By: Lunga Memela (Communications Engagement Lead)
In South Africa (SA), up to 80% of healthcare consultations are conducted across language barriers. Access to quality healthcare is enshrined in our Constitution, and more recently promised by National Health Insurance. However, for persons born deaf who rely on South African Sign Language (SASL) for communication, this access is thwarted by language barriers. Barriers include providers who cannot communicate in the patient's language, and an absence of SASL interpreter services. The consequences are a particular disadvantage for deaf healthcare users, who experience multiple axes of discrimination both in health care and in broader society, limiting their capacity to manage miscommunication in health care.
This is according to a review co-authored by health experts Leslie London, Virginia Zweigenthal and Marion Heap (published posthumously) from the Division of Public Health Medicine at the University of Cape Town's School of Public Health and Family Medicine, and the Cape Town-based organisation Equal Health for the Deaf. Appearing as the 19th chapter in the 2020 edition of the South African Health Review (SAHR) – a flagship publication of the Health Systems Trust – their review, Ensuring equal access to health services for the Deaf in South Africa, recommends that the provision of adequate interpretation services should be complemented by programmes that boost agency of the deaf in challenging the historical but persisting discrimination they experience.
The United Nations identifies the International Day of Sign Languages on 23 September as a unique opportunity to support and protect the linguistic identity and cultural diversity of all deaf people and other sign language users. The 2021 theme, declared by the World Federation of the Deaf (WFD), is "We Sign For Human Rights," highlighting how each of us – deaf and hearing people around the world – can work together, hand-in-hand to promote the recognition of our right to use sign languages in all areas of life.
The International Week of Deaf People (IWDP) is an initiative of the WFD and was first launched in 1958 in Rome, Italy. It is celebrated annually by the global Deaf Community during the last full week of September, to commemorate the same month the first World Congress of the WFD was held. The IWDP is celebrated through various activities by deaf communities all around the world. WFD signs about it in this video.
In March 2021, the World Health Organization (WHO) estimated that 1 in 4 people are projected to have hearing problems by 2050. WHO published a World Report on Hearing, which aims to provide evidence-based guidance to drive actions for integration of quality ear and hearing care services into national health plans of Member States, as part of their work towards universal health coverage. "According to the World Federation of the Deaf, there are more than 70 million deaf people worldwide. More than 80% of them live in developing countries. Collectively, they use more than 300 different sign languages," says WHO.
In the conclusion of their SAHR chapter London, Zweigenthal and Heap state "[t]he words below, from a participant in Tshegofatso Senne's study, capture both the challenges of a health system seeking to be responsive to [d]eaf patients, and the agency needed by the [d]eaf to make their constitutional rights real":
You need to know that you have your rights and you must fight for them. I have the right to go to the police station or to the clinic. Tell them you're [d]eaf and you have a problem and that you need SASL. I have the right to be treated as a normal person .... We have a right to be recognised in South Africa as a whole. If people know about accessibility and understand this, then we just need to make SASL an official language. There's no other way to solve it.
Access the full chapter here: Chapter 19: Ensuring equal access to health services for the Deaf in South Africa, or to see other contributions to the 2020 edition of the SAHR: Access to health care for persons with disability in South Africa, click here.
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