Background Many cultural and linguistic Deaf people in South Africa face disparity when accessing health information because of social and language barriers. The number of certified South African Sign Language interpreters (SASLIs) is also insufficient to meet the demand of the Deaf population in the country. Our research team, in collaboration with the Deaf communities in Cape Town, devised a mobile health app called SignSupport to bridge the communication gaps in health care contexts. We consequently plan to extend our work with a Health Knowledge Transfer System (HKTS) to provide Deaf people with accessible, understandable, and accurate health information. We conducted an explorative study to prepare the groundwork for the design and development of the system. Objectives To investigate the current modes of health information distributed to Deaf people in Cape Town, identify the health information sources Deaf people prefer and their reasons, and define effective techniques for delivering understandable information to generate the groundwork for the mobile health app development with and for Deaf people. Methods A qualitative methodology using semistructured interviews with sensitizing tools was used in a community-based codesign setting. A total of 23 Deaf people and 10 health professionals participated in this study. Inductive and deductive coding was used for the analysis. Results Deaf people currently have access to 4 modes of health information distribution through: Deaf and other relevant organizations, hearing health professionals, personal interactions, and the mass media. Their preferred and accessible sources are those delivering information in signed language and with communication techniques that match Deaf people’s communication needs. Accessible and accurate health information can be delivered to Deaf people by 3 effective techniques: using signed language including its dialects, through health drama with its combined techniques, and accompanying the information with pictures in combination with simple text descriptions. Conclusions We can apply the knowledge gained from this exploration to build the groundwork of the mobile health information system. We see an opportunity to design an HKTS to assist the information delivery during the patient-health professional interactions in primary health care settings. Deaf people want to understand the information relevant to their diagnosed disease and its self-management. The 3 identified effective techniques will be applied to deliver health information through the mobile health app.

South Africa has one of the most progressive constitutions in the world protecting the linguistic and cultural rights of Deaf people. However, there is a huge gap between policies and reality in schools for Deaf learners in South Africa. In this paper we critically unpack and reflexively explore the linguistic and cultural issues that emerged during the process of creating and implementing the new South African Sign Language (SASL) curriculum. This curriculum was produced as a result of a landmark court case. We use an ethnographic framework based on our own reflections, discussions with Deaf people, notes from meetings, and discussions with the other team members. Why and how did the process that started off with so much energy, excitement and goodwill break down? We argue that a key reason for this breakdown is inadequate linguistic knowledge and cultural sensitivity in relation to SASL and Deaf cultural identity. The paper concludes with an outline of lessons learnt.

While Deaf learners are fluent in a signed language they need to know a written language when acquiring computer literacy skills. We aim to allow Deaf people learn at their own pace and in turn reduce the need to interpret written text. Classroom dynamics and teaching method were studied to extract how lessons were conducted. We then implemented our solution: an authoring tool to structure lesson content and a mobile prototype. The prototype uses South African Sign Language videos arranged according to pre-existing lessons exported by the authoring tool. Results from the user testing showed a reduction in number of representational states which instructions appear in as well as allowing Deaf learners to learn at their own pace.

This paper discusses a prototype of a learning aid on a mobile phone to support Deaf people learning computer literacy skills. The aim is to allow Deaf people to learn at their own pace which in turn reduces the dependence on a teacher to allow weaker learners be assisted. We studied the classroom dynamics and teaching methods to extract how lesson content is delivered. This helped us develop an authoring tool to structure lesson content for the prototype. A prototype has been developed using South African Sign Language videos arranged according to the structure of pre-existing lessons. The technical goal was to implement the prototype on a mobile device and tie the resulting exported lesson content from the authoring tool to a series of signed language videos and images so that a Deaf person can teach him/herself computer literacy skills. Results from the user testing found the prototype successful in allowing Deaf users to learn at their own pace thereby reducing the dependence on the teacher.

When undertaking a project in community-based co-design, students and their teachers must embrace uncertainty.

In tightly circumscribed communication situations an interactive system resident on a mobile device can assist Deaf people with their communication and information needs. The Deaf users considered here use South African Sign Language and information is conveyed by a collection of pre-recorded video clips and images. The system was developed according to our method of community-based co-design. We present several stages of the development as a series of case studies and highlight our experience. The first stage involved ethnographically inspired methods such as cultural probes. In the next stage we co-designed a medical consultation system that was ultimately dropped for technical reasons. A smaller system was developed for pharmaceutical dispensing and successfully implemented and tested. It now awaits deployment in an actual pharmacy. We also developed a preliminary authoring tool to tackle the problem of content generation for interactive computer literacy training. We are also working on another medical health information tool. We intend that a generic authoring tool be able to generate mobile applications for all of these scenarios. These mobile applications bridge communication gaps for Deaf people via accessible and affordable assistive technology.

The computing for development community knows how to build user interfaces using qualitative methods for text illiterate users, especially on mobile devices. However, little work has been done specifically targeting Deaf users in developing regions who cannot access voice or text. This paper describes a multi-disciplinary collaboration towards iterative development of a mobile communication tool to support a Deaf person in understanding usage directions for medication dispensed at a pharmacy. We are improving usability and correctness of the user interface. The tool translates medicine instruction given in English text to Sign Language videos, which are relayed to a Deaf user on a mobile phone. Communication between pharmacists and Deaf patients were studied to extract relevant exchanges between the two users. We incorporated the common elements of these dialogues to represent content in a verifiable manner to ensure that the mobile tool relays the correct information to the Deaf user. Instructions are made available for a Deaf patient in signed language videos on a mobile device. A pharmacy setup was created to conduct trials of the tool with groups of end users, in order to collect usability data with recorded participant observation, questionnaires and focus group discussions. Subsequently, pre-recorded sign language videos, stored on a phone's memory card, were tested for correctness. Results of these two activities are presented and discussed in this paper.

In this paper, we present a description of an adult Deaf Literacy project in South Africa. The project is under the auspices of the Deaf Community of Cape Town, a grassroots organisation run by Deaf people to serve the needs of the historically disadvantaged Deaf. The literacy project is staffed by Deaf signers, paired with hearing support teachers. This pairing facilitates the use of a bilingual model of English literacy acquisition, in this case enabling the accessing of written English through the medium of South African Sign Language (SASL). There are currently five classes, each consisting of between 8 and 10 learners. There are slightly more men than women; they have all attended schools for the deaf for at least 12 years and are almost all currently employed, albeit in jobs which are menial, and require less of them than they may be capable of. They grew up in hearing homes where the languages used were English, Afrikaans, and Xhosa, but all prefer to use SASL as their primary language of communication. Reading levels are low, apparently ranging between first and fourth grade, even though the learners have attended residential schools for the Deaf for an average of 10 years.

This article considers the feasibility of inclusive education for Deaf students in a mainstream Further Education and Training (FET) classroom through the use of a South African Sign Language interpreter. It revisits the centrality of language in Deaf students' education and reports on progressive policy changes in the areas of language, education and disability in South Africa. The article surveys classroom discourse and literacy practices in a mainstream FET classroom, focusing particularly on students' acquisition of text literacy skills in Business English. Drawing on theoretical frameworks from the New Literacy Studies, Critical Discourse Analysis and the Social Model of Disability, the article argues that there is definitely potential for establishing inclusive education for Deaf students in a mainstream classroom. It however highlights that there are many difficulties and challenges around providing fully inclusive education for Deaf students. It was found that the signed interpretations in this classroom frequently represent an impoverished form of language while some types of pedagogic practice impede the interpreter's signing. The article concludes that interpreters and teachers need to be trained in forms of language and pedagogy that would benefit all students in class, including Deaf students.

Abstract: This paper presents a description of telecommunications for Deaf people in South Africa by contrasting the situation in the developed world. We explain the main motivations for providing a locally appropriate solution. Research activity began with a community-based,field trial of TTYs. The recommendations,of the trial motivated an innovative approach,to provide synchronous,and accessible relay services. Drawing from international technological developments, we designed a software solution called the SoftBridge. We employ,iterative Action Research cycles to drive technological modifications to the SoftBridge and to encourage adoption by the end-user community. Keywords: Deaf, telecommunications, relay, South Africa, Action Research

This paper presents a description of telecommunications for Deaf people in South Africa by contrasting the situation in the developed world. We explain the main motivations for providing a locally appropriate solution. Research activity began with a community-based field trial of TTYs. The recommendations of the trial motivated an innovative approach to provide synchronous and accessible relay services. Drawing from international technological developments, we designed a software solution called the SoftBridge. We employ iterative Action Research cycles to drive technological modifications to the SoftBridge and to encourage adoption by the end-user community.

Following on several partial prototypes, we built an automated Deaf Telephony bridging application with the SoftBridge platform. The SoftBridge performs multi-modal bridging in real-time using Text-to-Speech (TTS) and Automatic Speech Recognition (ASR) utilities accessed via web services. To perform Action Research with the Deaf community in Cape Town, we invited a Deaf user (DU) to participate in a pilot study. We conducted three tests varying the input/output modalities of the hearing user (HU). The DU had a standard text in/text out Instant Messaging client. The HU client used the following specific modality combinations: Text & TTS in/Text out, TTS in/Text out and TTS in/Text & ASR out. The SoftBridge logged the conversations for subsequent analysis. The trial showed a largely successful conversation. Success factors include a) a text and computer literate DU who is familiar with research practise, b) using the system to explain the research as we conducted it and c) that the multi-modal bridging capabilities overcame the expected shortcomings of TTS and especially ASR. The lessons learned from this trial will be applied to the next trial once the necessary modifications have been implemented.

We have developed a prototype bridge that relays text and speech between Teldem, a text telephone for the Deaf, and a standard telephone or H.323 endpoint. Telgo323 uses modified H.323 media gateways and open source Text to Speech and Speech to Text software. The approach allows for easy integration of new tools as the technologies mature. This paper presents the design of the implementation prototype, discusses Teldem tone decoding, and suggests directions for future work. The Telgo323 provides evidence that an automated relay bridge is imminently viable for the Deaf Community, and further demonstrates an attractive approach for building bridges over the Digital Divide. Index terms Deaf telephony, Digital Divide bridges, H.323 gateway modification, Speech to Text, Text to

A Teldem provides text-based telephony services to the deaf. Despite an array of text-based communications mechanisms on the web, the Teldem is the only means of synchronous telecommunication available to a deaf person. We examine a human -assisted relay that provides a bridge between the deaf and the hearing, and then propose several additional bridges. These bridges take advantage of both standard and cutting edge technologies. We present each bridge's impact on the deaf with respect to synchrony, connectivity, independence, and the Digital Divide. It is hoped that by deploying trials for each bridge, we can eventually provide the deaf with equal access.

This paper discusses a prototype for a communication aid on a mobile phone to support a Deaf person visiting a public hospital pharmacy. The aim is to prevent problems of non-compliance to treatment due to poor communication between a Deaf patient and a pharmacist. We studied the communication exchange between pharmacists and Deaf patients in a pharmacy setting in order to extract the most relevant content exchange between the two parties. A prototype was developed on a mobile phone and iteratively tested using role plays, questionnaires and focus groups with pharmacy students and Deaf participants. The prototype allows pharmacists to input text and make selections that provide detailed medical instructions in signed language to a Deaf patient. The prototype demonstrates the feasibility of encoding a limited communication flow on a mobile device, with carefully sequenced sign language videos that a Deaf patient can watch and understand in order to take medicine correctly.

This paper presents a case of iterative community-based co-design to facilitate the emergence of an innovative mobile system to address a potentially life-threatening scenario for Deaf people in South Africa. For Deaf people who communicate in South African Sign Language, miscommunication due to language barriers, under-education and under-employment can lead to a potentially dangerous therapeutic outcome when Deaf people misunderstand a pharmacist's instructions on how to take prescribed medicine. The design for a mobile communication aid to address this problem emerged from iterative cycles of action research performed with a local Deaf community that also involved pharmacists and a multi-disciplinary research team. Conventional user-centred design techniques were innovatively appropriated for the community-based co-design. The paper illustrates the community-based co-design process and points the way toward imminent implementation, as well as the potential application of the mobile solution to other scenarios in Deaf people's lives.