By Esuvath Daniel
For two Tanzanian women living with hearing loss, visiting a health centre is often more of a struggle than a treatment experience. They say communication barriers in hospitals continue to limit their access to care, exposing ongoing gaps in disability-inclusive healthcare.
There are 5,347,397 persons with disabilities in Tanzania (Mainland and Zanzibar), equivalent to 11.2 percent of the total population aged seven and above living with some form of disability.
Of the total persons with disabilities, 539,186 are persons with hearing impairments, a 1.1 percent of total population, about 518,846 live in Tanzania Mainland while the rest 20,340 live in Zanzibar.
For Jackline Mashingia, the condition began in childhood. The Dar es Salaam resident says she developed hearing impairment after suffering severe fever and malaria while in fifth grade in 2005, when she was treated at a clinic.
“It seems I am suffering from quinine side effects,” she said, recalling how limited medical awareness at the time meant neither she nor her caregiver understood that treatment could lead to disability.
Her challenges became more pronounced when seeking healthcare services later in life, especially during the COVID-19 pandemic.
With healthcare workers wearing masks, she was unable to lip-read, making communication difficult. She also noted that many health centers lack professionals trained to communicate with deaf patients, particularly when they are unaccompanied.
Also, Jackline’s caregiver described her academic journey as difficult. The schools she attended had no specialized units for learners with disabilities. She often sat close to teachers and relied on lip-reading to follow lessons.
Recent research has highlighted various systemic barriers contributing to the academic struggles of students with hearing impairments. Emphasized the shortage of specialized teachers as a critical obstacle, noting that the lack of trained professionals hindered the provision of effective support and instruction personalized to the needs of the students with hearing impairments. This shortage compounds the challenges educators contend with in delivering inclusive education.
Another case is Irene Ndunguru, who had communication problems during childbirth in 2023 at a government-owned hospital in Dodoma. She said healthcare workers did not properly consider her condition.
“I went to the hospital to give birth, I wanted to explain my condition to a nurse wearing a mask so I could understand her. I asked her to remove the mask so we could communicate, but she continued talking while I could not understand her,” she said.
She eventually left the interaction and relied on a relative to find another nurse to assist her.
For Walta Carlos, an activist and women’s rights lawyer, the women’s experiences are clear examples of obstetric violence against women with hearing impairments.
“When healthcare providers continue with labor and delivery without ensuring effective communication, they deny deaf women the information, understanding and informed consent they are entitled to,” she said.
“Such practices leave women excluded, powerless and unable to participate in decisions about their own bodies and care. The lack of sign language interpreters, accessible communication methods and disability-sensitive maternal healthcare services increases the risk of mistreatment, neglect and violations of the reproductive rights of deaf and hard-of-hearing women during childbirth,” she added.
Health experts say such experiences reflect a broader systemic gap and that effective communication remains central to quality healthcare, yet many facilities lack sign language specialists.
In such situations, deaf patients often rely on lip-reading, gestures, or writing which are methods that can easily lead to misunderstandings and potential medical errors.
Despite existing frameworks such as Tanzania’s National Policy on Disability (2004) and the Persons with Disabilities Act No. 9 of 2010, enforcement and practical implementation remain limited when challenges exceed available resources.
Dr. Erick Ibamba of Mwananyamala Hospital acknowledges the need for better understanding and communication with persons with disabilities. He says healthcare workers require both sign language skills and patience, noting that many disabled patients avoid seeking care due to mistreatment.
He also pointed out that medication errors can sometimes lead to disabilities, stressing the need for proper monitoring and referrals where necessary.
“In such cases, the patient should receive adequate monitoring and, if necessary, a referral for further medical treatment,” he said. He noted that side effects can sometimes result in conditions such as limb disability, mental health issues, or loss of hearing and speech.
Ms Tunu Amazulu, Coordinator of Deaf Rising Starstallent Hub and Student Welfare Coordinator at Buguruni School for the Deaf in Dar es Salaam, says that the challenges faced by persons with disabilities are best understood by those who live with them every day. She notes that healthcare services in Dar es Salaam remain inadequate in addressing the needs of people with hearing disabilities, citing shortages of accessible infrastructure, specialists and personnel trained to work with deaf patients.
According to Amazulu, communication barriers in healthcare settings remain one of the biggest challenges.
“Many doctors and nurses do not know sign language. As a result, a deaf patient may struggle to explain their pain, symptoms or medical history; this can lead to healthcare providers prescribing treatment without fully understanding the patient’s condition, while the patient may also leave without clearly understanding how to use the medication,” she explains.
She calls on the government to make sign language a formal subject taught from primary school through university level and to ensure that healthcare workers, teachers and other public service providers receive sign language training. She emphasizes that healthcare is a private matter and that deaf patients should not always have to rely on interpreters to communicate sensitive health information.
Amazulu also stresses the importance of raising public awareness about deaf people and hearing disabilities to reduce discrimination, stigma and social exclusion. She further advocates for investment in assistive communication technologies and more practical, inclusive learning approaches for deaf students, arguing that these measures would improve access to education, healthcare and meaningful participation in society.
