KERAN HOWE:
I think… can everyone hear me? Terrific. Well, my name is Keran Howe and I’m the executive
director of Women with Disabilities Victoria and I'm really pleased to be here this afternoon to talk
with you. I want to start by acknowledging the traditional owners of the land on which we are
meeting this afternoon, the Wurundjeri people, and pay my respects to the elders past and any
elders present today. And I also want to take the opportunity to thank the organisers of the
conference, DisabilityCare Australia, for the opportunity to talk today around gender and disability,
which also happens to be my great passion; the two issues.
SPEAKER:
(inaudible)
KERAN HOWE:
We should! (Laughs) And you will note it is under the ‘special interest’ column but I’ve got to say
that I don't actually think it is a special interest; it might be a special interest to some of us, but I
think it’s core business. And there's a bit of a debate raging in Australia - if anyone's been reading
the newspapers lately - around gender and whether it is core business but, for DisabilityCare
Australia, I think it absolutely needs to be central to any consideration of quality that we think about
what it means to be a woman with a disability or a man with a disability and what sort of care do we
need to provide with those two considerations. So it's terrific to be able to talk and that's what I
want talk to you about today.
I want to talk first about the context of human rights obligations as they relate to the provision of
DisabilityCare in Australia today and the particular social and economic issues that concern women
with disabilities and to discuss the gender implications, for both women with disabilities and
disability services under what we now call DisabilityCare Australia - I still have a little penchant for
National Disability Insurance Scheme - but to look at how a gender focus is essential to the provision
of quality of care and quality of service under DisabilityCare Australia. And I hope I don't talk so long
that you all go to sleep and don't have a chance to ask questions before we close.
But I will just start by talking a little bit about Women with Disabilities Australia and Women with
Disabilities Victoria. Can I have a show of hands, those of you who know the two organisations,
Women with Disabilities Australia…? So, some; that is terrific. Probably most. Well, for those of you
don't, Women with Disabilities Australia is a systemic organisation that focuses at the national level
and is an advocacy service for women with disabilities, so it has a focus on policy at the national
level. Women with Disabilities Victoria is a systemic advocacy organisation focusing at the state
level. So we have very parallel, if you like, agendas. We… both organisations focus on violence
against women with disabilities, access to health services, sexual and reproductive health and
parenting rights for women with disabilities. And I'm choosing today to talk about those issues and
to use a human rights framework to underpin the discussion because I think it so fundamental to the
way we provide care.
It almost doesn't need to be talked about; I know we’ve had a lot of discussion but, just so that
everyone is clear, the Convention on the Rights of Persons with Disabilities recognises that women
and girls with disabilities are subject to multiple discrimination and that states parties to the
Convention, have an obligation to take measures to ensure that disabled women and girls
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experience the full and equal enjoyment of all human rights and fundamental freedoms. So the
CRPD recognises that gender is one of the really important elements of social organisation and
emphasises the need to incorporate a gender perspective in all efforts to promote the full
enjoyment of human rights and fundamental freedoms of people with disabilities. And the CRPD’s
committee recently recognised that commitment in hosting a session at the ninth session of the
CRPD, as a half day general discussion on the rights and needs of women and girls with disabilities.
Yet, despite that clear articulation within the Convention, and all of the efforts to promote the
human rights of people with disabilities, we are still often treated as asexual, genderless. And this
view is borne out in disability policies the world over, which consistently fail to provide a gender
lens. Most proceed as though there is a common set of issues, and a common set of needs, and that
men and women experience disability in the same way. So I found it extremely heartening that the
National Disability Insurance Scheme Act, which gives effect to Australia's obligations under the
Convention on the Rights of Persons with Disabilities as its very first object and furthermore, has an
object on the Convention that Australia has obligations as a party to the Convention on the
Elimination of Discrimination Against Women. So those two conventions sit fair and square in the
objects of the Act for the National Disability Insurance Scheme and it means that any care that is
provided under the Scheme has to take account of gender.
The Act… the National Disability Insurance Scheme Act further states that, with regard to the general
principles guiding actions of people who may do acts or things on behalf of others, that the cultural
and linguistic circumstances and the gender of people with disability should be taken into account.
So it's clear at the very outset that human rights are at the core of the regulation of services.
So what are the issues for women with disabilities? Well, as I have said, women with disabilities and
men with disabilities have different life experiences due to biological, physiological, psychological,
economic, social, political and cultural attributes that are associated with being female and male. It
almost doesn't need to be said, except for the fact that this is often unsaid - it is obvious - but then it
becomes a bit unconscious, so we stop taking account of those issues. Patterns of disadvantage are
often associated with the difference in the social position of women and men. These gendered
differences are reflected in the life experiences of women and men with disabilities.
So this is what the evidence tells us about women with disabilities: women with disabilities
experience alarmingly high rates of violence, exploitation and abuse from a range of perpetrators,
yet remain largely excluded from violence prevention legislation, policies, services and supports.
They continue to be assaulted, raped and abused at a rate of at least two times greater than other
women and are at greater risk of severe forms of intimate partner and other forms of violence. More
than 70% of women with a wide variety of disabilities have been victims of violent sexual encounters
at some time in their lives. And if we look at women with cognitive disabilities, the research that we
get from overseas say that up to 90% of women with intellectual disability will experience sexual
assault at some time in their life. 68% of women with intellectual disabilities will experience sexual
assault before they are 18. So we are talking about a very significant issue.
The overwhelming majority of perpetrators of sexual abuse of disabled girls and women in
institutions are male caregivers, a significant portion of whom are paid service providers who
commit their crimes in disability service settings and other forms of institutional settings. Compared
to non-disabled women and men with disability, women with disabilities experience violence at
significantly higher rates, more frequently, for longer, in more ways and by more perpetrators, yet
programs and services either don't exist or are extremely limited. And in many respects, I think the
experience of women with disabilities parallels other women's experiences, but there is that added
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disadvantage and marginalisation of having a disability, so that compounds the intensity of women
with disabilities’ experiences.
So women with disabilities are more likely than disabled men to acquire a disability through genderbased violence, are poorer and more likely to be unemployed than men with disabilities, less likely
to be in the paid workforce than disabled men and have lower incomes from employment than men
with disabilities, are more likely to experience gender biases in labour market programs and are
more concentrated than disabled men in informal, subsistence and vulnerable employment. We also
share the burden of responsibility for unpaid work in private and social spheres including, for
example, cooking, cleaning, caring for children and caring for relatives. And we tend to have this
divide, if you like, a dichotomy, where we have carers and people with disabilities. But some years
ago, I undertook a study on the experience of rural carers and found that many of those carers were,
in fact, women with disabilities themselves. So I think that dichotomy and the separation is a false
one and we need to be aware in providing services that we are often providing services to people
with disabilities, and particularly women with disabilities who are… themselves have caring
responsibilities. And in that light, we need to be providing support services that take account of
caring responsibilities.
Women with disabilities are more likely to be sole parents, to be living on their own, or in parental
family situation rather than disabled men, are at higher risk of divorce than disabled men and often
experience difficulty maintaining custody of their children post-divorce; and often that situation of a
fear that the authorities will remove their children prevents women from attempting to escape
violent relationships because, in fact, they are not just going to lose the relationship, they are going
to lose their children and that is borne out by the evidence. Women with disabilities are up to 10
times more likely than other parents to have a child removed from care than other parents, and on
the basis of… it is on the basis of the mother’s disability rather than any evidence of child neglect.
Women are also more likely than disabled men to be affected by the lack of affordable housing due
to a major gap in overall economic security across the life cycle, and to their experience of genderbased violence, which leads to housing vulnerability, including homelessness.
We are less likely to receive support services than disabled men, and that is borne out by the
statistics that are released by the Australian Institute of Health and Welfare. And so that is, again,
something very important to be aware of in providing support services, that are we looking at the
statistics and making sure that we are tracking the data, that we are providing services in an
equitable way? We also face barriers in accessing adequate maternal and related health care and
other services for both ourselves and our children and are more likely than disabled men to face
medical interventions to control our fertility. We are more likely than disabled men to experiences
restrictions, negative treatment and violations of our sexual and reproductive rights.
We are more likely to experience extreme social categorisation, being more likely to be seen as
either hypersexual and uncontrollable, or desexualised and inert and passive. Sexuality is seen as
taboo, which makes it difficult then to discuss being lesbian, gay or, heaven forbid, transgender; and
how do we then talk about our sexual life when these issues are largely unrecognised? And I've
heard disability service providers who say, ‘No, people with disabilities are straight’. Women with
disabilities are also more likely than disabled men to be subjected to societal expectations around
beauty and to be seen to have to measure up against physical attractiveness in the same way that
other men… other women are expected to measure up to norms around social attractiveness being
a sign of real womanhood. So again, this is an area where women are… women with disabilities are
significantly disadvantaged.
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And if we look at women from cultural and linguistically diverse backgrounds or indigenous women,
we know that, again, there is another level of marginalisation that those women experience which,
again, makes them even more vulnerable to violence and subjected to discrimination with regard to
access to health services and other support services. And we know that 50% of indigenous
Australians are in fact… have a disability, and if we put that together with the high levels of violence
that indigenous women experience, then we, again, have a very serious situation that needs to be
taken into consideration in the way disability care is provided.
So you can see that the intersection of gender and disability holds some very series challenges for
individual women with disabilities and this has got to be taken into consideration. So what does this
mean then for quality services? What does it mean for women with disabilities under the
DisabilityCare Australia Scheme? Well, as I have said, under the Act, women now have the right to
expect gender sensitive services. Our right to dignity and respect is maintained within the Act and
the human rights Conventions and our right to health, personal safety and sexuality are required to
be recognised. So women can now check on how services do provide for a gender specific need.
Some of the questions that women might ask are things like, "What are your services… your workers
being provided with training around gender issues?" "Are women carers guaranteed under your
service?" "What is the service’s policy on touching?" "Is parent support available to parents with
disabilities?" "Can I, as a mother, expect to receive support in the way I provide care for my child?"
"Is there a policy on responding to violence and abuse?" "What are the complaint systems that are
in place?" These are the sorts of questions that you, as women with disabilities, can now ask of a
service provider, and these are the sorts of questions that you, as a service provider, need to be
ready to answer.
So what does it mean for you, for those of you who are providing disability services? Does your
service provide a gendered approach? Women tell us that they want the service to be a professional
service. The focus groups that we run with women with disabilities, women say that they want care
that is professional, for workers to be aware of the difference between friendship and the personal,
and the need for boundaries, so that a service provider takes a professional approach. One woman
said, "I have an expectation that they will do the things I ask for. Others might want to chat and
socialise but I don’t, I just want the specific help that I am asking for." Another woman told us, "I
want a support worker to see my disability and to relate to me on those terms, but I need to be able
to talk about my body and what I need. I don't want it to be seen as not important in my life.
Expressing needs, me explaining it in my own way with levels of disclosure that are comfortable for
me, with that person and at that time. I don't want my impairment to be the elephant in the room,
so let's talk about it, but let me choose the terms to talk about this."
Disability services should also be able to consider a gender friendly human resources approach.
What is the management ratio, men and women? Is there an inverse or a reversal of the ratio
between management and direct care? Do you see the majority of managers are men and the
majority of service providers are women? If so, what does that mean for a gender sensitive, gender
focused approach that is relevant for both men and women service users? So I think there is now a
great incentive to make the connections with your local women's support services and to utilise
them for training and for secondary consultation, so that your staff have got the knowledge of
where to go, if they need to, to get advice and support around issues or to refer clients if they need
to.
And I think there is a real risk that, without providing more gender friendly service, that disability
services will become irrelevant to their clients, who now will be in a position to choose services that
they want, so that quality will become inseparable from a gender focused service. So I want to finish
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by just briefly telling you about some good practice approaches to issues facing women with
disabilities that I am aware of here in Victoria that might be useful for you all to think about, either
as women with disabilities or service providers, or women with disabilities who are service
providers.
Firstly, I think what is really important is to be aware of violence prevention and violent response
services and there are a large range of services that are able to provide support in this area. Women
with Disabilities Victoria are currently developing a gender sensitivity learning package for disability
support services, and we are being funded to pilot that over the next couple of years. And so we will
be piloting it at Yooralla, but also hopefully within the Barwon region, if the Barwon region gets to
come up for breath from the current pressure it is under with the introduction of the Scheme.
And I think that is one way that you can ensure that your service providers are well versed on the
issues that I have talked about today and the ways… what the implications of that is for the way they
provide services. There are also programs like the Common Risk Assessment Framework on Family
Violence, that is rolled out through the Department of Human Services, and which means that all
services have a common approach to the way they assess and respond to family violence. And that is
particularly important, I think, you know, given what we have heard about today with the violence…
the severity and level of violence that women with disabilities experience. And it's not just… when
we talk about family violence, we tend to think about traditional notions of the family, but the
Family Violence Protection Act is broader than that and allows for violence that is experienced at the
hands of both paid and unpaid carers, amongst others.
There are also services such as family violence response services and centres against sexual assault
that will provide both secondary consultation, as well as crisis support and advice as to how to link
clients up with the right level of support that they might need. And there are a range of victim
support services that are provided through the Department of Justice, including a victim support
helpline that can be contacted for advice; and in different states there will be different victim
support arrangements that you can check out online. There are also a range of health promotion
programs and health services that are particularly important in regard to understanding how to
respond to sexual and reproductive health issues that women might present with. The most basic
things, such as pap screen and breast screen and, you know... making women aware of how they can
access these services I think is a really important part of providing a gender focused service.
And basic things like the local maternal and child health service, who I think are becoming
increasingly more skilled at being able to work with women with disabilities and to respond to the
needs, particularly of women with intellectual disabilities, but might also be looking for advice and
support and working collaboratively. So I think collaboration is a really critical word here in regard to
you being…. you might be the experts of your own disability and your own experience, you might be
an expert from having worked for many years in the disability sector, but you may not be an expert
around women's support services, so it's how to go and get to know your local service and how to
work collaboratively in providing the best service to women.
In Victoria, we have also got a fantastic advocacy service at the moment called Making Rights
Reality, which is a pilot program around advocacy for women with cognitive or communication
disabilities who have been sexually assaulted; and that is working with legal services and police and
it's getting some really good outcomes, much more positive outcomes for women who have
experienced sexual assault. And we also have a program called Living Safer Sexual Lives which is for
people with intellectual disabilities, and it’s people with intellectual disabilities peer mentoring
people with intellectual disabilities around sexual safety, what you should expect in a relationship,
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what is a healthy relationship. And, so again, that is a really important, I think, learning means for
people with intellectual disabilities that we are hoping to extend out to a broader group.
SPEAKER:
Sorry, what was the name of that second one?
KERAN HOWE:
Living Safer Sexual Lives. So that runs in Bendigo, down in Gippsland, and there is a group also in
Geelong and we are hoping to run it in parallel with our gender and disability training program that
we will be rolling out.
LAURA GREEN:
I think we have run out of time, do you want to…?
KERAN HOWE:
Yeah, I am about to finish.
LAURA GREEN:
(Inaudible)
KERAN HOWE:
No, I would like to finish up, because I think it would be really good to have a discussion, but there is
just two more things that I will tell you about. There is a crisis fund in Victoria which, again, is very
new and it’s specifically for women with disabilities who experience family violence. And it’s still not
known a lot about because it is so new, but if you're aware of someone who is experiencing family
violence and needs emergency support for additional care or whatever, that is something to check
out. So, sorry I have cut it short, but I would rather hear from you than for me to keep talking.
LAURA GREEN:
Thanks very much. So, we are really short on question time and I do think there is a 15 minute break
after this, so I think such a rich topic probably deserves some more time in that break, but perhaps if
we can go over here for a question before we are going to have to close, which is...
MICHELLE:
Hi, I’m Michelle from the ACT. As the mother of two children with disabilities - and my eldest child, a
girl, a 10-year-old girl with autism and Global Developmental Delay - I have to say, I’m feeling rather
sobered by what I have just heard here this afternoon. In your opinion, can you tell me, is the
introduction... I know we have just heard about all of the wonderful pilot programs and such that
you have got going on but, in your opinion, is the introduction of a scheme such as DisabilityCare
going to improve the lot of women with disabilities? Because I’m looking to the future for my 10
year old.
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KERAN HOWE:
Thanks, Michelle. Well, I think there is a great potential for it to. I mean, I know we expect a lot from
DisabilityCare because, you know… heard so much about what it can deliver and I think what's really
important is that we are informed as service users about what we want and what we need to ask for
and the questions, as I have said, that you might ask in interviewing a service around what sort of
care they are providing. So I think if we, you know… if it is a consumer led quality of care, then we
will get different responses, yes. But I think you need to be advocating that this is important.
LAURA GREEN:
Thank you. Now, in the interests of time, we are going to have to leave it but I just want to take the
opportunity to say thank you. For the first time I have heard in this conference the voice of some of
the most important issues that are going ahead of us as we do go forward. So thank you, Keran, for
raising them and for giving them that voice.
KERAN HOWE:
Thanks.
(Applause)
LAURA GREEN:
There is now a break before we head back into the plenary recession to close the conference, but I
suspect you might be getting held up here with a few more questions.
KERAN HOWE:
I’m really happy to stay and talk if anyone’s got further questions.
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