For 15 years, Maria Sikhosana from Orange Farm has relied on family members to take phone calls, listen to messages and help her communicate when she needs healthcare. 

The 43-year-old single mother of 12-year-old twins says she lost her hearing at the age of 28 after she was assaulted by her boyfriend in 2010. Since then, accessing hearing care has been a struggle because of miscommunication and uncertainty about medical referrals, while depending on relatives to communicate on her behalf. 

“I lost my hearing in 2010 after I was beaten by my boyfriend. Three days after the beating I started to hear uncomfortable ringing sounds in my ears. I ignored the sounds, in days my hearing was slowly disappearing and I decided to go and consult at the local clinic,” says Maria. 

After a check-up at her local clinic in Orange Farm, nurses gave her a referral letter to Chris Hani Baragwanath Hospital (Bara), where she was assessed and began receiving care from a specialist. Sikhosana says she was close to receiving a hearing aid when communication with the hospital broke down. 

Because Maria could not hear phone calls, she gave the hospital her sister’s number so her sister could receive messages about follow-up appointments on her behalf. However, Maria’s sister lost her phone and the call for a follow-up appointment never reached her.  

“I was scared to go back and report about the loss of my sister’s phone, I thought nurses would lash at me for missing the call and the follow-up appointment. Again missing an appointment would have meant waiting again to be contacted and start the queue from afresh,” says Maria.

‘I have to navigate life in my own silence’

This year, after 15 years, Sikhosana tried at least three times to get help through her local clinics. In June, when she went to her local clinic with ear pain, a nurse examined her, gave her pain medicine and sent her home without referring her for further hearing assessment. 

Sikhosana says in August she went to Stratform Community Health Centre in Orange Farm where she obtained a referral to the ear clinic at Bara. But she went there on a Wednesday, only to discover the clinic opens on Tuesdays and Thursdays. Sikhosana says she now has to save money for another return trip. 

Sikhosana’s hearing loss has affected her independence. She depends on family members to help her with phone calls and voice messages, and with job opportunities. 

“I can’t communicate, even when I go out to shops I have to always be with someone, in the absence of that someone I have to navigate life alone in my own silence.”

Locked out hearing world and the deaf community

The Deaf-Care Healthcare Initiative South Africa (DCHI) says communication is one of the most critical barriers affecting how deaf people and people with hearing loss can access healthcare. 

DCHI’s Seneliso Nkoyeni says Sikhosana is particularly vulnerable because she experienced hearing loss as an adult and does not use South African Sign Language (SASL). 

“An adult who became deaf 15 years ago post-GBV and does not know SASL represents the most vulnerable intersection,” says Nkoyeni. “She is locked out of both the hearing world and the deaf community, and the public health system has no protocol for her.”

Nkonyeni says relying on family members or other people to communicate can also compromise a patient’s privacy and independence. “Her communication challenge is not just about language, but about profound isolation,” says Nkoyeni. 

“Without SASL, limited English or vernacular language literacy, and ineffective lip-reading abilities, the trauma of GBV makes relying on male family members or random interpreters unsafe and re-traumatising. This is why she has slipped through the cracks for 15 years.”

Gold standard must be language-independent

Nkoyeni says for someone in Sikhosana’s position, healthcare cannot depend solely on SASL.

“The gold standard must be trauma-informed and language-independent. Medically, this means starting with a qualified audiologist and ENT for a full audiological workup, but delivered via visual communication boards, gestures, and a trained female Deaf Relay interpreter or intermediary not SASL alone.”

Following her account, DCHI has offered to help her access care. Representatives from the organisation plan to accompany her to an audiology clinic in Lenasia for an assessment, and provide communication support.

Sikhosana says she is hopeful to get the hearing care she first sought 15 years ago. 

“It has been a struggle to get the service and support I need so that I can live normal again. It has been a long silent 15 years.”