of
Dar Es Salaam, Tanzania. With a university teaching and research experi-
ence of ten years, Mtasigazya has written in national and international
journals in the areas of Local Governance, Health Service, Education,
Decentralization and Financial Management.
Omolade Olomola obtained LLB (Hons.) from the University of
Ibadan in 1997 and was subsequently called to the Nigerian Bar in 1999.
She also holds an LLM (Master of Laws) 2003 and a PhD Degree in Law
(2013) from the University of Ibadan with specific interests in
Reproductive Health Rights. She has professional certificates in Social
Science Research Methodology and Capacity Building, International
Criminal Justice and Administration, International Humanitarian Law
(IHL) and Ethics. She teaches Family Law, Reproductive Health Law and
Rights, Gender Justice and IHL. She is a member of the Nigerian Bar
Association, Nigerian Association of Law Teachers, International
Federation of Women Lawyers, Society for International Humanitarian
xii Notes on Contributors

Law Teachers and Global Alliance for Justice Education. Her research
work is focused on gender and social justice, reproductive and sexual
health rights, child rights, IHL, clinical legal education, family law and
property rights and she writes in these areas. She has supervised under-
graduate and postgraduate students’ research work in reproductive rights
and related gender areas. She won the prestigious MacArthur Foundation
funding grant which she utilized during the fall semester of 2009 at the
University of Toronto, Canada, where she understudied the curriculum
of International Reproductive and Sexual Health Rights Programme.
Olomola was the sub-dean (Undergraduate) of the Faculty of Law
between 2008 and 2009. She is a senior lecturer and she doubles this
position with her responsibilities as a staff clinician at the Women’s Law
Clinic of the Faculty of Law. She was the pioneer head of department of
Private and Property Law. She is actively involved with the implementa-
tion of the clinical legal education mode of teaching in Nigerian
Universities. She is an alumnus of the prestigious Nigerian Institute of
Advanced Legal Studies Lagos. She is also a faculty member of the Centre
for Child and Adolescent Mental Health at the University College
Hospital (UCH), Ibadan, Nigeria. In the course of her personal research
in the socio-cultural milieu, she developed an excellent eye for detail and
has significant experience on family law issues generally and on gender-
based violence. As part of her duties at the Women’s Law Clinic of the
Faculty of Law, University of Ibadan, she undertakes a number of team
projects on gender-based violence, intimate partner violence, marital
challenges, child abuse and forced migration. She supervises students
working on community outreach projects on gender-based issues in a
patriarchal society. She is adaptable and research oriented with proven
teaching, leadership and administration skills, impacting lives through
clinical legal education, excellent at understanding of legal research and
willing to take on daily challenges. Her current research efforts are on
intimate partner violence, gender dimensions of mental health and gen-
der-based violence in armed conflicts. She is also involved with the AHI
project in UCH, through ethics training in HCT (HIV/AIDS Counselling
and Training) of peer investigators. She was the Acting Dean of Law in
Elizade University, Ilara-Mokin, Ondo State, Nigeria, during her sabbati-
cal leave between 2017 and 2019.
 Notes on Contributors xiii

Parimala Raghavendra is Associate Professor in Disability and

Community Inclusion, College of Nursing and Health Sciences at
Flinders University, Adelaide, Australia. Dr. Raghavendra is a speech
pathologist with extensive research, teaching and clinical experience in
working with children and young people and adults with disabilities
especially those with severe communication impairments who can bene-
fit from augmentative and alternative communication. Her research
focuses on investigating the impact of internet and mobile technologies
on communication, social networks and social of young people and
adults with developmental or acquired disabilities. She supervises several
PhD and Honours research students.
Tafadzwa Rugoho (PhD) is a lecturer at Great Zimbabwe University in
the Department of Development Studies. Tafadzwa holds an MA in Policy
Studies, an MSc in Development, an MSc in Strategic Management and a
BSc in Sociology. He has authored more than 15 book chapters as well as a
number of journal papers on disability issues. Tafadzwa has presented several
papers at local and international research conferences in this area over the
past five years. Tafadzwa is also a guest lecturer at the University of Pretoria,
where he teaches Sexuality and Social Media. He sits on several boards of
disabled people’s organisations. Tafadzwa is coediting a book titled Disability
and Media—African Perspectives (Routledge 2020) with Mike Kent.
Seema Sharma is a PhD candidate and a senior research fellowship
recipient with the School of Health Systems Studies, Tata Institute of
Social Sciences, Mumbai, India. Her areas of research interest include
sexual and reproductive health, disability, chronic illness and catastrophic
expenditures. She holds a Master of Philosophy (MPhil) degree from Tata
Institute of Social Sciences and has a Masters in Economics (MA) from
Gokhale Institute of Politics and Economics, Pune, India. She has recently
written on the issue of neglect of sexual and reproductive health concerns
of persons with disabilities in India in the Journal of Biosocial Science.
Muthusamy Sivakami is a professor in the School of Health Systems
Studies (SHSS), Tata Institute of Social Sciences (TISS), Mumbai. She is
also the Chairperson of the Centre for Health and Social Sciences—one
of the four centres in SHSS. Having a university teaching experience of
xiv Notes on Contributors

over 15 years, Sivakami broadly works in the area of Demography, Gender

and Health and has written widely in peer-reviewed national and inter-
national journals such as BMJ Open, Journal of Biosocial Science, Asian
Population Studies, Health Transition Review and Economic and Political
Weekly. She has been awarded several research grants from major national
and international funding organisations. She holds a PhD in Population
Studies from Bharathiar University, Coimbatore, Tamil Nadu, India.
 List of Tables

Table 2.1 Inclusion and exclusion criteria 16

Table 2.2 Description of identified programmes 19
Table 2.3 Description of the curricula of the programmes 27
Table 2.4 Description of instructional materials and delivery strategies
in the twelve programmes 33
Table 2.5 Content and teaching strategy appraisal 36
Table 7.1 Demographic and socio-economic characteristics of
respondents135
Table 8.1 Sample characteristics 150

xv
 1
Introduction: Locating Sexual
and Reproductive Rights
for Adolescents with Disabilities
Tafadzwa Rugoho and France Maphosa

Introduction
The majority of the over one billion people with disabilities (PWDs)
around the world face challenges related to sexual and reproductive health
and rights (SRHR). The main causes are cultural, legal, political and
social practices that continue to marginalize people with disabilities when
it comes to SRHR. Literature shows that societies do not approve for
PWDs to engage in sexual and reproductive issues. PWDs were regarded
as people without sexual feelings. Women with disabilities were sterilized
without their consent. PWDs were seen as people who cannot make deci-
sions when it comes to sexual and reproductive rights (Rugoho &
Maphosa, 2017). PWDs are also systemically denied the opportunity to
access SRHR information. Parents and teachers are not comfortable in

T. Rugoho (*)
Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
F. Maphosa
Department of Sociology, University of Botswana, Gaborone, Botswana

© The Author(s) 2021 1

T. Rugoho, F. Maphosa (eds.), Sexual and Reproductive Health of Adolescents
with Disabilities, https://doi.org/10.1007/978-981-15-7914-1_1
2 T. Rugoho and F. Maphosa

discussing sexual and reproductive issues with children with disabilities as

shown by various studies. Even their peers are discouraged from discuss-
ing sexual and reproductive issues.
Recently, SRH for PWDs has received the attention of world leaders
and policy makers through the adoption of the United Nations
Convention on the Rights of Persons with Disabilities (CRPD). The
CRPD explicitly recognizes sexual and reproductive rights of PWDs. The
Convention challenges all cultural, social, political and religious practices
that may harm the rights of people with disabilities, especially in matters
of marriage, family, parenthood and relationships. The right of persons
with disabilities to the autonomy of their bodies was recognized, includ-
ing attendant rights to be married and to have children. The Convention
mandates governments to promote access to good quality and affordable
SRH care and programmes to people with disabilities. Governments are
further mandated to guarantee access to sexual and reproductive health
to people with disabilities. However, it has been over ten years now yet
the millennia of stigma has not disappeared. People with disabilities are
still facing challenges in accessing sexual and reproductive information.
The current book seeks to add more evidence on how disability and
sexual and reproductive health issues are handled the world over. The
book also shows different opportunities and initiatives that are currently
being promoted the world over in an effort to assist people with disabili-
ties to access sexual and reproductive rights. Chapter 2 is broadly based
on examining the sexuality education programmes available in global lit-
erature. The focus of the chapter is mainly adolescents with severe dis-
abilities. As demonstrated by D.P. Ngilangwa in 2016, adolescents with
severe disabilities constitute one of the most neglected groups when it
comes to sexual and reproductive issues yet more vulnerable to sexual
abuse, unplanned pregnancy, HIV and sexually transmitted diseases. A
systematic review of literature in the chapter shows that most efforts on
sexual and reproductive rights of adolescents with severe disabilities
focused more on sexual abuse prevention and neglected the positive cog-
nitive emotional, social interactive and physical aspects of sexuality.
However, delivery strategies were better represented and included multi-
modal communication, the use of concrete materials, social stories,
instruction, modelling, role-play, repetition and review. In conclusion the
 1 Introduction: Locating Sexual and Reproductive Rights… 3

chapter recommends for the need to develop theoretically sound pro-

grammes which cover the full extent of sexuality.
The United Nations’ 2030 agenda for sustainable development has
called for availability and sustainable management of sanitation and
water for all including people with disabilities. In most low-income
countries, sanitary infrastructure facilities for people with disabilities
have always been a challenge and this has caused trauma to girls and
women with physical disabilities every month in most developing coun-
tries. Chapter 3 clearly demonstrates that while international policies and
declarations on the inclusion of persons with disabilities at all levels in
society have been put in place, people with disabilities continue to be
discriminated against. Lack of access to sanitary facilities—especially toi-
lets—has seen girls with physical disabilities absenting themselves from
school during menstruation period. The majority of the suffering of ado-
lescents with disabilities (AwDs) has not been well documented. There
are few researches targeting sexual and reproduction issues of adolescents
with disabilities. This is also common in countries such as India as pointed
out in Chap. 4. Over the past few years there has been a general recogni-
tion that the educational and employment opportunities of adolescents
with disabilities (AwDs) in India need to be improved and that their
sexual needs and aspirations, sexuality concerns and SRH and rights have
been largely ignored. India has got a very large population of people with
disabilities yet there is very little research on the SRH concerns of AwDs
in the Indian context by reviewing the existing literature in India. The
study describes the challenges faced by AwDs in acquiring sexuality and
SRH education based on the results of empirical studies conducted
globally.
Adolescents with visual disabilities face challenges during their men-
struation. In some cases they will have their garments with menstrual
blood. Chapter 5 examines in detail the nature of menstruation and atti-
tudes towards menstruation and discusses practical menstrual manage-
ment tips for girls with visual impairment and their significant others.
Tips which enable females who are visually impaired to manage their
menstruation more independently and with confidence are also offered.
Some of these tips include the following: (1) provide information on
menstruation to the female who is visually impaired by someone who the
4 T. Rugoho and F. Maphosa

girl with visual impairment is comfortable with. This may include mother,
a trusted or familiar female relative, mentor, teacher, who are all of the
same sex unless otherwise requested by the girl. (2) Make the female who
is blind or visually impaired choose the place where she feels comfortable
to learn to use sanitary items or manage her menstrual flow. (3) Ensure
enough time is devoted for individual demonstration on how to use vari-
ous sanitary products of their choosing. (4) Where possible, introduce
her to a range of sanitary products in order for her to be able to choose
the one that best suits her circumstance and makes her very
comfortable.
Recently schools have started introducing curriculum on sexual and
reproductive health to all learners. Teachers and caregivers play a pivotal
role in adolescent girls with disabilities’ sexual and reproductive health.
Chapter 6 presents findings from secondary data analysis of qualitative
focus group data with adolescent girls with disabilities and caregivers
within the Lakes region of Kenya as part of the DFID-funded Girls
Education Challenge Transition (GEC-T) project. The findings highlight
perceived openness and approachability as important to adolescents
when selecting a source of information about sexual issues. They also sug-
gest that while sexual education in formal schooling provided a good base
knowledge to adolescents, caregivers felt that they had to supplement
teaching with additional examples taken from their life histories and the
wider community. Overall, the findings highlight the central role that
both teachers and parents/caregivers, as well as others such as close family
members, play in the provision of sex education to adolescents with dis-
abilities. Chapter 7 is also on teachers and students’ perception of sexual
and reproductive health (SRH) education in secondary schools in
Tanzania. The findings revealed that the majority of teachers and stu-
dents with disabilities perceive that SRH education is important for
learning in secondary schools in Tanzania. Teachers and students with
disabilities believed that teaching of SRH education is important for
good health and as a control mechanism for the behaviour of adolescents.
Furthermore, the findings revealed that SRH education is suitable for
students aged 13–17 years of age. To them, SRH education helps to con-
trol awkward behaviours because of the transition period from adoles-
cence to adulthood. In addition, it was found that cultural practices did
 1 Introduction: Locating Sexual and Reproductive Rights… 5

not hinder students from learning SRH education. It is therefore con-

cluded that SRH education was perceived as vital for health and behav-
iour control. The study recommends that secondary schools should
educate students on the importance of SRH education. Also, the govern-
ment should invest in training teachers on how to teach SRH education.
Chapter 8 is on the experiences of sexually active women with disabili-
ties and men of reproductive ages with regard to their sexual and repro-
ductive health needs and access to services in Durban, South Africa.
Participants expressed that sexual and reproductive health services are a
big part of their lives. However, there seemed to be a huge gap between
their needs for services and their rights to access services. From the dis-
cussions it was apparent that respondent’s rights to be treated with dig-
nity, respect and to access sexual and reproductive health services is often
overshadowed by the stereotypical assumptions that society holds about
the sexuality of persons with disabilities. Participants mentioned that
there is preconception that persons with disabilities are not capable of
engaging in sexual activities and hence they are often considered as not
sexually active. This was one of the major barriers persons with disabili-
ties experienced not only in the public healthcare sector but also in the
general society. Foremost this means that information on sexual and
reproductive health matters is not widely available and/or accessible to
them. This leaves them with vague knowledge about such matters. Many
women reported that health providers appeared surprised that they will
need family planning services. Often they are not given choices about
suitable birth control methods, rather the healthcare providers usually
suggested that they undergo abortion or get sterilized. Sterilization may
protect women against future pregnancies, it does not, however, promote
healthy sexual behaviours, which increase their risk of contracting STIs.
The study findings revealed a need to address access to sexual and repro-
ductive health services for persons with disabilities especially, through
public healthcare system in South Africa.
Mental health is one of the major health challenges of the twenty-first
century. People living with mental health conditions suffer the greatest
discrimination demeaning their personality and they are perpetually
restrained from living normal lives. Being mentally disabled constitutes
an insurmountable illness in a society like Nigeria, not to describe the
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Hause als Herrin zu wohnen und sich bedienen zu lassen, vor Allem
jedoch von dem Gedanken geschmeichelt, dem schönen Prinzen,
dem ihr Herz sogleich entgegen geflogen war, so sehr gefallen zu
haben und nun oft von ihm besucht zu werden. Seit dem Tage, als
sie der Prinz selbst mit seinem Wunsch bekannt gemacht hatte,
schwellte Glückseligkeit ihre Brust und sie bekümmerte sich wenig
über die Abreise desselben. Es verstand sich von selbst, daß das
strengste Geheimniß über Alles beobachtet werden mußte, damit
nicht etwa durch den Fürsten eine Störung erfolgte.
Bei der Rückkehr beeilte sich Mühlfels, des Prinzen Befehl wegen
des Ankaufs der Villa sofort auszuführen. Als dieser nach kurzer Zeit
erfolgte, wurde das Landhaus in der prächtigsten Weise eingerichtet,
während eine Vertraute des Prinzen, Madame Voisin, die Sorge für
Marianens Ausstattung übernahm. Der Prinz ließ darauf ganz
außerordentliche Summen verwenden, welche ihm seine
Geldfreunde vorschießen mußten, da seine Mittel dazu nicht
ausreichten.
Nachdem alle diese Geschäfte erledigt waren, wurde Mariane
durch Madame Voisin aus ihrer Heimath abgeholt und langte mit
dieser in einem schönen Reisewagen, den ihr der Prinz geschickt
hatte, eines Abends in der Villa an. Mariane war gleich einer Dame
gekleidet und führte den Namen eines Fräulein von Waldstein, wie
es der Prinz gewünscht hatte, um ihre niedere Herkunft zu
verbergen. In ihrem Namen war auch die Villa gekauft und für sie
verschönert worden. Der Prinz empfing sie, und es gewährte ihm
kein kleines Vergnügen, das erstaunte und befangene Mädchen als
die Besitzerin des prächtigen Landhauses durch die Gemächer zu
führen. Madame Voisin wurde Marianen von dem Prinzen als ihre
künftige Gesellschafterin bezeichnet, doch bemerkte er zugleich,
daß nur sie hier die Gebieterin wäre.
Das strengste Geheimniß sollte fortan über Alles beobachtet
werden. Die Dienerschaft, nur aus den nothwendigsten Personen
bestehend, war durch Madame Voisin verpflichtet worden, gegen
Jedermann sowol über Marianens Anwesenheit als des Prinzen
Besuche zu schweigen, um in solcher Weise jedem Verrath
vorzubeugen.
 Der Prinz fühlte sich in dem endlichen Besitz Marianens
außerordentlich glücklich. Seine Leidenschaft für dieselbe steigerte
sich mit jedem neuen Tage. Er führte fortan, wie er es gewünscht, in
der That ein idyllisches Leben, und jede Stunde, die er irgend
abmüßigen konnte, brachte er in der Villa zu.
Jetzt war auch für Mühlfels der Zeitpunkt gekommen, sich
Sidonien zu nähern, und er konnte dies um so bequemer und
häufiger thun, da der Prinz ihm die vollste Freiheit und Muße
gewährte. Seine Bemühungen, durch seine Mutter unterstützt, waren
wohl berechnet und verfehlten darum die beabsichtigten Wirkungen
auf Sidonie nicht. Bedacht, ihr die Wünsche abzulauschen und sie
durch deren Erfüllung zu überraschen, viel zu vorsichtig und
geschickt, seine Absicht zu verrathen, erschien er stets als der
ergebene Diener und theilnehmendste Freund der Prinzessin, dem
sie ihre Dankbarkeit für seine Ergebenheit nicht versagen durfte.
Seine Vorschläge für die Unterhaltungen zum nächsten Winter
waren ganz in ihrem Sinn ausgedacht und gewannen ihren Beifall,
und so geschah es, daß man den Baron fortan häufiger denn sonst
bei der Prinzessin sah.
Die Brust von beglückenden Hoffnungen für die Zukunft erfüllt, war
Sidonie um so mehr geneigt, ihren Freunden ein vermehrtes
Wohlwollen zu schenken, besonders Mühlfels, dessen
Diensteifrigkeit sie zu Dank verpflichtete. Dieser Umstand war
jedoch nur zu sehr geeignet, den verliebten Baron immer mehr in der
Ueberzeugung der Gunst der Prinzessin zu befestigen und daran die
besten Hoffnungen zu knüpfen. Ein wichtiges Mittel zur Erreichung
seines Ziels sah er in des Prinzen Verhältniß zu Marianen, indem er
im Hinblick auf der Prinzessin leicht verletzbaren Charakter durch
den Verrath desselben die letzte Bedenklichkeit zu beseitigen hoffte,
die sie etwa noch abhielt, seinen Bewerbungen Gehör zu schenken.

Ende des ersten Bandes.

Druck von G. Pätz in Naumburg a/S.
 *** END OF THE PROJECT GUTENBERG EBOOK PRINZESSIN
SIDONIE (BAND 1/3) ***

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