My silent world: Hearing impaired struggle to communicate with facemasks

In June last year, Uganda commenced the distribution of more than 300,000 facemasks to communities, especially those most at risk and those who could not afford to buy their own as a measure to curb the spread of Covid-19.
However, persons with hearing impairment were not considered during the designing  of the facemasks.
Since the masks cover the mouth and nose and limit facial expressions, they were not helpful to those with hearing impairment because they have to remove them while communicating in sign language.
Uganda has more than four million people with hearing impairment, according to the 2016 National Housing and Population Census.
About 100,000 of those have access to the Internet and use video chat platforms to communicate, a recent survey by Uganda National Association of the Deaf (UNAD) in Kiwanga, Wakiso District, indicates.
Innovators consider this as a virgin area to enable planning and development of transparent facemasks and shields that can enable persons with hearing impairment communicate and remain safe from Covid-19.
Whereas scientists recommend vaccination to reduce chances of severe disease, protection using facemasks as one of the standard operating procedures (SOPs) remains a challenge for persons with hearing impairment.
When one is vaccinated, they still have to wear a mask to reduce the risks of exposure to droplets of the virus from an infected person.
More than 5 per cent of the world’s 7 billion population – or 430 million people – require rehabilitation to address their ‘disabling’ hearing loss (432 million adults and 34 million children).
It is estimated that by 2050, more than 700 million people – or one in every 10 people – will have disabling hearing loss.
The years seem far but for now, the need to keep safe for especially the deaf is a daunting task.
The SOPs have three key requirements, including properly wearing a facemask to cover the nose and mouth, washing hands with water and soap or use alcohol-based sanitisers, and maintaining a social distance of about two metres apart.
What has been common during interactions with persons with hearing impairment in any setting is that they do not wear masks or if they do, the mask is below the chin, leaving their mouth and nose exposed.
“The challenge for deaf people has been social distancing because deaf people depend on touches and signs. They use tactile communication,” Mr Robert Nkwangu, the executive director of UNAD, says.
“Sign language depends more on facial expressions. When you have the mask on, it is hard for me to know if you are smiling, laughing or sad,” Mr Nkwangu adds.
When the Nation Media Group crew comprised of NTV and Daily Monitor visited the home of nine-year-old Blessing Atwijuka in Kyetume, Mukono District, she was excited to see visitors and run to hug almost everyone while wearing her mask.
Her head teacher, Mr Stephen Odeker of Hand in Hand Special Needs Education Centre in Mukono Town, was the first to receive the hug.
When he tried to tell her about Covid-19, the little girl could not understand what he was saying.
Their sign language conversation could only be sustained when they both removed their facemasks.
Mr Balinya Sulaiman, a resident of Kiwanga, says he also finds it difficult to interact with another person whose mouth and nose are covered in a mask.
“We depend on facial expressions. When someone is wearing a mask, it is hard for me to understand the exact message. And when you remove the mask, you are at risk of getting Covid,” says Mr Balinya.
At the Hand in Hand Special Needs Education Centre, children aged six and above wear facemasks as per the SOPs
The school is quiet as about 20 learners interact, some knitting woollen door mats and others making liquid soap.
The mask is important and those with hearing impairment know this. But how to communicate in it is still a challenge.
Mr Alex Ndeezi, the MP for Persons with Disabilities, demonstrated to the Nation Media Group crew how he would communicate with a mask.
He puts on the mask but his sign language interpreter says she cannot read his expressions and lips because some signs are similar and can only be differentiated with the facial expression.
“See how I am interacting with you now. I cannot wear a mask. If I do, it will be difficult to comprehend what I am signing. The facemasks are not favourable to persons with hearing impairment,” Mr Ndeezi says through his sign language interpreter.
“Innovations for facemasks would help in solving the problem. Where the masks are made transparent and I am able to see the mouth movement. Or we can also use the face shields,” Mr Ndeezi adds.
Earlier this year, Parliament discussed the idea of transparent facemasks but there are no funds available for them.
Some innovators such as Sign Tapp, which connects sign language interpreters to persons with hearing impairment through online Apps, tried to develop a prototype for transparent facemasks but could not get funding to continue to the development and production stages.
However, one project under the Makerere Research and Innovation Fund at Makerere University got funding and was able to produce about 500 3D face shields earlier this year.
Although the research aimed at finding a way to keep frontline health workers safe from Covid while on duty, it has since been considered for multipurpose use to include those with medical conditions that do not allow them use other facemasks and persons with hearing impairment.
Under the project, the innovators bought machines and could produce more for public use but lacked funds to produce cheaply and make them affordable to the public. Mr Erias Muhoozi, the 3D face shield project lead at Makerere University, says they developed the multipurpose face shield that could help when schools reopen and persons with hearing impairment could use such to return to class.
“When we came up with the face shield, we wanted to find a way to make those left out by other facemask designs protected. But we do not have the capacity to produce at a mass level. Say if a school for a deaf or the government wants us to produce the masks for these categories of people, it would not be easy because we do not have the materials enough for mass production,” Mr Muhoozi says.
He says the project is able to produce 500 face shields a month on demand by organisations that invest their resources in it.
Mr Andrew Mubangizi, the principal occupational therapists at the Disability Department, Ministry of Health, says at the beginning of the SOP implementations in March last year,  it was difficult to know what each innovator was working on.
“There could be special masks designed for protection and ease of communication. Lip reading is part of communication for the deaf and we need to invest and source out those who can make these masks. At the beginning, it was an ocean of masks and everybody was making masks but they did not come up clearly with the ones for persons with hearing impairment. If they were there, we would have appraised them and given them the go ahead to produce,” Mr Mubangizi says.
His concern is that to date, no innovator has approached the disability department for appraisal of transparent facemasks or shields for persons with hearing impairment.
“We need to invest and source out for funds, contact other innovators and be in touch with the government so that we know what you are doing and can come to it to support where we can,” Mr Mubangizi says.
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