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Protecting The Vulnerable

The recent edition of The Monitor sounded the alarm with a story headlined: “Rape Of Imbiciles [sic] Spirals Out Of Control- Police Boss”. The story reports on the rising number of, what the reporter also calls, ‘mentally challenged’ women being raped in Mahalapye.

The manner in which the story was reported and the content of the story indicates the need for our society as whole to work towards the dignified and compassionate care of those living with intellectual disability.

Regarding the manner of the reporting, it is regrettable that words like “imbecile” were used. The reporter and editor perhaps may be excused for using the words in the legal context of criminal cases. Legislation in Botswana (the Penal Code and Criminal Procedure and Evidence Act) unfortunately has frozen in time and continues to use derogatory terms like imbecile and idiot. One needs to ashamedly admit that these terms originate from our health disciplines.

However, these terms are not used in 21st century health care. Idiot, imbecile, and moron were used clinically to describe what we now call intellectual disability. In their original usage the three terms were not the same, they described different levels of impaired intellectual functioning.  However, the terms were found to be inaccurate clinical descriptors, and they are plain offensive!

The story also interchanges the word imbecile with phrases like “mentally disturbed”, “mentally unstable”, and “mentally challenged”. But these replacement terms do not technically carry the same meaning. Generally, even in the day-to-day use of the words, there is nothing ‘disturbed’ or ‘unstable’ about people with intellectual disability. Someone with intellectual disability is perhaps ‘challenged’ if anything.  Our society and its institutions need to guard against such terms and importantly also guard against the attitudes leading to such terms. There is a need to substitute offence terms with more helpful and kinder terms. 

This is not just to be politically correct, but this is a crucial aspect of reducing the burden of living with intellectual disability by reducing stigma and affording dignity.

Regarding the content of the story, it was heart-breaking to learn of abuse towards individuals with intellectual disability. The story indicates that there is an urgent need to increase protection of individuals

with intellectual disability. Families need to continue playing an active role in ensuring this protection.

Depending on the severity of the intellectual disability life-long supervision is important. Due to deficits in reasoning and problem solving, individuals with intellectual disability are vulnerable to being taken advantage of. Some are raped, while others are used to commit crimes like theft. So families need to monitor their movements but not be too restrictive.

Our government also needs to establish supervised, free residential facilities like in other parts of the world where individuals with intellectual disability are supported in finding some employment and allowed to manage their affairs under supervision.

In the health sector, sexually abused individuals with intellectual disability need to be protected from the risk of sexually transmitted infections like HIV by ensuring that post-exposure prophylaxis is available country-wide.

In addition, women and girls with intellectual disability need to be protected from unplanned pregnancies by the use of long-acting reversible contraceptives. Furthermore, should the individual with intellectual disability present with a high appetite for sexual gratification, anti-libidinal medication needs to be an available option country-wide.

Educationally, there is a need for country-wide well resourced (in terms of physical infrastructure and human personnel) specialised centres to educate or train individuals with intellectual disability. The training should include both hard (practical) skills and soft (social and conceptual) skills.

By correcting the terms used and improving the protection and provision of services, we improve the chances of individuals with intellectual disability to live productive and meaningful lives. We need to remove the barriers that make it difficult for individuals with intellectual disability from contributing meaningfully to our society.

*Author: Maphisa Maphisa (B.Psych., UB; M.A .Clin.Psych., Rhodes) is a clinical psychologist and lecturer in the Department of Psychology, University of Botswana. The ideas expressed here are solely his and not of his employer. The article is not intended to be a substitute for professional psychological and medical advice.

Opinion & Analysis



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