"I just answer 'yes' to everything they say": Access to health care for deaf people in Worcester, South Africa and the politics of exclusion

Objective: To explore whether there are other factors besides communication difficulties that hamper access to health care services for deaf patients. Methods: Qualitative methodology using semi-structured interviews with 16 deaf participants from the National Institute for the Deaf in Worcester and 3 Key informants from the Worcester area, South Africa. Results: Communication difficulties were found to be a prominent barrier in accessing health care services. In addition to this interpersonal factors including lack of independent thought, overprotectedness, non-questioning attitude, and lack of familial communication interact with communication difficulties in a way that further hampers access to health care services. Conclusion: These interpersonal factors play a unique role in how open and accepting health services feel to deaf patients. Practice implications: Health care services need to take cognizance of the fact that providing sign language interpreters in the health care setting will not necessarily make access more equitable for deaf patients, as they have additional barriers besides communication to overcome before successfully accessing health care services. © 2013 Elsevier Ireland Ltd.