In a country where access to healthcare can mean the difference between life and death, thousands of deaf Ugandan women face an invisible barrier” silence”. Without sign language interpreters, their voices go unheard, and critical health information slips through the cracks.
Introduction
Being deaf is not just about the physical inability to hear but also involves cultural and social aspects, especially for those who identify as part of the Deaf community, which has its own language, culture, and shared experiences.
A deaf person is someone who has a significant hearing loss that affects their ability to hear sounds normally. This hearing loss can be mild, moderate, severe, or profound. People who are deaf may use various ways to communicate, including, sign language, lip reading, written communication or hearing aids.
Background
In Uganda, people living with hearing impairments continue to face significant barriers in accessing essential health services, particularly due to the absence of sign language interpreters in public healthcare facilities. While the Uganda Sign Language Policy of 2017 mandates the inclusion of sign language services across sectors, implementation in health facilities remains limited. According to the Uganda Bureau of Statistics, about 1.2 million Ugandans live with hearing disabilities many of whom are women who struggle to access clear, timely, and dignified healthcare, especially regarding maternal and sexual reproductive health. The communication gap often leads to misinformation, fear, and exclusion from critical services.
Women Living With Hearing Impairments
Annet Kissa , a woman living with a hearing impairment, describes her experience navigating Uganda’s healthcare system as a constant struggle of silence and guesswork. With no access to sign language interpreters at most health facilities, especially public hospitals, communication becomes a daily hurdle.
“I only go to the doctor when the children are sick or during antenatal visits,” Kissa explains. “But even then, communication is hard. I try to use gestures or local signs, but often, the doctors don’t understand me.”
During antenatal scans, Kissa says she receives no explanation about her medical reports. “You just look at the scan results and leave. If you fail to understand, you just go back and sit. There’s no one to explain what’s going on.”
Frustrated by the communication gap, Kissa often resorts to private hospitals, which are more expensive. “I go to private facilities because I hope to be understood, but the cost is too high,” she says. “We need sign language interpreters in hospitals. That would help many deaf women not to miss important medical information.”
The lack of interpreters doesn’t only affect understanding it directly affects access to treatment. “Sometimes I try to describe my illness with signs and gestures. If the doctor doesn’t understand, they just chase me away. They promise to follow up, but they never do.”
Annet adds that many deaf women are abandoned by their partners, making their situation even more difficult. “We are left alone, without support, and accessing proper medication becomes nearly impossible,” she shares.
She appeals to the government and health authorities to ensure that sign language interpreters are deployed at health centers across the country. “Communication would be easier. We wouldn’t be left behind,” Kissa says.
For Uganda’s deaf community, especially women, health care isn’t just about medicine it’s about being seen, heard, and understood.
Hindu Luyinda, a woman living with a hearing disability, says many Deaf women and girls struggle to discuss Sexual and Reproductive Health and Rights (SRHR) issues even within their own community.
“Many Deaf women and girls are not comfortable discussing SRHR, especially within the Deaf community,” she says. “Even among my close friends, we only talk about these topics in small, safe spaces like group chats or when we’re together.”
She adds that even in these spaces, a lot remains unknown.
“The truth is, most Deaf women and girls are left behind when it comes to SRHR information. Many don’t have access to accurate and accessible information in sign language, and that creates huge knowledge gaps.”
Luyinda shares a recent example from a WhatsApp group for Deaf women, where she posted a video explaining emergency pills.
“From the reactions, I could tell that most of them didn’t know there are different family planning methods. Some didn’t know that emergency pills shouldn’t be taken frequently,” she says.
In another conversation about genital warts and herpes, she realizes many members have little or no knowledge.
She also shares a concerning story she heard from a friend:
“A girl had sex with her boyfriend, and he used two condoms thinking it would offer more protection from HIV. One condom got stuck inside her, but she was too scared to seek help. She stayed silent until the situation got worse,” Luyinda explains.
From these experiences, she believes stigma, fear, and lack of information make Deaf women uncomfortable discussing SRHR.
“We need accessible, inclusive training in sign language to empower Deaf women and girls with accurate information,” she says. “Silence is deadly when it comes to our health. It’s okay to speak up, ask questions, and seek help without fear or shame.”
Luyinda emphasizes the importance of inclusion by asking:
“If SRHR service providers do not involve us directly, how will Deaf women access the information and services they need? Many are suffering in silence, completely left out of the conversations and programs meant to protect their health and rights.”
Irene Okyo, a mother of two living with a hearing impairment, is calling for the integration of sign language into Uganda’s school curriculum, citing the numerous challenges she faces when accessing essential health services.
Okyo shared that she has never tested for HIV nor actively sought information about it not out of negligence, but due to fear and a lack of accessible communication.
“When I go for antenatal care, I always have to take my brother with me to interpret,” she explained. “If I don’t go with him, I miss out on important health information. Sometimes they write it down for me, or try to use the local sign language, but that’s not always enough especially when it comes to private matters.”
For Okyo, this lack of effective communication in health settings is not just an inconvenience it’s a barrier to proper care, personal dignity, and the right to make informed decisions about her health.
She believes that if more people particularly teachers, healthcare workers, and public officials could communicate in sign language, it would greatly improve the lives of people with hearing impairments.
“We deserve to be heard and understood,” she said.
Okyo’s story highlights the urgent need to bridge the communication gap between service providers and the deaf community in Uganda, particularly in critical sectors like health and education.
video of Ugandan women living with hearing impairments
NUDIPU
Esther Kyozira, the CEO of the National Union of Disabled Persons of Uganda (NUDIPU), says that information in the health sector remains largely inaccessible to people with hearing impairments.
“Most people with hearing impairments use sign language, yet health information is often shared through written notices, flyers, and posters which are only accessible to those who are educated and can read,” Kyozira explains. “For those who cannot read, there is a clear need for sign language interpreters. However, these interpreters are not easily available in hospitals, and expecting patients to come with their own is not a sustainable solution.”
Kyozira emphasizes that NUDIPU works in partnership with organizations such as those in the Sexual and Reproductive Health and Rights (SRHR) space to conduct trainings and raise awareness about the need for inclusion across all sectors.
“As NUDIPU, we operate in different districts across Uganda, advocating for inclusivity in every space. We are calling on the government to formally include sign language interpretation under the Ministry of Health’s employment structure, so that interpreters are deployed and employed in public health facilities.
Emmanuel Ainebyona Spokesperson Ministry of Health said that in the newly revised health structures, the government is working to employ sign language interpreters at all levels including national, regional, and district referral health centers. He emphasized that the aim is to ensure inclusive healthcare where everyone is catered for, including people with hearing impairments.
However, he noted that the main challenge remains insufficient wages to support the recruitment of interpreters across all facilities. On March 9, 2023, the Ministry of Public Service shared the newly approved structure for general and regional referral hospitals with all district local governments. The updated structure includes provisions for sign language interpreters as part of hospital staffing.
Audio of Emannuel Ainebyona Ministry of Health spokesperson.
Medical Team and Civil Society Organisations
According to Ramla Faraji, a Village Health Team (VHT) member in Makindye Division, communication with deaf individuals often depends heavily on their next of kin due to the limited use of formal sign language. She explains that when interacting with a deaf person, their next of kin usually helps with translation. “In some cases, we use basic local signs to convey simple messages, but if that fails, we write down the information we want them to understand,” Faraji says. This reliance becomes particularly crucial in health matters like giving medical prescriptions or during child immunizations, where the next of kin is responsible for accurately receiving and relaying instructions.
Dr. Gerald Karuhanga, a gynecologist from Praise Medical Center, echoes these challenges. He notes that deaf women seeking sexual and reproductive health services often come accompanied by a caretaker who assists with communication. When clients can write, the facility provides pen and paper to express concerns, yet Dr. Karuhanga emphasizes the preference for clients to bring caretakers or interpreters.
This communication barrier is a widespread issue, as Miranda Bagamba, Advocacy and Communications Officer at The Sexual Reproductive Health and Rights (SRHR) Alliance Uganda, points out people who are hard of hearing continue to struggle when accessing sexual and reproductive health services due to major communication barriers. She explains that most health centers and medical practitioners are not trained in sign language, making it nearly impossible for deaf individuals to communicate their needs or understand medical guidance.
“This is unfortunate because these people deserve to be healthy, informed, and able to make decisions about their own bodies,” Bagamba says. “But because of the communication gap, many shy away or never even attempt to seek care.”
Organizations like the Uganda Red Cross are also stepping up to address these communication challenges. Jonathan Ntabazi from the Kampala East Branch shares that the Red Cross partners with Ntinda School for the Deaf to promote inclusion. During events involving deaf individuals, the organization ensures active participation of its partners and is training its members in basic sign language. Ntabazi stresses the need to hire sign language interpreters to guarantee equal access and participation in institutional and community activities. The Red Cross also prioritizes making sexual and reproductive health information accessible to everyone, including people with hearing impairments, by integrating sign language and inclusive communication strategies to ensure no one is left behind in accessing vital health services.
. These insights highlight the persistent communication gaps that hinder healthcare delivery for people with hearing impairments, underscoring the need for more inclusive communication systems in community health services
Conclusion
The stories of Kissa Annet,Hindu Luyinda, Irene Okyo, and others like them illustrate a pressing need for inclusive communication in Uganda’s health sector. Experts and advocates, including NUDIPU and grassroots health workers, are calling for the institutionalization of sign language interpretation within government health services. Additionally, they urge the integration of sign language education across all university courses to build a more inclusive society. For Uganda’s deaf community particularly women true access to healthcare means more than just physical presence at a clinic, it means being seen, heard, and understood. Without these changes, the silent barriers will continue to deny thousands their right to informed and respectful healthcare.
“The production of this story was made possible through financial support from the Finnish Foundation for Media and Development (VIKES), in partnership with the Uganda Media Women’s Association (UMWA)”
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