Access to healthcare is largely a private affair, especially at the point of diagnosis for an ailment.
But for the people with hearing impairments, a third party is often involved in the medication process unless one finds medics who understand basic sign language or who will allow them to communicate through writing.
Medical workers do not have sign language as part of their training but they often encounter deaf persons who are about 3.2 percent of Uganda’s population.
As a result, most persons with hearing impairment desert government health facilities and look for where they can find a medical person who understands them.
Mr Sulaiman Balinya, a resident of Kiwanga in Mukono District, has traversed neighbouring health facilities hoping to find a medical worker who understands sign language.
For more than a year, he has suffered from ulcers and feels he has not been given the right treatment to save him from pain.
When the Nation Media Group (NTV and Daily Monitor) crew met Mr Balinya last week, he was in pain.
Asked where he preferred to get his treatment from, he said Doctor’s Medicare Centre in Kiwanga because the facility has a medical worker who knows basic sign language.
The team followed him to the facility to see how he interacts with others and the doctor. The medical facility gave the team access to the diagnosis room to observe the process.
His interactions with the receptionist at Doctor’s Medicare Centre using gestures was exciting to watch. The receptionist knew common gestures and he keenly followed every instruction from taking his weight and temperature till he sat down with the clinician, Mr Fred Aniku.
“The main challenge we face when we are accessing medical care is the communication between a deaf patient and the doctor. You know the science words are hard. Even the sharing through writing is not enough. As a deaf patient, sometimes I feel like the doctor is not understanding how I am feeling,” Mr Balinya said.
“I always come here because the doctor understands me and he tries to communicate to me using sign language and sometimes I write if he is not understanding what I am saying in signs,” he added after getting treatment.
Mr Fred Aniku, the clinician at Doctor’s Medicare Centre, said he had to adapt since his patients needed his service.
He learnt basic sign language from the deaf people who visit his facility and sometimes he visit the Internet for more lessons.
“The first time I encountered a deaf person, I did not know how to communicate with them and my training as a medical worker had not prepared me for this. But they have a right to quality medical care so I learnt and now try to use basic sign language to be able to treat them. Sometimes the patient writes on a piece of paper and we communicate like that,” Mr Aniku says.
Because of Mr Aniku’s interest in learning sign language and embracing the deaf community, he has since seen more deaf patients come to the facility.
As he treats more deaf patients, he has had the uphill task to understand movement of the hands and facial expressions as part of his work.
He says once deaf people realise that someone cares or knows how to communicate to them, they all go to that person at the facility.
Dr Joyce Nalugya, a consultant psychiatrist at Mulago National Referral Hospital, learnt sign language more than 20 years ago because she had a deaf child to communicate with.
She says deafness must be understood before one tailors solutions or ways to get involved in the lives of such persons. She interacts with her 23-year-old daughter, an accounting student at Kyambogo University using sign language. This has been a challenge for many parents.
Dr Nalugya says her ability to use sign language has led her to many patient diagnosis rooms at Mulago hospital whenever there is a deaf patient and others cannot communicate to the patient.
“Sometimes I leave my work and go to interpret for my colleagues because I know sign language. I had to learn because I have a child who has hearing impairment and I needed to know how to communicate with the child,” says Dr Nalugya.
Deaf persons depend on touch, signs and facial expressions.
Mr Robert Nkwangu, the executive director of Uganda National Association of the Deaf, is concerned that the plight of deaf persons in access to medical care has not been prioritised in government planning and implementation of health care services and strategies.
“Interpreters are very far from deaf people and also lockdown has seen them stay home. In most of the hospitals, doctors and nurses do not know sign language so communication is difficult. Deaf people have been getting coronavirus but they cannot go to the hospital because communication is a challenge,” Mr Nkwangu explains.
Mr Alex Ndeezi, the Member of Parliament for Persons with Disabilities, says the legislation by parliament was to address gaps for those with hearing impairment.
“Parliament approved laws on sign language but they have not been implemented. Communication can be effective with a fluent interpreter,” he says.
Part two (15) of Persons with Disabilities Act, 2019 provides for the government to; “promote the development, training and use of sign, tactile and sign language interpreters in, in all public institutions and at all government functions.”
Mr Andrew Mubangizi, the principal occupational therapist in the Disability Department at the Ministry of Health, says each institution should take interest in learning sign language.
“Every entity must have focal persons to encourage their staff to learn basic sign language. It is simple if people are willing to do short courses in sign language,” Mr Mubangizi says.
“Government has created posts for sign language interpreters and we are hopeful that public service will recruit them. I do not know how many and when, but there is a provision for that already,” he adds.
There are no clear statistics of professional sign language interpreters in the country. Only Kyambogo University offers a diploma course in sign language. Others learn through the Internet, peers or schools that offer special needs education.