Double Marginalisation: The Silent Exclusion of Women with Disabilities from Breast Cancer Awareness

By Lloyd Mangoh and Virginia Zifesho

When 27-year-old Hazel Muchuma received a breast cancer awareness message on WhatsApp, she did what she always does: she activated her phone’s screen reader.

The robotic voice began to read, but soon stuttered and froze on an image-based poster.

The message was in a visual format, inaccessible to her as a young woman with a visual impairment.

“I could tell it was important,” Hazel says softly, her hands resting on her walking stick.

“But there was no audio or Braille version. I had to ask my cousin to read it for me, and even she wasn’t sure what it meant.”

For Hazel, the challenge is not just about missing a single message.

It is about being left behind in a world where information, especially life-saving health information, assumes everyone can see, hear, and read.

October may be Breast Cancer Awareness Month, but for many women with disabilities, the pink ribbons and television jingles mean little more than distant echoes of a conversation they cannot join.

Technology could have been her bridge to access, yet it often becomes another wall. “Some of my friends who are visually impaired don’t even have smartphones,” she explains.

“Even those who do often don’t know how to use screen readers.

They depend on someone else to read messages out loud, which means they lose their privacy and sometimes, they miss life-saving information.

”While the world advances digital health campaigns, Hazel and others like her remain on the margins of visibility.

Information about free screening services is rarely available in Braille or audio formats, and public hospitals often lack staff trained to communicate with people who have visual impairments.

For Natasha Sibanda, Programmes Officer at Miss Deaf Pride Zimbabwe, exclusion takes a quieter, yet no less painful form.

“Many Deaf women are being diagnosed with breast cancer late,” she says.

“The main reason is that there’s almost no breast cancer awareness information in Sign Language.”Inside hospitals, the silence deepens. “Most health workers don’t know Sign Language,” Sibanda explains.

“Some even pretend to, and that can lead to wrong diagnoses. Deaf women are scared to go to hospitals because they can’t explain what they feel.”

Natasha’s message is firm: “We have the capacity to partner with health institutions to translate materials into Sign Language. It’s not complicated, it just needs willpower.”

The sense of exclusion is also echoed by Gamuchirai Uzande, a disability inclusion advocate and a member of the Alive Albinism Initiative, who recalls a breast cancer screening event she attended.

“The assessment team was in a small gazebo tent,” she says.

“But the rest of us had to wait outside in the blazing sun. For someone like me, with albinism, exposure to sunlight is not only uncomfortable, it’s dangerous.”

For Gamuchirai, accessibility is not just about communication; it is about dignity. “Communication and logistics must be deliberate,” she insists.

“It’s not just about telling women with disabilities to come; it’s about making sure they can participate safely and meaningfully. Most of the time, we are invisible in these programs.”

She believes the low participation of women with disabilities is largely due to structural inaccessibility and poverty.

“Information and services are not just unavailable; they are unreachable.”

Joyce Matara, Acting Director for the National Association of Societies for the Care of the Handicapped (NASCOH), agrees that the gap is systemic.

“I think the awareness campaigns being done are not disability-inclusive because most breast cancer awareness materials are not available in accessible formats such as Braille, large print, audio, or easy-read versions,” she explains.

“Women with visual impairments cannot access visuals, and most websites where this information is posted are not compatible with screen readers. Socially, women with disabilities are often overlooked in mainstream health campaigns, and caregivers sometimes act as gatekeepers to information.”

Joyce adds that the problem cuts across disability types: “Those with hearing impairments are also affected because of limited Sign Language interpretation in awareness videos and campaigns.

Complex medical terminology creates barriers for those with intellectual disabilities.

In terms of physical accessibility, mammography equipment and facilities are often not wheelchair accessible, and examination tables cannot be adjusted for different mobility needs. Most healthcare providers also lack training on communicating with women with various disabilities.”

She concludes on a somber note: “The lack of disability-inclusive images in campaigns reinforces exclusion. It’s safe to say that the intersection of disability and women’s health remains largely ignored in public health messaging, leaving women and girls with disabilities significantly underserved and at higher risk due to delayed detection.”

Edith Masango, a visually impaired disability inclusion advocate, shares a similar frustration.

Every October, she gets concerned as breast cancer awareness walks, fun runs, and pink-themed marches dominate the streets and social media.

“It’s like women with disabilities have no breasts,” she says sarcastically.

“We are completely left out of the awareness activities as there are no deliberate efforts taken by organisers to ensure that we are also able to participate.”

Besides awareness activities, even though clinics are physically accessible, the information is not.

“There are flyers and posters everywhere, but none are in Braille,” Edith adds.

“People are busy; no one has time to read for you. You end up leaving without knowing what the poster says.”

For these women, exclusion goes beyond frustration; it becomes a matter of survival. Without access to information, they cannot detect symptoms early or seek timely screening.

According to UNFPA Zimbabwe, women with disabilities are three times less likely to access sexual and reproductive health information compared to women without disabilities.

The same disparity applies to cancer awareness and screening, where most materials are not available in Sign Language, Braille, or audio formats.

Lack of access breeds silence, and silence can be deadly.

“Information is power,” Edith says. “But for many women with disabilities, that power is locked away.”

Hazel echoes her sentiment.

“If I could access breast health information in Braille or through voice notes, I would know what signs to look for. Right now, I depend on others and sometimes, I’d rather not ask.”

Despite the odds, these women continue to raise their voices, demanding inclusion not as a favour, but as a right.

They call for all public health campaigns to adopt universal design, ensuring that information is accessible to all from the outset.

That means Braille materials, Sign Language videos, large-print posters, audio formats, and trained health workers who can communicate inclusively.

“We need health communication that sees us, hears us, and respects our bodies,” Gamuchirai emphasizes.

“Inclusion should not come as an afterthought.”

Though the barriers remain high, hope persists.

Disability advocates and women’s rights groups continue to campaign for inclusive cancer awareness in Zimbabwe.

Their message is clear: accessibility is not charity, it is survival.

Hazel sums it up with quiet conviction: “People think breast cancer awareness is about wearing pink. But for us, it’s about being seen, being heard, and being given a fair chance to live.”