The challenge that the project addresses
An open and just society in Zimbabwe is only possible if the linguistic and health rights of the deaf people are prioritized. This project promotes and bridge the communication gap between the deaf and hearing community in the health domain in Zimbabwe. This project addresses the politics of inclusion and exclusion of the Deaf community in the health domain, occasioned by the marginalisation of Sign language in Zimbabwe. Worldwide public health authorities are taking action to contain Covid-19. While the bulk of research on the pandemic focuses on understanding the spread and seeking a cure for the virus from a virology perspective, research of the same magnitude should also focus on the risks of the pandemic for society, particularly among disadvantaged groups. This project adopted a community-centred approach to information and health rights and utilised the case study approach to investigate the quality and access to health related information Covid-19 information, care and treatment by the Deaf community in Zimbabwe. More than 60% of health related issues and of Covid-19 messages communicated in Zimbabwe’s mainstream media do not cater for the needs of these disadvantaged groups. Brochures, videos and infographics, for instance, appear in English, yet there is a significant population of people with Low English Proficiency in Zimbabwe. As regards the Deaf community, videos, conversations and interviews with health specialists, which rarely appear in mainstream public media, include Zimbabwean Sign Language interpretation. In this case, the choice of language and medium used to communicate vital health information and Covid-19 messages in mainstream public media may pose language barriers to effective and equitable health information for these vulnerable groups. What this reality hints at is that public communication that does not discriminate is a necessity to allow all members of the community to fight the spread of diseases such as Cancer, HIV, Cholera, Typhoid, Covid-19 and hence, reduce its potential risks.
What is your project doing to respond to this challenge?
Sign Language workshops in Hospitals
The project is bridging communication gaps by teaching nurses and doctors Sign Language in hospitals. Access to information at the right time, in the right language, and of the right quality is critical in the fight against pandemics. However, when disadvantaged groups are deprived of essential health information, they are left at an increased risk of contracting the disease and exponentially spreading the disease; thereby, increasing the burden on already underfunded health facilities. The Deaf community remain susceptible to contracting the disease because vital information about killer diseases shared in mainstream media is often inaccessible to them.
Deaf Awareness Programs in Hospitals and communities
In this project l am doing some deaf awareness campaigns in health set ups. Deaf awareness refers to a knowledge and awareness of the terms and characteristics of deafness, what it means to be deaf, how deaf people communicate and what is the best practice when communicating and working with deaf people. From a service provider’s perspective, to be highly Deaf aware would be to understand how a deaf person would access their service and what provisions they would need so that they were able to access the service fully. To not be Deaf aware is to not consider or care how a deaf person would access a service, to be unaware of their needs and to not take any special measures to account for their needs.
Content Creation of Sign Language Videos
Producing health related information in accessible formats e,g Sign Language videos, Health related Sign Language dictionaries, Sign Language Charts with basic signs to bridge the communication gap between nurses, doctors and deaf patients. The Deaf community in Zimbabwe remained relegated to the periphery in as far as access to Covid-19 information is concerned. Efforts to make sure information reaches this community are still minimal across the nation. Deaf people are exposed to serious risk because information on Covid-19 is not being presented to them in accessible formats. Covid-19 for example poses unique challenges to the Deaf community in Zimbabwe, many of whom rely on visual cues such as lip-reading and sign language (ZSL), which leans heavily on facial cues and expressions. Communicating in international lingua francas or national (official) languages like English, in the case of Zimbabwe, makes marginalised people more vulnerable. While English is the official language of government business in Zimbabwe, it is spoken by the majority of Zimbabweans as a second or even third language. For the Deaf and other disadvantaged groups, most of whom often have fewer educational opportunities and are less likely to speak or read English as a second language, marginalisation in the face of pandemics like Cholera, Tuberculosis and Covid-19 is exacerbated. In Zimbabwe the Public Health Act of 2018 section 34 state that the user should have full knowledge of services (2) The Health practitioner concerned shall where possible inform the user as contemplated in subsection (1) in a language that the user understands and, in a manner, which considers the user’s level of literacy. This therefore shows that, for one to have full access to healthcare he or she should be addressed in a language they understand.
Describe the project's impact
Significant gaps and challenges still exist about Covid-19 and other killer diseases; these gaps are especially evident in resource-limited settings and the challenges impact heavily on disadvantaged groups in society such as the Deaf community. Evidence suggests that the likelihood of pandemics has increased over the past century because of increased global travel and integration, urbanisation, changes in land use, and greater exploitation of the natural environment. This implies that communicative efforts, especially those aimed at disadvantaged groups, should also be improved. Most data regarding the risks, impacts, benefits and cost of mitigation measures against pandemics that are generally reported in the literature come from high-income countries, leading to biases and potential blind spots regarding the risks, consequences and optimal interventions specific to low-income countries such as Zimbabwe.
According to UNESCO, persons with disabilities remain an invisible population group, and this accentuates their vulnerability and marginalisation in times of emergency. Literature on the Spanish flu pandemic of 1918 reveals that people with poor literacy were much more likely to transmit the disease, and to die. During the H1N1 swine flu outbreak, Chinese people with limited English proficiency living in King County, Washington were reportedly unlikely to obtain information from the public health System. Similarly, Spanish speakers were found to be at the greatest risk of exposure to H1N1 during this outbreak. What these few examples suggest is that people with limited English proficiency do not receive adequate health information, which ultimately exacerbates health disparities.
In times of crisis and disaster, a lack of access to communication and information platforms for people living with disabilities makes them more vulnerable and prone to life-threatening situation. Communication problems between healthcare staff and patients are common. Many people do not understand the language used in health care units and these problems are exacerbated for people with disabilities. Chakuchichi, Chitura and Gandari (2011) in their study about equity and access to HIV/AIDS information dissemination to people with disabilities note that information dissemination is the strongest strategy of mitigating the impact of the HIV/AIDS pandemic. According to Pasipanodya in The Voice of the Voiceless newspaper 03/04/2017 reports that gleams of inexplicable joy could be seen all over her face as she walked out of the New Start Centre that does HIV testing, a deaf and dumb youth, had just been told she was HIV positive. In the world of the deaf, anything “positive” means it must be good. According to Pasipanodya (2017) the seventeen year old vendor was not aware that the diagnosis was not really positive at all, it required through counselling, a balanced diet and lifetime ant-retroviral treatment. But no one at the centre spoke Sign language. So no-one was able to explain to her what she needs to do, and what she is up against.
These are sad realities which deaf people are experiencing when accessing HIV/AIDs information in most health institutions. According to Nyakanyanga in Bhekisisa All Africa Global Media newspaper report (2017), the 2015 baseline study by Deaf Zimbabwe Trust highlights the lack of access to health information by the deaf community. When asked about their understanding of a medical male circumcision drive aimed at protecting men from HIV infection, some deaf participants answered “I thought that my penis would be cut”. The nexus of this research is perpetrated by the idea that medical practitioners use spoken language to communicate with their clients in their day to day business, therefore chances of having a ready programme or resources to cater for the deaf maybe non-existent or limited. Disabled People Organisation (DPOs) expressed concern over delays in domesticating the acceptance of Sign language by the Zimbabwean 2013 Constitution. The DPOs emotionally revealed “we have had Deaf adults especially women in the maternity wards who have been given wrong medication, but this goes on unpublished and unnoticed just because the concerned people are a minority”. DPO’s expressed that people who are Deaf but found HIV positive are likely to go with misconceptions and uncounselled too just because of communication barriers. Echoing the same sentiments, Masinike reported in The Herald (August 20, 2015) on a title Teach Sign language in schools that a communication barrier between a Harare doctor and a patient a few years ago led to the tragic death of the patient. This raises the assumption that the Deaf are meeting communication challenges in the health set-up.
It is against this background that this project is focusing on bridging the gap by collaborating with Deaf organisations and Sign language students at the University of Zimbabwe in carrying out family planning programmes and awareness programmes on killer diseases like Cancer, Malaria, Cholera and Typhoid for people with hearing impairments in different communities, in clinics and hospitals, creating dictionaries, charts which are health related and teaching doctors and nurses at Parirenyatwa group of hospitals and Harare hospital.
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