AREA OF INVESTIGATION

Hearing allows us to gather important information about the surrounding environment

through
listening but profound deafness variably affects communication modalities and understanding
of the spoken language (Johnson 2014). This study is about communication challenges faced
by persons with disabilities in accessing healthcare services at Esigodini community. Access
to health is the ability to obtain healthcare services such as prevention, diagnosis, treatment,
and management of diseases, illness, disorders, and other health-impacting conditions.
Communication according to the National Disability Policy (2020) includes languages,
display of texts, Braille, tactile communication, large print, accessible multimedia as well as
written, audio, plain- language, human-reader and argumentative and alternative modes,
means and formats of communication, including accessible information and communication
technology. According to the Disabled Persons Act of 1995 (Amended in 2000 and 2001), the
government of Zimbabwe defines a person with disability as

‘A person with physical, mental or sensory disability including a visual,

Hearing or speech functional disability which gives rise to physical,

Cultural or social barriers inhibiting him or her from participating at

An Equal level with other members of the society in activities

Undertaking or fields of unemployment that are open to others members of

Society.’

It can be estimated that 15% of the Zimbabwe’s population of about 15 million people
encompasses persons with disabilities (National Disability Policy 2020) and more than half of
that proportion are women and causes of disability are congenital (23.2%), illness or disease
(47.4%), injury or accident (11.2%) and violence including domestic violence (5.5%). This
study will therefore analyse the communication challenges faced by the disabled in accessing
healthcare services i.e. the deaf because they are at risk of being excluded from society i.e.
denied the right access to healthcare systems through language barriers, stigma and myths
around people with disabilities, discrimination not to forget negative attitude of healthcare
staff. Esigodini which is a small community located in Bulawayo along Gwanda road will
be used as the main case study in this research, however, the researcher will make reference
to other communities so as to come up with a balanced conclusion.

This study will analyse the communication challenges faced by the deaf in accessing
healthcare services and by definition deafness refers to those people who are unable to hear
or pay attention to something unwillingly and there are two types of deafness. Deaf with
capital ‘D’ are those who are born deaf or experience hearing loss before spoken language is
acquired and regard their deafness as part of their identity and culture rather than as a
disability. Deaf with small letter’d’ are those who have become deafened or hard of hearing
in later life, after they have acquired a spoken language and so identify themselves with the
hearing community.

OBJECTIVES
This study aims to:

1. Analyse the communication challenges faced by the disabled (deaf) people of Esigodini
community in accessing healthcare services

2. Find out ways of dealing with the challenges faced by the disabled (deaf) people of
Esigodini community in accessing healthcare services.

STATEMENT OF THE PROBLEM

Lack of sign language interpreters, lack of attention to the communication preferences of the
deaf people, lack of covid-19 adjustments (issues to do with face masks and maintaining
social distance-Covid-19 rules), lack of communication technology, lack of deaf-awareness
training for health workers, lack of an enabling language policy, negative attitudes from the
healthcare services staff lead to communication barriers hence a lot of communication
challenges for the deaf community. Gibson and O’Connors (2010) notes that people with
disabilities feel like patients of low priority and poorer access to health care services (due to
language barriers) can then lead to even poorer health.

UNCRPD (United Nations Convention Rights of People with Disabilities (2006) and
Arneson (1999), notes that all human beings possess fundamental rights and freedom to use
the means of communication they are comfortable with. The UNCRPD (2006) further notes
that deaf people are entitled and support of their linguistic and cultural needs on equals basis
as hearing peers. Identifying such problems that affect the deaf community will help the
researcher in proposing or coming up with strategies to transcend these challenges and they
will help in promoting easy access to healthcare services and that’s the deaf community gets
to fully enjoy their right to healthcare as stated in Section 76 of the Constitution of Zimbabwe
Amendment No 20 Act that states that;

(1) Every citizen and permanent resident of Zimbabwe has the right to have access
basic health-care services, including reproductive health-care services.

(2) Every person living with a chronic illness has the right to have access to basic

healthcare services for the illness.

RESEARCH QUESTIONS

1. What are the communication challenges faced by the deaf in accessing healthcare services
in Esigodini community?

2. What are the ways and strategies that can be used in order to solve the communication
challenges faced by the deaf people of Esigodini community?

JUSTIFICATION

This study is on the challenges faced by the deaf in accessing healthcare services in Esigodini
community and the researcher choose this community so as to create a context which is
designed to fulfil the requirements of this research. The sole purpose of this research is to
suggest strategies that can be used to solve the communication challenges faced by the deaf
that will lead to the enjoyment of the right to health without any language barriers as
stipulated in Section 3.7 of the National Disability Policy (2020) which states that;
 3.7 (2) ‘Persons with disabilities must have access to free health services in public

Healthcare institutions, including in the areas of sexual and reproductive

Healthcare and population based public health programmes’.

3.7 (4)’ Persons with disabilities must be provided with the same range, quality and

standard of healthcare as provided to other persons’.

This research will be useful to the communities that discriminate the deaf community
linguistically and also useful especially the healthcare practitioners as it will help them
understand how to deal with deaf patients in facilitating communication and also realise that
these people have only been having physical access and linguistic access is not guaranteed.
They will also benefit from the study’s insight on the strategies which they can use when they
face language barrier situations with deaf persons especially in this Covid-19 pandemic era
i.e. helping the deaf community enjoy their right of persons with disabilities enshrined in
section 83 of the Constitution of Zimbabwe Amendment (No20) Act that states that the State
must take appropriate measures, within the limits of the resources available to it, to ensure
that persons with disabilities relies their full mental and physical potential, including
measures-

(d) To give them access to medical, psychological and functional treatment

This then justifies the importance of this research study as the researcher is trying is not
aware of the materials that has been produced that focuses on the communication challenges
faced by the deaf ( taking note of specific sections of the Zimbabwean policy documents)
especially in this Covid-19 era in Esigodini community. Also not to forget the methods that
can been used to transcend these communication challenges.
LITERATURE REVIEW

Persons with disabilities are the most marginalised and discriminated minority groups in the
World and their needs are often ignored and they are at risk of being refuse access to
healthcare services due to communication failures and the negative attitudes from the
healthcare staff. Most literature on the deaf people focuses mostly on generalising the
challenges deaf people face and at the end of the day, not much is being said on the
‘communication’ challenges specifically especially in small developing communities, for
example, like Esigodini community located in Matabeleland. The researcher then saw the
chance to fill in the gaps of the loopholes found in the written literature that is already
available that does not say much on the communication challenges faced by the deaf people
in accessing healthcare services especially in this Covid-19 pandemic era that has a lot of
rules and regulation that somehow affect the deaf community.

According to Mutswanga (2017),some deaf-blind participants in (Miles 2003) stated, ‘Hands

are my freedom from a dark world of silent world’, some said, ‘Hands are my window to life.
Through them I can truly see’ and another said, ‘My hands are my ears and my voice’. This
therefore shows that hands serve as ways of making language accessible to a person who is
blind or deaf.
Miles (2003) and Stokoe (2001) propose that Sign Language is one of the most
efficient ways to make language accessible. Hands are therefore reliable sense organs that
access language. However, these two scholars only focus on the issues of the use of hands
only i.e. Sign Language as a tool to help in accessing healthcare services and due to this, the
researcher saw a cause of concern to talk about other methods besides hands i.e. Sign
Language that serve as a way of making language accessible i.e. through training of
healthcare staff, linguistic support from the government and communities not to forget use of
communication technology.

Very little has been said and done on the ‘communication’ challenges faced by the deaf in
accessing healthcare services. Some sources do not give vivid information on challenges and
strategies that can be used to transcend the challenges faced. Lawthers, Pransky, Petersen
and Himmelstein (2004), notes that barriers to access have been well studied and include
geographical barriers (location of services), financial barriers (cost of getting to care),
organizational barriers (lack of appointments, long waits for care, transportation, or referral
requirements), and cultural barriers (differing languages or health belief models). They
further allude that access to services, especially financial, physical, and organizational access,
can present particularly potent challenges for persons with a disability.

Also not to forget that they identified four major access barriers to persons with disabilities:
physical and transportation barriers; limited access to assistive technology and equipment;
limited access to medications, specialists; and limitations in access to personal care
attendants. This journal then proves that a lot has not been said especially on the issues of
language which are vital to human beings and NgugiWa Thiongo (1981) states that ‘the
choice and use to which language is put is central to a people’s definition of themselves in
relation to their natural and social environment, indeed in relation to the entire universe. The
researcher therefore intends to fill this gap in literature i.e. communication challenges as a
barrier and strategies to solve these problems.

The challenge to the health care system is to deliver services to people with disabilities that are
appropriate, efficient, effective, and coordinated in such a way so that the unique needs of each
member of this heterogeneous population are met.
THEORATICAL FRAMEWORK

METHODOLODY

The data for this research will be collected at Esigodini because that is where the research
resides and she is familiar with what happens and how people are treated in that community
hence making the data collection easier because she is familiar with the place. The researcher
will therefore use qualitative research methodology which Shank (2002) defines as ‘a form of
systematic empirical inquiry into meaning’. By systematic he means ‘planned, ordered and
public’, following rules agreed upon by members of the qualitative research community. By
empirical, he means that this type of inquiry is grounded in the word of experience and
inquiry to meaning says researcher try to understand how others make sense of their
experience.

The researcher chose this methodology as it is considered as a ‘warm’ approach in a sense

that it is in great part concerned with human beings i.e. personal values, interpersonal
relationships, beliefs, thoughts and feelings. Also because it allows researchers to explore the
views of homogenous as well as diverse groups of people help unpack these differing
perspective within a community i.e communication challenges faced by the disabled in the
health sector in Esigodini community. Because social capital is relational, it exists between
people and asking a group of people to respond together to a certain questions and
hypothetical situations may yield information that is more nuanced than data derived from
surveys (Dudwick, Kuehnast, Jones and Woolcock 2006;3).

Yauch and Steudel, (2003; 472), notes that the great benefit of using qualitative approach is
that the inquiry is broad and open-ended allowing participants to raise issues that matter most
to them and in this case participants are the deaf community or people and what matters the
most to them is being exclusion or the denied right to enjoy access to healthcare services due
to language barriers and that data will be collected through the in-depth open ended
interviews.

The researcher chose this research approach because it is concerned with a quality of
information and it also provides insights into the setting of a problem not to forget that the
researcher wants to be the voice to the voiceless i.e. deaf people through data interviews
which consists of direct quotations from people about their experiences, opinions, feelings
and knowledge.