Iryna Tverdokhlib is the Regional Representative of the National Assembly of People with Disabilities of Ukraine, Deputy Chair of the Regional and Municipal Accessibility Committees, and Coordinator of the Women’s Health Project in Poltava Region. She leads a local organization of persons with disabilities, is actively engaged in civic advocacy, and has spent many years working to improve accessibility and protect the rights of persons with disabilities.
Today, accessible gynecological services are available in Poltava, and accessibility in healthcare is increasingly becoming part of professional discussions. However, just ten years ago, even Iryna herself had never heard of universal medical equipment that allows women with different types of disabilities to undergo examinations comfortably and safely.
What does a comfortable and safe gynecological appointment mean to you?
I think about this very often. In fact, I have often reflected on what comfort actually means to me.
For me, it is a comprehensive approach. It is not only about physical accessibility. It is equally important that a doctor is willing and prepared to work with women with disabilities, follows medical ethics, and approaches the appointment not only professionally but also humanely.
I go to a doctor when I need a medical examination. But what matters most to me is whether the specialist is open to communication and interaction. You can sense it immediately: in the way they look at you, the way they speak to you, and in the atmosphere that develops once the consultation room door closes behind you. That is what matters most to me.
Have you been able to find a doctor you feel comfortable with?
Yes, and I consider myself very fortunate.
One of my former classmates became a gynecologist. She visited me once before leaving for a health resort, and since then she has remained my doctor for many years.
Whenever I faced difficult health situations and needed consultations with other specialists, I never chose them randomly. They were always recommended by people I trusted. It was important for me to find professionals who would understand my situation and with whom I would feel comfortable.
At that time, accessibility in healthcare facilities was rarely discussed. Many buildings were inaccessible. However, from a psychological and ethical perspective, everything was done correctly. I had a great deal of trust in those doctors.
How important is it to find “your” doctor?
For me, it is extremely important. If I notice hesitation, impatience, or feel that a doctor is not interested in communication, I try to keep the appointment as short as possible. I receive the recommendations, thank them, and look for another specialist. That is why I have remained with the same doctors for many years, the ones who make me feel calm and comfortable.
Have there been moments in your life when this trust in a doctor became especially important?
Yes, there have.
There was a period in my life when I had to undergo serious treatment and surgery. It was during that time that I truly understood how important not only a doctor's professionalism is, but also their willingness to work with a patient who has a disability.
The surgeon who operated on me later admitted that I was the first patient with a visible disability he had ever treated. He was a very demanding person. Everything in his department functioned almost to the minute. You could hear him throughout the entire ward every morning. Everyone knew there had to be order, cleanliness, and discipline. At the same time, I could see that he was also learning to understand that certain things may work differently for a woman with a disability than what he was accustomed to seeing in his medical practice.
For example, I had specific rehabilitation needs after surgery. The medical staff genuinely cared, but they did not always understand how the body of a person with a spinal cord injury functions. We had to explain many things to each other. Looking back, I think it was a mutual learning process.
I remember my discharge day very clearly. Until then, he had always been very strict. But as I was preparing to leave, he took a moment, approached me, and said: "You did a great job. I didn't think we would get through this the way we did." For me, it was a deeply human and meaningful conversation.
Why is it important for healthcare professionals to learn more about the experiences of women with disabilities?
Because many things cannot be fully understood from textbooks alone.
During my treatment, the medical team and I realized that many professionals simply lacked knowledge about the specific needs and physiological characteristics of women with spinal cord injuries. That does not mean they were poor specialists. They had simply never been taught these things.
People often genuinely want to help but do not have the necessary knowledge. That is why training healthcare professionals is just as important as purchasing new equipment.
You have worked on accessibility issues for many years. How did the issue of accessible gynecological services become part of your life?
It is a very personal story.
In 2016, I attended a meeting in Kyiv dedicated to the reproductive health of women with spinal cord injuries. That was the first time I heard about a universal gynecological examination chair. I was shocked. I did not even know such a chair could exist. I had never imagined that there was equipment that would allow a woman to undergo an examination comfortably and safely.
When I returned to Poltava, I immediately approached the city health department and asked whether it would be possible to purchase such equipment for our city. They said it was possible. At that time, however, we were unable to move the initiative forward. Later, after changes in the local government team, we returned to the idea.
How did you manage to secure the purchase of the chairs?
To be honest, I did not even know the word advocacy back then. I simply wanted it to happen. I explained that such equipment was not only necessary for women who use wheelchairs. It was also important for pregnant women, older women, women recovering from surgery. In fact, it was important for all women.
Two months later, local council members approved the purchase of two universal gynecological examination chairs. I remember the emotions I felt when I saw the equipment for the first time. For me, it was a real achievement. I wanted gynecological appointments to be comfortable both for doctors and for patients.
Is purchasing modern equipment enough?
No. And this is a very important point.
We often see a genuine desire to improve accessibility for persons with disabilities. People renovate buildings, create accessible sanitary facilities, install handrails. But they do it without consulting those who will actually use these solutions. For example, handrails may be installed incorrectly. Technically, they are there. But using them is difficult or even unsafe. Or equipment is purchased that appears modern but does not meet all users’ needs. The problem is not a lack of goodwill. The problem is that people often lack the necessary knowledge.
How do you assess the accessibility of healthcare services today?
Accessibility has become part of the public agenda. People talk about it much more than before. Doctors know what universal medical equipment is. They understand that healthcare services must be accessible. However, there is still a significant gap between understanding the need for accessibility and having the resources to implement change. This is especially true in rural communities.
Healthcare facilities are closing. There is a shortage of specialists. Young professionals are not always willing to work in smaller communities. Women are often the ones most affected by these challenges, particularly women with disabilities. In addition to the barriers faced by everyone else, they must also deal with transportation issues, inaccessible infrastructure, and financial constraints.
Many women postpone medical examinations not because they do not understand their importance, but because they simply do not have the resources needed to complete the journey.
How does the journey to healthcare influence the decision to seek medical care?
Because accessibility does not begin at the door of the doctor's office. You can have an excellent healthcare facility. You can install modern equipment. But if the road leading to the hospital is inaccessible, or if a person cannot reach it using public transport, the problem remains.
In Poltava, we spent many years working to improve accessibility beyond healthcare facilities themselves. We worked with public transportation providers and organized training sessions for drivers and conductors of the municipal trolleybus company. We discussed different types of disabilities, communication, and passengers’ needs. Today, I can see the results of that work. People often think accessible transport simply means a low-floor trolleybus. In reality, it is much more than that. It is a driver who knows how to stop close to the curb. It is a bus stop where people can wait safely. It is understanding how to assist someone when assistance is needed.
When trolleybus drivers in Poltava see a wheelchair user at a stop today, they already know what to do. They know how to approach safely and appropriately. And that makes a huge difference.
What motivates you to continue this work?
Results. I understand women who face barriers because I have walked that path myself. I know how much effort even a single medical consultation can sometimes require. That is why seeing change is my greatest motivation.
When accessible equipment becomes available, when healthcare professionals gain new knowledge, when a woman can receive medical care without unnecessary obstacles, I see the impact. And when I see results, I know we need to keep moving forward.
Oleksandra Perkova, Communications Manager of the Project
