29 June 2014

Zimbabwe: Chitungwiza Hospital Moves to Master Sign Language

When Robert Katana and his wife Lilian, a couple with speech and hearing impairment, arrived at Chitungwiza Central Hospital five months ago, seeking treatment for Lilian who had fallen sick, they encountered what Katana recalls as "a nightmare of my life".

It took them hours to pass through the clerks' desk, to the nurses' post and eventually to the doctors' rooms.

The reason was that nobody could understand what the two were trying to say with their hands and fingers. Katana and his critically ill wife were getting desperate, and frustrated.

They were unable to make out what the clerks, the nurses and the doctor were asking or saying because they cannot hear or speak.

"When we finally got to see the doctor, it was clear he too was unable to understand what we were trying to tell him. After almost 10 minutes of vain communication, the doctor, apparently pretending to have understood our problem, started writing. He went on writing and writing on the card which he later handed to me.

"The nurses gave us the medicines that the doctor had prescribed and we went home. After days of taking the medicine, my wife did not get any better. The doctor had prescribed the wrong medicine because he had not understood the nature of my wife's problem," Katana said.

Although they had lost trust in the hospital, the couple had no choice but to return there when Lilian developed another problem several weeks later.

Katana was pleasantly surprised when, upon realising his challenges, one of the clerks who had been behind the counter on his first visit -- but could only watch as he struggled to communicate -- smiled as he moved forward and responded in sign language, inquiring about his wife's particulars and scribbling on the card as Katana explained in hand and finger gestures.

The clerk later referred them to a nurse who came to them and, to Katana's further surprise, also communicated in sign language.

The nurse took them to the doctors' rooms and this time the doctor "was writing on and on as he communicated with us through the nurse to whom my wife explained, in sign language, what was afflicting her".

Katana (not his real name) related this experience at the recent graduation ceremony for health workers who had completed a course in sign language at Chitungwiza Hospital.

The course is a brainchild of The TJ Stamps Trust for Chronic Conditions programme for the training of health personnel in sign language. The Trust is headed by Timothy Stamps, the former Health minister who is now Health Advisor in The President's Office.

Katana's experience is the predicament faced by up to 200 000 Zimbabweans that have hearing and speech impairment whenever they visit health institutions seeking medication.

There are no health workers trained in sign language throughout the country, a situation that has placed the multitudes of citizens with hearing and speech impairment in very difficult situations each time they need medical help.

This disadvantaged section of society has also been left out from the tools used to communicate information on prevention, control and management of diseases.

Perhaps more tragic is the fact that this limited or non-existence of skills in sign language among health professionals has resulted in inaccurate diagnosis leading to wrong treatment.

Even in the rare instances where diagnosis and medicine prescription may be accurate, the likelihood is high that people living with hearing and speech impairment rarely understand the diagnosis and or treatment instruction from the medical personnel, a situation leading to poor administration of the medication at home.

Because of the absence of this crucial communication channel, there is next to zero awareness among this vulnerable group of existing sexual reproductive and health rights programme activities that may be benefitting other citizens.

The training of sign language in the health sector is targeted at nurses and nurse aides, doctors, pharmacy dispensers, clerical personnel, rehabilitation personnel, general hands, medical social service officers and counsellors.

Speaking at the graduation ceremony, the chief executive officer for Chitungwiza Hospital, Dr Obediah Moyo said the programme would bring a lot of relief to the hundreds of speech and hearing impaired patients that visit the hospital for treatment.

Chitungwiza Hospital, he said, has a vast catchment area covering the whole of Mashonaland East province and stretching as far as Mutoko -- serving a population in excess of three million.

"We are pleased because Dr TJ Stamps chose Chitungwiza Central Hospital to be pioneers of the sign language training. I understand that this training programme will be cascaded to other hospitals. The sign language training was endorsed by the Ministry of Health and Child Care so as to improve communication between workers and patients who have hearing and speech impairment," Moyo said.

He said lack of communication severely marginalised people with speech and hearing impairment.

"No one chose to have speech and hearing impairment. We should support these people and also show them love. When they come to the hospital we will try our best to attend to them indiscriminately. The participants were drawn from all wards and departments to ensure maximum coverage for assisting the patients.

"There are dangers of giving them wrong treatment because of communication breakdown. The scenario before the training was that the staff communicated with patients using pen and paper. To those who were literate we managed to communicate. But to those who were illiterate it was a challenge. Therefore the use of Sign Language training will improve the communication gaps and we are assured that the patients will have proper management. I highly commend the health advisor Timothy TJ Stamps for identifying that training need in our health delivery system," Moyo said.

Guest of honour at the ceremony, Minister of Information Communication Technology, Postal and Courier Services, Webster Shamu lauded the introduction of the programme to train health personnel in sign language saying this would go a long way in doing away with discrimination against disadvantaged members of society.

"Since time immemorial, people with hearing and speech impairment have been relegated to social obscurity because the communication barrier between them and society which is further compounded by negative societal attitudes," the minister said.

Shamu lamented the present absence of Sign Language skills in health institutions saying such a situation resulted in people with hearing and speech impairment failing to access information on health-related issues or sexual and reproductive health rights, making them vulnerable to sexual abuse.

Stamps said in an interview that the speech and hearing impaired members of society were seriously discriminated against not only in the health sector but in all facets of society.

"Can you imagine the problem that a speech and hearing impaired individual faces when they take their broken down vehicle to a garage for repairs," he asked.

The Dr TJ Stamps Trust, he said, expected to roll out Sign Language training at all the country's five central hospitals and all provincial hospitals to begin with. The Trust would also develop a Sign Language policy which would make compulsory the incorporation of the Sign Language in the health training curricula.

Stamps said his organisation would lobby for free health services for the hearing and speech impaired as well as ensuring the provision of health information material produced in sign language formats.

"There is a huge discriminatory gap between people that have hearing and speech challenges and the vocal majority. The aim is to have doctors diagnose accurately and prescribe correct medication for the disadvantaged members of society who have equal health rights with everybody else," Stamps said.

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