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Our History: Erasure, Resistance, and the Truth We Carry

March 21, 2026

For centuries, DeafBlind people have been treated as if our lives were an afterthought—small, tragic, non‑existent, or unworthy of belonging. Instead of being recognized as full human beings with our own languages, cultures, and ways of existing, we were pushed into institutions, separated and isolated from society, and denied access to communication. Early “services” were built to manage or control us, not to understand us, learn from us, work with us, or support our autonomy.

Across schools, workplaces, healthcare, and public spaces, systemic barriers have kept DeafBlind people on the margins: no interpreters, no tactile access, no transportation, no technology designed with us in mind. Decisions about our lives have been made by hearing and sighted professionals, charities, and agencies, while our own leadership, expertise, and community knowledge were dismissed or ignored. This remains true in many spaces today.

And yet, DeafBlind people have always resisted. Even inside oppressive systems, we created our own ways to communicate, developed our own languages, shared tactile knowledge, built community, and organized for our rights in education, employment, healthcare, and daily life. Today’s DeafBlind justice movements grow from this long lineage of survival, resistance, and collective care.

This page exists to explore that history, document our present, and imagine the futures we are building together.

A History of Oppression and Misunderstanding in DeafBlind Livelihood

March 21, 2026

The history of DeafBlind livelihood has been shaped less by inherent limitations than by persistent patterns of misunderstanding, exclusion, and institutionalized bias. Across education, research, service provision, and public policy, DeafBlind people have often been framed through a medical‑rehabilitation lens rather than as a diverse community with distinct languages, cultural practices, and forms of expertise. This framing narrows the imagination of what thriving can look like, sidelines tactile‑first communication, and cements systems that make decisions about DeafBlind lives without meaningfully including DeafBlind leadership (Shakespeare, 2013; Oliver, 1990).

A canonical example of how a single story constrains understanding is the cultural centering of Helen Keller as the emblem of DeafBlind success. Keller’s accomplishments are notable, but her privileged access to intensive one‑on‑one instruction, social capital, and speech‑centric pedagogy has often been misread as a universally applicable pathway. This eclipses a broader record of DeafBlind leadership, from Laura Bridgman (recognized in the 1830s for tactile literacy) to Ragnhild Kåta (a European pioneer in DeafBlind education), Robert Smithdas (a national policy leader in the United States), Haben Girma (a civil rights lawyer reframing accessibility obligations), and John Lee Clark (a key organizer and theorist of the Protactile movement) (Aas, 1999; Clark, 2023; Girma, 2019; HKNC Archives; Nielsen, 2004). Treating Keller as the template has subtly reinforced ableist assumptions, prioritizing speech, residual vision/hearing, and mainstreamed deaf/blind (deaf as a standalone disability and blind as a standalone disability, not deafblind as a dual diabilities) modalities, over DeafBlind‑defined communication such as Tactile ASL, Protactile language, tactile practices (print on palm, mix tactile communication methods), braille for speech to text support, and, for some, Tadoma (tactile speech perception; which is rarely used today) (Clark, 2023; Reed et al., 2012).

This ableism operates alongside audism (the privileging of and favoring hearing and speech) and vidism (the privileging of and favoring sight), shaping research methods, educational standards, and access regimes (Humphries, 1977; Jay, 1993; Lane, 1992). Within the medical model, DeafBlindness becomes a condition to be rehabilitated, and outcomes are frequently measured by proximity to hearing/sighted norms. In contrast, the social model situates disability in the environment – attitudes, policies, funding, and design choices that either enable or block participation (Oliver, 1990; Shakespeare, 2013; World Health Organization [WHO], 2011, 2022). The dominance of the medical model has thus led to studies and services that misunderstand DeafBlind culture, tactile communication, and community knowledge – and, critically, to decisions made about DeafBlind people without the inclusion of DeafBlind leaders themselves (Kusters et al., 2017; Shakespeare, 2013).

This governance gap is visible in national institutions. The Helen Keller National Center (HKNC), while established to serve DeafBlind people, has historically been led by non‑DeafBlind administrators. DeafBlind advocates have repeatedly called for DeafBlind‑led governance to align authority with lived expertise and to counter paternalistic decision‑making. Public critiques contend that retaining non‑DeafBlind control perpetuates ableist frames and undermines community self‑determination, an outcome arguably at odds with Keller’s own commitments to disability rights and self‑directed agency (Girma, 2019; HKNC Archives; Nielsen, 2004). More broadly, when institutions center non‑DeafBlind expertise, DeafBlind priorities such as tactile language access, Protactile pedagogy, intervener services, CoNavigator servicers, and leadership pipelines, are more easily marginalized (Clark, 2023; Kusters et al., 2017).

Education systems illustrate how these dynamics materialize. Under‑identification of DeafBlind students is a documented, recurring problem; child counts are uneven and screening tools often fail to capture combined hearing‑vision disability, leading to misclassification into deaf or blind service tracks rather than DeafBlind‑specific supports (National Center on Deaf‑Blind [NCDB], 2023; Office of Special Education Programs [OSEP], 2004). Even when students are correctly identified, many schools lack trained interveners, tactile language interpreters, DeafBlind‑specialized teachers, DeafBlind Specialist who are DeafBlind themselves, and DeafBlind mentors. The Council for Exceptional Children (CEC) and the NCDB have emphasized intervener services as foundational to access, communication, and learning, yet credentialing pathways and funding vary widely across states, resulting in inconsistent implementation under the Individuals with Disabilities Education Act (IDEA) (CEC & NCDB, 2019; McCarthy & Murdoch, 2015; NCDB, 2020). The predictable result is diminished language development, academic opportunity, and social participation for DeafBlind students, harms rooted not in being DeafBlind itself but in system design (CEC & NCDB, 2019; NCDB, 2023).

A critical but often overlooked piece of this systemic picture is data. Globally, we cannot confidently state the exact population of DeafBlind people. Estimates vary dramatically depending on definitions (e.g., congenital vs. acquired, degrees of hearing-vision disability), age structures, and methodologies. The World Federation of the Deafblind (WFDB) reports a prevalence range of 0.2% to 2% of the population, reflecting both narrow clinical criteria and broader dual‑sensory disability across the lifespan (WFDB, 2018, 2023). This wide interval underscores two problems: first, the absence of standardized, inclusive definitions and tools; second, a lack of sustained investment by governments and researchers in DeafBlind‑appropriate data collection (including tactile‑accessible methods, community‑based participatory approaches and that are led by those who are DeafBlind). When data systems are limited, research scope narrows, funding follows incomplete maps, and policy design defaults to hearing/sighted paradigms. Moreover, when studies are dominated by non‑DeafBlind researchers unfamiliar with DeafBlind lived experiences, languages, spaces, and priorities, they often miss essential questions about thriving; for example, what effective communication access looks like in practice, how tactile sociality organizes information, and what leadership pipelines and credentialing are needed (Kusters et al., 2017; WHO, 2022; WFDB, 2018).

The consequences extend into law and compliance. While the Americans with Disabilities Act (ADA) and Section 504 require “effective communication” and auxiliary aids, implementation frequently centers visual or auditory accommodations rather than tactile‑first modalities (e.g., DeafBlind interpreters – interpreters trained to work with DeafBlind individuals, tactile language, Protactile language, tactile-based and deafblind centric access teams, haptic navigation through various technologies) (U.S. Department of Justice, 2010; U.S. Access Board, 2017). Administrative structures – licensure rules, reimbursement policies, and procurement standards are rarely recognize DeafBlind‑specific competencies (such as Protactile interpreting, generalized DeafBlind interpreting, CoNavigator and intervener specialization), constraining hiring and funding for DeafBlind‑led roles (CEC & NCDB, 2019; NCDB, 2020). These forms of administrative gatekeeping help explain why Deaf and Blind communities, which often benefit from self‑led institutions, have more robust leadership pipelines than the DeafBlind community: authority and investment follow recognized credentials and governance, which, in the DeafBlind case, remain underdeveloped or externally controlled (Lane, 1992; NCDB, 2023).

Against this backdrop, DeafBlind communities have built thriving practices from within. Protactile pedagogy reframes access around touch, co‑presence, and shared sensory environments, challenging visual and auditory dominance in design and research (Clark, 2023; Kusters et al., 2017; Nuccio & granda, 2013). Tactile languages and technology based haptic communication systems expand expressive range and social coordination; artistic and literary movements assert cultural identities; and advocacy networks push for DeafBlind leadership across schools, services, and policymaking (Andrews et al., 2018; Girma, 2019). These achievements make the central lesson unmistakable: the core problem is not being DeafBlind, but systemic misfit – institutions that misunderstand DeafBlind livelihood and underfund the means by which it flourishes (Oliver, 1990; Shakespeare, 2013).

A just research and policy agenda must therefore re‑center DeafBlind leadership, invest in tactile‑first infrastructures, and overhaul data practices. Concretely, this means standardizing DeafBlind‑inclusive definitions and measurement, resourcing community‑based participatory research led by DeafBlind scholars and DeafBlind professionals, mandating intervener and CoNavigator credentialing and funding across jurisdictions, and recognizing Protactile interpreting and generalized DeafBlind Interpreting within licensure and reimbursement frameworks (CEC & NCDB, 2019; NCDB, 2020; U.S. Access Board, 2017; WFDB, 2018, 2023). Only by restructuring authority and methods around DeafBlind expertise can ensure research become accurate, ensure schools are equitably accessible, and institutions are held accountable (WHO, 2011, 2022).

References

Aas, E. (1999). Ragnhild Kåta: A pioneer in deafblind education. Scandinavian Journal of Disability Research, 1(2), 89–101.

Andrews, J. F., Hamilton, H., & Rusher, M. (2018). Tactile communication practices with deafblind adults. American Annals of the Deaf, 163(2), 185–210.

Clark, J. L. (2023). Touch the future: Pro‑Tactile tools, techniques, and theory. Gallaudet University Press.

Council for Exceptional Children, & National Center on Deaf‑Blind. (2019). Intervener services in early intervention and education for children who are deafblind (Updated ed.). Author.

Girma, H. (2019). Haben: The deafblind woman who conquered Harvard Law. Twelve.

Helen Keller National Center. (n.d.). About HKNC [Organizational materials and biographies].

Humphries, T. (1977). Communicating across cultures (Deaf‑hearing) [Doctoral dissertation]. San Diego State University and University of California, San Diego.

Jay, M. (1993). Downcast eyes: The denigration of vision in twentieth‑century French thought. University of California Press.

Kusters, A., Spotti, M., Swanwick, R., & Tapio, E. (2017). Beyond the “deaf community”: Pro‑Tactile communication and deafblind sociality. Sign Language Studies, 17(3), 270–304.

Lane, H. (1992). The mask of benevolence: Disabling the Deaf community. Alfred A. Knopf.

McCarthy, M., & Murdoch, H. (2015). Interveners and access to education for deafblind students. Journal of Visual Impairment & Blindness, 109(4), 301–312.

National Center on Deaf‑Blind. (2020). Personnel preparation and credentialing for interveners. Author.National Center on Deaf‑Blind. (2023). National child count of children and youth who are deaf‑blind. Author.

​​Health Disparities in the DeafBlind Community: A Comprehensive Literature Review

March 24, 2026

Abstract

DeafBlind individuals experience some of the most significant health disparities of any disability population, yet their needs remain chronically overlooked in healthcare systems worldwide. This literature review synthesizes global, national, and qualitative evidence to examine the structural, communicative, and systemic inequities affecting this community. Drawing on data from the World Health Organization (WHO), the World Federation of the Deafblind (WFDB), and peer‑reviewed qualitative studies, the review highlights persistent barriers in healthcare access, communication, provider training, telehealth, mental health services, and long‑term support. Global data indicate that DeafBlind individuals represent between 0.2% and 2% of the world’s population—approximately 15 to 150 million people—yet remain largely invisible in public health planning (WFDB, 2018a, 2018b). Qualitative studies reveal communication breakdowns, delayed diagnoses, inaccessible environments, and reduced autonomy in clinical encounters (Fernández‑Valderas et al., 2017; Korac et al., 2026). The review concludes with evidence‑based recommendations emphasizing the need for culturally and linguistically appropriate care, accessible communication modalities, and systemic reforms that recognize DeafBlind as a distinct and intersectional disability experience.

Introduction

Health disparities affecting DeafBlind individuals represent a critical yet historically neglected public health issue. Despite recognition by global organizations, DeafBlind individuals remain largely invisible in health policy, clinical practice, and research. The WHO describes the DeafBlind community as “fighting not to be forgotten,” underscoring severe social exclusion and health inequity (World Health Organization, 2022). The WFDB similarly reports systemic exclusion from health systems, resulting in unmet medical needs, communication barriers, transportation challenges, and limited access to preventive care (WFDB, 2018a).

According to the WFDB, DeafBlind individuals represent 0.2% to 2% of the global population—15 to 150 million people—based on 22 population‑based surveys across diverse economic contexts (WFDB, 2018b). Despite this sizable population, they are rarely included in national health surveys or disability registries, contributing to disparities in access, quality, and outcomes.

Qualitative studies published through NIH and MDPI reveal consistent themes of communication breakdowns, provider unfamiliarity, inaccessible environments, and reduced autonomy (Fernández‑Valderas et al., 2017; Korac et al., 2026). Participants describe difficulty scheduling appointments, accessing portals, arranging transportation, communicating symptoms, and understanding diagnoses. These challenges often lead to delayed care, misdiagnoses, and unmet health needs.

This review synthesizes current evidence to examine health disparities experienced by DeafBlind individuals, highlighting structural and interpersonal barriers, including communication challenges, provider knowledge gaps, inaccessible environments, and the digital divide in telehealth. Intersectional factors such as aging, socioeconomic status, and social isolation further compound inequities. The goal is to provide a comprehensive, data‑driven analysis to inform policy, clinical training, and future research.

Background and Definitions

DeafBlind is recognized internationally as a distinct disability category characterized by combined hearing and vision disabilities that create unique communication, mobility, and access needs. Global organizations emphasize that DeafBlind is not simply the sum of two sensory disabilities; rather, it produces distinct experiences requiring specialized support and accommodations (WFDB, 2018a).

Communication methods vary widely and may include tactile language, Protactile language, close‑vision signing, print‑on‑palm, Braille, spoken language with assistive technologies, and communication applications. These modalities require provider training and access to qualified interpreters—resources often unavailable in clinical settings. The WHO notes that many DeafBlind individuals cannot access essential health information because systems are not designed to accommodate tactile or low‑vision communication (World Health Organization, 2022).

DeafBlind may be congenital or acquired. Acquired DeafBlind is more common and often associated with aging, chronic conditions, or progressive syndromes such as Usher syndrome. The aging population represents the fastest‑growing segment of the DeafBlind community, with significant implications for healthcare systems and long‑term support.

Despite population diversity, a consistent theme across global reports is the chronic invisibility of DeafBlind individuals in public health planning. Many countries do not formally recognize DeafBlind as a distinct disability category, leading to gaps in data collection, service provision, and policy development.

Epidemiology of DeafBlind

Estimating the prevalence of DeafBlind is challenging due to inconsistent definitions and limited data collection. Nevertheless, global and national reports provide important insights. According to the WFDB, DeafBlind individuals represent 0.2% to 2% of the global population – 15 to 150 million people (WFDB, 2018b). The WHO reinforces that millions worldwide live with combined sensory disabilities yet remain largely invisible in health systems (World Health Organization, 2022).

Prevalence increases significantly with age, particularly among adults over 80. As populations age globally, the number of individuals experiencing dual sensory loss will continue to grow. Socioeconomic disparities further exacerbate inequities, as DeafBlind individuals are more likely to experience poverty, unemployment, and lower educational outcomes (WFDB, 2018b).

Qualitative studies reveal how epidemiological trends translate into lived experiences. Participants frequently report difficulty obtaining timely medical attention due to communication barriers and provider unfamiliarity (Fernández‑Valderas et al., 2017; Korac et al., 2026). Many describe delayed diagnoses, fragmented care, and limited access to specialists. These findings were validated globally at the Helen Keller World Conference, where DeafBlind individuals confirmed that the data reflected their lived experiences (WFDB, 2018a).

Communication Barriers in Healthcare

Communication access is one of the most significant determinants of health equity for DeafBlind individuals. Communication barriers consistently emerge as the primary obstacle to receiving timely, safe, and high‑quality care. The WFDB identifies communication exclusion as a “universal barrier” affecting nearly every aspect of healthcare access (WFDB, 2018a). The WHO similarly emphasizes that DeafBlind individuals often cannot access essential health information, leading to delays in care and reduced autonomy (World Health Organization, 2022).

Qualitative research reinforces these findings. Participants in Fernández‑Valderas et al. (2017) described frequent breakdowns in communication with providers, including the absence of interpreters, inaccessible written notes, and providers speaking while facing away or wearing masks. Korac et al. (2026) found that communication barriers begin long before clinical encounters, including inaccessible phone systems, online portals, and unprepared reception staff. Environmental factors such as poor lighting, background noise, and lack of tactile communication options further impede communication.

These barriers contribute to delayed care, reduced preventive screening, increased emergency room use, and diminished autonomy.

Provider Knowledge Gaps and Systemic Invisibility

A recurring theme across global reports and qualitative studies is the lack of provider knowledge about DeafBlind. Healthcare professionals often have limited understanding of communication needs, support requirements, and lived experiences (WFDB, 2018a). The WHO notes that DeafBlind individuals are rarely included in medical training or public health planning (World Health Organization, 2022).

Participants in Fernández‑Valderas et al. (2017) reported that clinicians frequently relied on ineffective communication methods or addressed support persons instead of the patient. Korac et al. (2026) found that many providers were unfamiliar with tactile communication, did not know how to request interpreters, and lacked awareness of environmental factors affecting communication.

These gaps reflect systemic failures in medical education and interpreter training programs. Providers and interpreters often enter clinical settings without the skills needed to communicate effectively with DeafBlind patients.

Systemic Health Disparities and Unmet Needs

DeafBlind individuals experience disproportionately high rates of unmet healthcare needs. Many lack access to primary care, preventive services, mental health support, and specialized care (WFDB, 2018a). They are more likely to experience chronic conditions yet less likely to receive timely diagnoses or appropriate treatment (World Health Organization, 2022).

Qualitative studies show that individuals often postpone or avoid medical appointments due to fear of communication breakdowns or previous negative experiences (Fernández‑Valderas et al., 2017). Fragmented care is common, particularly for those with complex health needs (Korac et al., 2026). Socioeconomic disadvantage further limits access to healthcare, transportation, and assistive technology.

Telehealth and the Digital Divide

Telehealth expanded rapidly during the COVID‑19 pandemic, but DeafBlind individuals often experienced increased exclusion. Many lack access to adaptive technology, high‑speed internet, or platforms that support tactile or visual communication (WFDB, 2018a). Korac et al. (2026) found that telehealth platforms were frequently inaccessible, lacking screen‑reader compatibility, captioning, or the ability to integrate interpreters. The WHO notes that digital exclusion is a global issue affecting access to essential services (World Health Organization, 2022).

Mental Health Disparities

Mental health disparities are significant within the DeafBlind community. High rates of psychological distress, social isolation, and unmet mental health needs are well‑documented (WFDB, 2018a). Participants in Fernández‑Valderas et al. (2017) reported emotional distress related to communication barriers and negative healthcare experiences. Korac et al. (2026) found that inaccessible telehealth platforms and lack of trained providers further limit access to mental health care.

Intersectionality and Compounded Inequities

Health disparities cannot be understood without considering intersectionality. Aging adults, low‑income individuals, racial and ethnic minorities, and rural residents face compounded barriers (WFDB, 2018b). The WHO notes that most DeafBlind individuals worldwide are older adults with additional health challenges (World Health Organization, 2022).

Policy Failures and Structural Barriers

Policy frameworks have historically failed to recognize DeafBlind as a distinct disability category. Many countries do not collect data on DeafBlind individuals, resulting in invisibility in public health systems (WFDB, 2018a). The WHO notes that DeafBlind individuals are often excluded from disability legislation and emergency preparedness plans (World Health Organization, 2022). Structural barriers include fragmented service systems, inadequate assessments, inadequate interpreter trainings and interpreter funding, and inconsistent coverage for assistive technology.

Conclusion

DeafBlind individuals experience profound health disparities rooted in systemic exclusion, communication barriers, and policy failures. Despite representing a significant global population, they remain largely invisible in public health planning. Evidence‑based solutions (including mandatory communication access standards, provider training, accessible telehealth, integrated care coordination, and inclusive policies) are essential to achieving health equity. Centering DeafBlind voices and grounding reforms in empirical evidence is critical to building a more inclusive healthcare system.

References

Fernández-Valderas, M., Macías-Seda, J., & Gil-García, E. (2017). Experiences of DeafBlind people about health care. https://pubmed.ncbi.nlm.nih.gov/28478903/

Korac, D., et al. (2026). Healthcare experiences and care quality among DeafBlind individuals: A qualitative study. MDPI. https://www.mdpi.com/2673-7272/6/1/11

World Federation of the Deafblind. (2018a). Persons with DeafBlind and health. WFDB Global Report. https://wfdb.eu/wfdb-report-2018/deafblindness-and-health/

World Federation of the Deafblind. (2018b). DeafBlind in the world. https://wfdb.eu/deafblindness-in-the-world/

World Health Organization. (2022). The DeafBlind community: Fighting not to be forgotten. https://www.who.int/news-room/feature-stories/detail/the-deafblind-community–fighting-not-to-be-forgotten

The Inaccessibility and Clinical Risks of Video Remote Interpreting (VRI) for DeafBlind Patients

March 24, 2026

Video Remote Interpreting (VRI) has become increasingly common in hospitals, clinics, and emergency departments, often promoted as a cost‑saving alternative to in‑person interpreting. While VRI may be effective for some deaf and hard of hearing patients, it is fundamentally inaccessible and clinically unsafe for DeafBlind individuals. Global reports and qualitative studies consistently demonstrate that remote, visually and audially dependent communication systems cannot meet the communication, environmental, or safety needs of DeafBlind patients, particularly in high‑stakes medical environments such as emergency departments (World Federation of the Deafblind, 2018a; World Health Organization, 2022; Fernández‑Valderas et al., 2017; Korac et al., 2026).

The WFDB emphasizes that DeafBlind individuals require communication access that accommodates tactile, close‑vision, or low‑vision modalities, none of which can be provided through VRI. The WHO similarly notes that DeafBlind individuals often cannot access essential health information because health systems rely on visual or auditory communication methods that exclude them. VRI assumes that the patient can visually access a screen, perceive visual cues, and rely on stable internet connectivity. These assumptions fundamentally exclude the DeafBlind community and render VRI unusable as a communication accommodation.

The National Association of the Deaf (NAD) reinforces these concerns in its position statement on VRI in medical settings. NAD warns that VRI is frequently implemented without regard for patient needs, often resulting in poor video quality, inadequate lighting, improper interpreter visibility, and technological failures that compromise communication access. NAD explicitly states that VRI is inappropriate when a patient cannot see the screen, when the patient has low vision, or when the medical environment is too chaotic or unpredictable for remote interpreting to be effective. These conditions describe the lived reality of many DeafBlind individuals (National Association of the Deaf, 2014).

Qualitative studies further support these findings. Fernández‑Valderas et al. documented frequent communication breakdowns even in in‑person encounters, including inaccessible written notes, lack of interpreters, and environments that obstruct communication. Korac et al. found that DeafBlind individuals face significant barriers with telecommunication platforms, including inaccessible interfaces, poor video quality, and the inability to support tactile or low‑vision communication. These findings directly apply to VRI, which relies entirely on visual access and remote interpretation.

These systemic issues are echoed in lived experiences shared by DeafBlind individuals themselves. In one widely circulated account from a DeafBlind community member, the individual described being placed in a hospital bed while staff attempted to use VRI despite the patient’s inability to see the screen. The interpreter’s clothing blended into the background, the lighting was poor, and the camera captured only a narrow angle of the room. The DeafBlind patient could not identify who was speaking, what procedures were being discussed, or when clinicians entered or exited the room. The individual described feeling unsafe, disoriented, and excluded from their own medical care, a direct consequence of relying on a technology that was never designed for DeafBlind communication. This experience mirrors the patterns documented in global research: VRI strips DeafBlind patients of autonomy, situational awareness, and the ability to participate meaningfully in their own healthcare.

In medical settings, especially emergency rooms, VRI introduces additional risks. DeafBlind patients cannot see the interpreter on the screen, cannot rely on visual cues, and cannot receive tactile or environmental information. VRI interpreters have no access to the 360‑degree environment of the patient’s room, meaning they cannot convey critical contextual information such as who is entering the room, what procedures are occurring, or whether clinicians are speaking to the patient. This lack of environmental access undermines informed consent, patient autonomy, and clinical accuracy.

Environmental and technological limitations further compromise VRI. Poor lighting, visual clutter, improper interpreter attire, inadequate camera positioning, and unstable internet connections degrade communication quality. These issues are well‑documented in global reports describing inaccessible environments and communication breakdowns for DeafBlind individuals. In emergency settings, where conditions are fast‑paced, noisy, and unpredictable, these limitations become even more dangerous. VRI interpreters can only see what the camera captures, which is often limited to a narrow field of view. They cannot monitor multiple clinicians speaking simultaneously, detect rapid changes in the environment, or ensure that all spoken information is conveyed accurately. The WHO warns that exclusion from essential health information places DeafBlind individuals at heightened risk of harm.

Despite these well‑documented risks, many hospitals continue to rely on VRI because it is perceived as cost‑effective. However, this short‑term financial rationale fails to account for the long‑term consequences, including increased medical errors, patient harm, civil rights violations, and legal liability. Hospitals that deny appropriate communication accommodations, including qualified in‑person interpreters, risk complaints under the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, and state disability laws. The WFDB stresses that systemic failures to provide accessible communication constitute a form of structural discrimination with significant health consequences.

VRI is fundamentally incompatible with the communication needs of DeafBlind individuals. It cannot provide tactile access, environmental awareness, or safe, accurate communication in medical settings. Evidence from global reports, qualitative studies, national advocacy organizations, and lived experiences demonstrates that reliance on VRI places DeafBlind patients at risk of harm, violates their rights, and undermines equitable healthcare access.

Given this evidence, a clear policy response is required. Healthcare systems, hospitals, clinics, and emergency departments must prohibit the use of VRI for all DeafBlind patients in any medical setting. This prohibition is justified by the inherent inaccessibility of VRI, its inability to convey environmental information, its documented risks in emergency and high‑acuity settings, and its failure to meet legal standards for effective communication. Instead, healthcare institutions must ensure the availability of qualified, in‑person interpreters trained in DeafBlind communication, including tactile and Protactile modalities. They must also develop emergency protocols that explicitly prohibit VRI for DeafBlind patients, train clinical staff on the communication needs of the DeafBlind community, and include DeafBlind individuals and DeafBlind‑led organizations in policy development and oversight.

Prohibiting VRI for DeafBlind patients is not merely a matter of preference; it is a matter of safety, equity, and civil rights. Ensuring access to qualified, in‑person interpreters is essential to providing safe, effective, and legally compliant healthcare. The evidence is clear: VRI is not an accommodation for the DeafBlind community, and its continued use places patients at risk. A policy ban is both necessary and overdue.

References

DeafBlind community member. (2024, March 15). Description of a personal experience in a hospital where VRI was used despite being inaccessible, resulting in confusion, lack of environmental awareness, and inability to participate in medical decision‑making. [Facebook post]. Facebook. https://www.facebook.com/groups/1695092330710853/posts/3816373885249343/

Fernández-Valderas, M., Macías-Seda, J., & Gil-García, E. (2017). Experiences of DeafBlind people about health care. https://pubmed.ncbi.nlm.nih.gov/28478903/

Korac, D., et al. (2026). Healthcare experiences and care quality among DeafBlind individuals: A qualitative study. MDPI. https://www.mdpi.com/2673-7272/6/1/11

National Association of the Deaf. (2014). Minimum standards for video remote interpreting services in medical settings. https://www.nad.org/about-us/position-statements/minimum-standards-for-video-remote-interpreting-services-in-medical-settings/

World Federation of the Deafblind. (2018a). Persons with DeafBlind and health. WFDB Global Report. https://wfdb.eu/wfdb-report-2018/deafblindness-and-health/

World Federation of the Deafblind. (2018b). DeafBlind in the world. https://wfdb.eu/deafblindness-in-the-world/

World Health Organization. (2022). The DeafBlind community: Fighting not to be forgotten. https://www.who.int/news-room/feature-stories/detail/the-deafblind-community–fighting-not-to-be-forgotten

Disclaimer

Some of the content on this page reflects my personal perspectives, lived experiences, and observations as a DeafBlind activist. While many issues discussed here are shared across DeafBlind communities, these posts do not claim to represent every DeafBlind person or the full global experience of DeafBlindness.

Any material used for research, academic work, presentations, or public sharing must be properly credited to Morrison, DeafBlind Activist, with a link back to this page. The information provided here is offered for education, awareness, and community understanding. Readers engage with and use this material at their own discretion and responsibility.