Background
In November 2013, Typhoon Haiyan surpassed records for wind speeds, casualties, and displaced persons—leaving the Philippines in a state of national disaster. In the year following, advocates for the Deaf community have raised questions about how persons with disabilities (PWD) may be disproportionately affected by the typhoon and the long-term recovery. The latter has not been well documented by mainstream media. Information about emergency preparedness for Deaf individuals in peer-reviewed literature is virtually non-existent. Even in the U.S., public warning and emergency communications systems serving the Deaf and hard of hearing post-9/11 were given a “failing grade.”1 Like other PWDs, the Deaf face challenges accessing health and social services.2 When looking at disaster preparedness, it is important to create informed infrastructure that serves all populations.
Community Partners
The Development and Accessibility Fund for the Deaf (DeAF Deaf) is a non-profit organization “that aims to develop self-reliant and independent Deaf Filipinos” through education, provision of basic needs, and interpreter services. ABC’s for Global Health, which works primarily in the Philippines, seeks to foster healthier living through prevention and control of non-communicable chronic diseases with an emphasis on community-centered education and collaboration.
Process
About the film. This film was produced as part of a series of short video vignettes that explore how different communities in Tacloban are navigating the long-term recovery following Typhoon Haiyan. The other two vignettes, which discuss regional sources of livelihood and the experiences of health professions students in Tacloban, are referenced in this piece.
Recruitment. Team meetings primarily occurred at Greenboxx, a local café owned by one Deaf participant’s family. Deaf participants were recruited through personal referrals, attendance at PWD events, and meetings at Greenboxx. In general, it was important for us to develop our film and spend time in locations where the Deaf community congregates.
Production. Filming was conducted over a period of two months. We used HD video cameras to record on-location interviews, and then we captured supporting footage (“inserts”) around the community based on those interviews. We also carried two HD consumer-grade cameras to share with participants who wished to take part in the filming and collect their own footage. We conducted both individual and group interviews (n=23), which included members of the Deaf community, health professionals, Deaf interpreters and advocates.
We established multimodal means of communication with Deaf participants. This involved learning basic Filipino Sign Language (FSL), keeping an open laptop on site for written communication, and typing responses on mobile phones. The director used smartphone voice-to-text functionality so that Deaf participants could read spoken word in real time.
Post-production. The footage was edited primarily in the United States. Cuts of the film and subtitles were validated by our community partner, DeAF Deaf.
Outcomes
Deaf interviewees and advocates raised several recurring themes over the course of the project—including shortcomings of mass media, systematic exclusion from disaster relief, and difficulty accessing health care.
Multimedia Shortcomings. The Deaf were unable to hear community alarms, warnings, and sirens. On television, channel TV5 is the only network in the Philippines an inset for sign language interpreters. However, the inset is too small to make out some of the fingerspelling and detailed signs. It also disappears during the weather forecast, of particular importance before a typhoon. Closed captions are hard to come by and do not account for the variability in literacy and preferred written language of Deaf Filipinos, which is often English.
Exclusion from Aid. Relief is distributed geographically by “barangay,” or neighborhood. Government and non-governmental organizations coordinate with barangay leaders to distribute clothing, food, and other basic necessities. Claiming these items often require vouchers or coupons, which are distributed ahead of time within the barangay. However, persons with disabilities that affect mobility or communication may not
be able to access these resources. Moreover, the Deaf often congregate outside of barangays, in places that provide interpreters and community, like churches. It is important to note that, while this may limit direct access to aid and disaster relief, it also highlights a unique strength of the Deaf to form community, share FSL signs, and provide crucial support in settings where accessibility and resources are limited.
Barriers to Health. Employment opportunities are few for PWDs, which contributes to financial constraints and lack of insurance. When Deaf people do seek medical attention, few providers know basic signs, and most struggle to communicate with Deaf patients, even in writing, for the aforementioned variability in (principally English) literacy among Deaf Filipinos. In addition, Filipino Sign Language grammar is distinct, and sometimes the complete reverse of English grammar. Even simple directions such as “two tablets three times a day” may appear confusing, so prescriptions
and medicine packaging may be difficult to comprehend.
Discussion
The use of the documentary process creates avenues for health professionals to both research and collaborate with marginalized communities, giving those communities agency in how their issues are understood and portrayed.3 Collaborating with community partners not only gave us insights into the obstacles the Deaf face, but it also gave the film an effective distribution outlet; the film can be used as an advocacy and educational tool at venues like medical schools or events for PWDs.
The documentary’s production as a short film allows it to screen a standalone presentation or a springboard for further programming like workshops or discussions. It has screened at events for PWDs, for medical students interested in working more effectively with Deaf patients, and to Filipino Senator Bam Aquino.
A key limitation of this qualitative project was its relatively small sample (n=23) of interviews with voluntary participants. While some interviews, especially those with authority figures, hope to illustrate perceived trends within the Filipino Deaf community, the film cannot by design represent every member of the Deaf community.
Recommendations
After Haiyan shows how multimedia can simultaneously be used for research, advocacy, and education. The project illuminates that the Deaf are a linguistic and cultural minority with unique needs and much to offer. They cannot be effectively served through a ‘one-size-fits-all’ approach to aid and health care. The following have been proposed by our team and community
partners as future goals and areas of interest:
• Continued screening of the film through DeAF Deaf, focusing on medical training and cultural competency workshops for health and social workers.
• Developing a visual sheet for prescribed medications. Following the initial release of the film, a Deaf designer working with our community partner produced prototypes of pictorial medication sheets that doctors might use for basic consultations with Deaf patients. Such a tool could be validated, tested in the field, and distributed to health centers.
• Advocating for expanded closed captioning and FSL insets on television programs.
• Adopting a community-based participatory approach to aid and health care. The Deaf community may be seen as a resource, and not as an obstacle, to providing services to PWDs. Deaf leaders may serve as liaisons to their own community, identifying other PWDs and proving direct assistance to relief and health-related efforts.
Acknowledgments
The team would like to acknowledge our community partners, DeAF Deaf and ABC’s for Global Health, for their support. This project was also made possible by the Stanford School of
Medicine Traveling Scholars Program, Manila Doctors Hospital, Save the Children International, and Corporal Works of Mercy.
Website
haiyan.cinemedical.com
References
[1] Engelman, Alina, et al. “Responding to the deaf in disasters: establishing the need for systematic training for
state-level emergency management agencies and community organizations.” BMC health services research 13.1
(2013): 84. [2] Barnett, Steven, et al. “Peer Reviewed: Deaf Sign Language Users, Health Inequities, and Public Health:
Opportunity for Social Justice.” Preventing chronic disease 8.2 (2011). [3] Hergenrather, Kenneth C., et al. “Photovoice
as community-based participatory research: A qualitative review.” American journal of health behavior 33.6
Community Partners
The Development and Accessibility Fund for the Deaf (DeAF Deaf) is a non-profit organization “that aims to develop self-reliant and independent Deaf Filipinos” through education, provision of basic needs, and interpreter services. ABC’s for Global Health, which works primarily in the Philippines, seeks to foster healthier living through prevention and control of non-communicable chronic diseases with an emphasis on community-centered education and collaboration.
Process
About the film. This film was produced as part of a series of short video vignettes that explore how different communities in Tacloban are navigating the long-term recovery following Typhoon Haiyan. The other two vignettes, which discuss regional sources of livelihood and the experiences of health professions students in Tacloban, are referenced in this piece.
Recruitment. Team meetings primarily occurred at Greenboxx, a local café owned by one Deaf participant’s family. Deaf participants were recruited through personal referrals, attendance at PWD events, and meetings at Greenboxx. In general, it was important for us to develop our film and spend time in locations where the Deaf community congregates.
Production. Filming was conducted over a period of two months. We used HD video cameras to record on-location interviews, and then we captured supporting footage (“inserts”) around the community based on those interviews. We also carried two HD consumer-grade cameras to share with participants who wished to take part in the filming and collect their own footage. We conducted both individual and group interviews (n=23), which included members of the Deaf community, health professionals, Deaf interpreters and advocates.
We established multimodal means of communication with Deaf participants. This involved learning basic Filipino Sign Language (FSL), keeping an open laptop on site for written communication, and typing responses on mobile phones. The director used smartphone voice-to-text functionality so that Deaf participants could read spoken word in real time.
Post-production. The footage was edited primarily in the United States. Cuts of the film and subtitles were validated by our community partner, DeAF Deaf.
Outcomes
Deaf interviewees and advocates raised several recurring themes over the course of the project—including shortcomings of mass media, systematic exclusion from disaster relief, and difficulty accessing health care.
Multimedia Shortcomings. The Deaf were unable to hear community alarms, warnings, and sirens. On television, channel TV5 is the only network in the Philippines an inset for sign language interpreters. However, the inset is too small to make out some of the fingerspelling and detailed signs. It also disappears during the weather forecast, of particular importance before a typhoon. Closed captions are hard to come by and do not account for the variability in literacy and preferred written language of Deaf Filipinos, which is often English.
Exclusion from Aid. Relief is distributed geographically by “barangay,” or neighborhood. Government and non-governmental organizations coordinate with barangay leaders to distribute clothing, food, and other basic necessities. Claiming these items often require vouchers or coupons, which are distributed ahead of time within the barangay. However, persons with disabilities that affect mobility or communication may not
be able to access these resources. Moreover, the Deaf often congregate outside of barangays, in places that provide interpreters and community, like churches. It is important to note that, while this may limit direct access to aid and disaster relief, it also highlights a unique strength of the Deaf to form community, share FSL signs, and provide crucial support in settings where accessibility and resources are limited.
Barriers to Health. Employment opportunities are few for PWDs, which contributes to financial constraints and lack of insurance. When Deaf people do seek medical attention, few providers know basic signs, and most struggle to communicate with Deaf patients, even in writing, for the aforementioned variability in (principally English) literacy among Deaf Filipinos. In addition, Filipino Sign Language grammar is distinct, and sometimes the complete reverse of English grammar. Even simple directions such as “two tablets three times a day” may appear confusing, so prescriptions
and medicine packaging may be difficult to comprehend.
Discussion
The use of the documentary process creates avenues for health professionals to both research and collaborate with marginalized communities, giving those communities agency in how their issues are understood and portrayed.3 Collaborating with community partners not only gave us insights into the obstacles the Deaf face, but it also gave the film an effective distribution outlet; the film can be used as an advocacy and educational tool at venues like medical schools or events for PWDs.
The documentary’s production as a short film allows it to screen a standalone presentation or a springboard for further programming like workshops or discussions. It has screened at events for PWDs, for medical students interested in working more effectively with Deaf patients, and to Filipino Senator Bam Aquino.
A key limitation of this qualitative project was its relatively small sample (n=23) of interviews with voluntary participants. While some interviews, especially those with authority figures, hope to illustrate perceived trends within the Filipino Deaf community, the film cannot by design represent every member of the Deaf community.
Recommendations
After Haiyan shows how multimedia can simultaneously be used for research, advocacy, and education. The project illuminates that the Deaf are a linguistic and cultural minority with unique needs and much to offer. They cannot be effectively served through a ‘one-size-fits-all’ approach to aid and health care. The following have been proposed by our team and community
partners as future goals and areas of interest:
• Continued screening of the film through DeAF Deaf, focusing on medical training and cultural competency workshops for health and social workers.
• Developing a visual sheet for prescribed medications. Following the initial release of the film, a Deaf designer working with our community partner produced prototypes of pictorial medication sheets that doctors might use for basic consultations with Deaf patients. Such a tool could be validated, tested in the field, and distributed to health centers.
• Advocating for expanded closed captioning and FSL insets on television programs.
• Adopting a community-based participatory approach to aid and health care. The Deaf community may be seen as a resource, and not as an obstacle, to providing services to PWDs. Deaf leaders may serve as liaisons to their own community, identifying other PWDs and proving direct assistance to relief and health-related efforts.
Acknowledgments
The team would like to acknowledge our community partners, DeAF Deaf and ABC’s for Global Health, for their support. This project was also made possible by the Stanford School of
Medicine Traveling Scholars Program, Manila Doctors Hospital, Save the Children International, and Corporal Works of Mercy.
Website
haiyan.cinemedical.com
References
[1] Engelman, Alina, et al. “Responding to the deaf in disasters: establishing the need for systematic training for
state-level emergency management agencies and community organizations.” BMC health services research 13.1
(2013): 84. [2] Barnett, Steven, et al. “Peer Reviewed: Deaf Sign Language Users, Health Inequities, and Public Health:
Opportunity for Social Justice.” Preventing chronic disease 8.2 (2011). [3] Hergenrather, Kenneth C., et al. “Photovoice
as community-based participatory research: A qualitative review.” American journal of health behavior 33.6
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