Maternal mortality: Language glossary for deaf women to the rescue?

Maternal mortality remains a challenge in developing countries including Nigeria. In this piece ENE OSHABA writes on high maternal mortality rate among deaf women and examines how far the newly launched sign language glossary can go in curbing the scourge.

The challenges faced by deaf women, especially when it comes to accessing healthcare cannot be measured as women with hearing impairments have continued to loss their lives during childbirth and as a result of other treatable illnesses due to the huge communication barrier between them and healthcare providers.

According to the World Health Organisation (WHO) about 15 per cent of every country’s population live with disabilities. In Nigeria, about 30 million Nigerians, representing 15 per cent of the population, have at least one disability and over 10 million, representing 5per cent of the population are deaf and half of this population are women. However, sign language remains one of the unofficial languages in Nigeria.

It is in the effort to tackle this huge challenge that the Deaf Women Aloud Initiative (DWAI), with support from Voice Nigeria, launched a language glossary to facilitate easy communication between deaf women and health workers in the country.

Causes of deafness

As explained by a healthcare worker at the Ear Nose and Teeth (ENT) Clinic of the National Hospital, Dr Omezi Kam, deafness is a technical term that has to do with hearing loss that is profound with 80 decibels or more.

Dr. Omezi said once the decibels are above 26 in any patients the person is considered as having hearing loss. He described it as a particular range of decibels which is profound.

“Deafness has various causes either congenital or acquired due to a disease process. The most common deafness in our society could be genetic when it’s congenital but the acquired deafness could be from exposure to very loud sound, infections or medications.

“It is not the fault of a deaf person that they are deaf, they are human like us so we should not discriminate against them rather we should accept, understand and develop ways of communicating with them in order to relate better with them,” he urged.

Similarly, a nurse working with the National Hospital, Vincit Paul Ebiai, said deafness has various causes such as drug complications and untreated ear injuries especially among children.

Ebiai emphasised the need for training and retraining of health workers on sign language to enable easy communication between them and the deaf, however urged everyone to learn to visit the hospital early when there is the need for that.

“Deafness is not bought from the market and it’s not their fault that they are deaf so people should stop discriminating against the deaf.

“From the experiences they share they have really been disenfranchised in healthcare delivery system. We have not really been fair to them and when they visit a facility no signs to show them around and that is really touching,” she said.

Also, a nurse in the Gender Health Department, FCT Primary Healthcare, Abba Zainab, urged health workers to be friendly with the deaf, especially with facial expressions, to enable them share their problems freely with health workers to be able to administer treatment effectively.

“I have worked with people with disabilities and most of them are my friends because I’m friendly with them but people keep telling me to stay away from them that they are possessed and my children will become like them but I don’t believe that.

“Doctors should be friendly to enable the deaf share their problems. Facial expressions matters a lot because they will always look at your face, also treat them first instead of asking them to wait long even when they came first,” she said.

Ordeal at hospitals

The Executive Director, DWAI, Mrs. Hellen Beyioku-Alase, while sharing her experience and that of other deaf women when they try to access sexual and reproductive health services said it was very frustrating as health workers often found it difficult to understand their language or communicate effectively with them.

“When I was pregnant for the first time in 2012, I had heard many unpleasant tales of how people with speech and hearing loss were marginalized at public hospitals, but I thought health workers in the hospital where I enrolled for the ante-natal care would be sympathetic with me but I was wrong.

“Usually, I would leave home very early in the morning so that I would be among the first few pregnant women to arrive at the hospital, yet I always ended up being the last patient to leave the hospital as a result of the communication barrier because my hospital card would be abandoned after the nurses have repeatedly called my name without any response.

“This continued to happen and one day I was very angry, so I summoned the courage to approach the Medical Director of the hospital. I laid my complaints to her in writing and she was sympathetic with my plight and the issue was resolved.

“I thought that was all, but I was wrong. When I went into labour subsequently and went to the hospital, there was no health worker to explain to me what I should do at each stage of my labour. The nurses just signalled with their hand that I should wait and left me in severe pain for up to 45 minutes. I felt so bad,” she narrated.

“It was since then that this vision of a sign language glossary was birthed, but bringing it to fruition has not been a walk in the park but the passion to stand up for our rights have made it possible for us to produce it,” she further stated.

Beyioku-Alase further lamented the absence of interpreters in healthcare facilities as well as the inability of healthcare providers to understand and make use of sign language, saying this has constituted a barrier to deaf women’s access to healthcare, making it difficult for them to claim their sexual and reproductive health rights hence the production of a sign language glossary.

“DWAI realised the inability of Deaf Women to access healthcare, especially in the area of sexual and reproductive health rights in Nigeria, we decided to put information together in a book to address the challenge.

“The glossary will give stakeholders the opportunity to address the perceived challenges as it includes illustrated signs and descriptions for common sexual and reproductive health and rights words that have been developed, making it invaluable reference for both the deaf, hard of hearing and those who are not deaf,” she explained.

Need for inclusion

The Project Coordinator, Voice in Nigeria, Ijeoma Okwor, while stressing that no one should be left behind, said the promotion of access to health information for women with hearing impairments could not be more empowering and Inclusive than the production of a sign language glossary.

Okwor lauded the idea, stating it would provide the deaf with independence to access healthcare facilities, as it will enable them explain what is happening to them with or without an interpreter.

“They simply need to point to the particular health conditions within the glossary. It is a beautiful innovative way of connecting the women to their health service providers. It is a more sustainable way of bridging the communication gap than having an interpreter who may not always be there,” she said.

Also, the Secretary, FCT Health and Human Services Secretariat, Dr. M.B. Kawu, noted the challenges deaf women face when trying to have access to sexual and reproductive health and rights, and expressed hope that the glossary would bridge the existing communication gaps.

Govt, stakeholders tasked

The executive director maintained that there cannot be any support said to be given to the deaf without them being fully involved through sign language, hence she called on the government and relevant stakeholders to show more commitment to ensuring a meaningful life for the deaf.

She noted all the good policies created by government to better the lives of people with disabilities, however lamented that these policies have not be well implemented and therefore called on the ministry of health to direct all hospitals to document these policies and implement them at the various health facilities.

“The Ministry of Health should make it mandatory and compulsory for all hospitals to have the policy documents for people with disabilities at the hospitals and also implement them.

“I beckon on the International communities, governments and Non-Governmental Organisations (NGOs) to key into our project; collaborate with us and ensure full participation of persons with disabilities and with sign-language because there is Nothing about Us without Us.

“According to the UN Secretary-General, when we secure the rights of people with disabilities, we move closer to achieving the central promise of the 2030 Agenda – to leave no one behind,” she noted.

She commended the efforts of President Muhammadu Buhari, the Ministry of Humanitarian Affairs, Disaster Management and Social Development, Ministry of Women Affairs and National Assembly for taking the giant step of appointing the executive members who are also persons with disabilities for the newly established National Commission for Person with Disabilities as well as Senior Special Advisers (SSAs) and Special Advisers (SAs).

“These acts deserve applaud and this is a good step toward ensuring full realization of persons with disabilities in almost every area in our societies.

“Despite the giant strides, a lot still needs to be done to sensitize the society, about the disability inclusive, accessible and the content of Discrimination against persons with Disabilities (Prohibition) Act 2018 yielded the best outcomes,” she added.

Also speaking during the launch of the sign language glossary in Abuja, a staff of the Family Health Department, Ministry of Health, Stella Adaeze Ike, disclosed that since the ease of the lockdown the ministry has began the training of healthcare workers at various facilities on how to attend to people with disabilities including the deaf.

She noted the communication barrier between deaf and health workers, saying while training is important and ongoing it was pertinent to inculcate sign language glossary in the school of nursing and collage of medicine.

“There is need to inculcate sign language is school of nursing, collage of medicine so health workers can from an earlier stage surmount barriers in communication between themselves and the deaf.”

Similarly, the Minister of Women Affairs, Dame Pauline Tallen, noted that a great number of women with disabilities record more sexual violence in their lives and non-inclusion in the scheme of things.

The minister, who was represented by the Head, Women Rights Division, stressed the need to actively avail as many trusted channels of information for the deaf.

“In order to bridge the existing information gap, there is a need to actively avail as many trusted channels as possible including those at home.

“Deaf women just like other women living with disabilities face a lot of challenges which are majorly communication, fear of going to hospital, education, hunger, domestic violence. All these majorly because of inadequacies of sign language experts in our public institutions like hospitals, schools and markets.

“There is no doubt that the glossary of sexual and reproductive health in Nigeria is a great innovation and coming at a very good time. It will go a long way to ameliorate some of the challenges deaf women and their children go through,” she said.

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