Should medical students learn sign language? A pilot introductory course for Third Year MBChB students
Language is a critical element of health communication, so often missing in clinical practice. When Professor Bongani Mayosi was interviewed soon after his appointment at UCT he had this to say:
“For 85 years, the department [of Medicine, UCT] has been looking to its origins in Europe for ideas, for its symbols, and its language …. For example, it is not unusual for Xhosa-speaking patients to have no history taken because the doctor cannot even greet the patients in their language. We need to discover the language of our patients and connect with the soul of Africa (see Chimombe , 2006).
A lot has changed since then. UCT health science students now learn isiXhosa and Afrikaans (see also http://www.sll.uct.ac.za/sll/sections/african_languages/healthsciences) and Professor Hellenberg of Family Medicine has a project that offers classes in isiXhosa and Afrikaans to health professionals in the health care facilities. But what about Sign Language for Deaf patients? IsiXhosa and Afrikaans, while two of the three main languages in the Western Cape, are not the language of the Deaf, who comprise an estimated population of between 500,000 and 1.5 million people. They communicate largely and only in South African Sign Language (SASL). With Deaf patients, medical practitioners have no alternative, such as calling on the nursing staff to interpret as so often happens. The question is – should medical students learn sign language?
Banele Mhlongo and Vuma Mthembu
In June 2017 two medical students– Banele Mhlongo and Vuma Mthembu contacted Dr Marion Heap in the School of Public Health and Family Medicine with a proposal. They wanted a course in sign language for their Third Year MBChB student class. There was support from the Head of Division and the Deputy Dean for Undergraduate Education, who in turn referred Banele and Vuma to Professor Louw. Professor Louw too was supportive. Dr Ramesar stretched the budget to cover costs and she and Candice Dykes found time slots and venues.
So, in November this year, the Third Year medical students completed a short pilot course to introduce them to South African Sign Language (SASL). It was the second of its kind, the first in 2015, convened by Sarah Crawford-Browne. Both courses were given by Ms June Bothma. June is deaf from six months of age and also teaches Speech Therapy and Audiology students at UCT. She is a passionate and gifted teacher with up to 20 years’ experience.
June Bothma facilitating a workshop in the Pathology Learning Centre
The course was very well attended, even though it was an extra-curricular activity (added on to the students’ busy schedule) which took place at the end of the year – and an anxious end of the year with protests happening on Upper Campus. Exams were looming. The course was neither credit-bearing nor required for DP purposes. And the first Introductory lecture was schedule for 16h00-17h00 on a Friday afternoon, not always a good time. But the students were there in large numbers and it was the same the following week. The attendance at the workshops was good.
It is debateable whether medical students should learn SASL.The curriculum is already over loaded. Is it necessary? Some medical practitioners may never meet a signing Deaf person in the entire careers. However, as Vuma and Banele have argued – ‘it may seem a drag in the short term but there are some definite advantages over the long term’. It will add value to the degree and skills giving UCT health science graduates the competitive advantage over the other university students. It will allow medical practitioners to stand for the marginalised and offer more inclusive healthcare. Importantly it enables good history taking, ensures informed consent and maintains confidentiality. It addresses deafness as a consequence of meningitis and drug induced deafness in Multi-Drug-Resistant Tuberculosis, especially in children. Without sign language Banele and Vuma conclude, health professionals will not be able to fulfil the health care rights and needs of the Deaf community.
Teaching medical students basic SASL will not address all language barriers facing signing Deaf people. For example, it will not replace the trained medical SASL interpreter. But if we are to discover the language of our patients and connect with them, then, as Professor Mayosi has recommended, perhaps medical students also need to know basic SASL. If you talk to people in a language they understand, that goes to the head. If you talk them in their language, that goes to the heart - Nelson Mandela.
- Chimombe Shumi. (2006) Open heart. UCT News, Alumni Magazine
Health and Human Rights Programme
Division of Public Health Medicine