For over a month, people here in Madrid have been wearing face masks on the crowded city streets to help limit the spread of COVID-19, and it is obligatory for travellers to use face coverings on public transport and in shops. Face masks pose challenges for people with hearing loss, who rely on clearly articulated speech and/or lipreading for effective communication.
I have had some positive experiences, especially in small shops, where shopkeepers have used hand gestures to help aid communication when I’ve failed to understand something they have said through their mask. I have also had some frustrating and upsetting incidents. During a recent medical assessment, I interacted with three healthcare workers, who each had a different method of communicating through the face mask barrier.
I normally attend appointments alone, but this time my boyfriend came to accompany me. We joined the short queue outside the health centre and a few minutes later, a receptionist started questioning the people waiting. The noise of traffic from the main road hindered my ability to catch what was being said and I was relieved my boyfriend was with me to listen and to help me navigate the situation.
When we reached the front of the queue, my boyfriend was promptly told that he wasn’t allowed in the building with me, due to COVID-19 safety measures. I hadn’t been to this health centre before and so I was unfamiliar with the protocols. I started to feel a little nervous. I waved goodbye to my boyfriend and followed the receptionist inside the building.
There were two receptionists, both wearing face masks and sitting behind a desk, each with a corresponding queue of patients. While waiting in a queue with two other people in front of me, I observed the procedure. The person at the front of each queue was required to stand behind a line marked with tape on the floor, 2 metres away from the reception desk. The patient was asked a series of questions and the receptionist entered the data into their computer.
Communicating Through the Face Mask Barrier, Method 1: Remove the Mask
As I went up to the desk to answer the questions, the person being attended to in the neighbouring queue started to speak at the same time as me. The sound of their voice made it difficult for me to gauge my own volume level. I stated my identity number as clearly as I could through my mask. The receptionist responded with a blank look and asked me to repeat myself. Perhaps I hadn’t spoken loud enough. Since it is difficult to gauge the volume of my voice over background noise, I often speak too quietly or conversely end up shouting. I spoke my number again, yet again she didn’t understand. Perhaps the receptionist also had hearing loss. Some people started to have a conversation in the waiting area and the receptionist requested them to be silent as I simultaneously uttered that I have hearing loss.
She pulled down her mask and I felt the weight of the communication barrier removed. She proceeded to ask me questions clearly and with her lips visible. I was surprised at how much I rely on lipreading. Communication was now more comfortable and I was able to answer the questions. She found my name and appointment in her computer system. Next, instead of giving verbal directions (as she had done for the previous patients), she kindly left her position behind the desk and accompanied me to the correct area of the building for my appointment.
Communicating Through the Face Mask Barrier, Method 2: Speak Clearly
I was greeted by a male nurse. The receptionist had alerted him to my hearing difficulties and he spoke slowly and clearly; I understood everything he was saying. He was extremely accommodating and even attempted to speak some English to me to help aid me further. I thanked him for being kind and for speaking clearly. As I went to leave the room, he acknowledged the communication difficulties of wearing a mask and announced in English, “With this mask is impossible!”
Communicating Through the Face Mask Barrier, Method 3 (the least effective): Make No Amendments
My final consultation was with a doctor. She was sitting behind her desk, wearing a face mask and a visor which she continuously adjusted throughout our interaction. I was in this room for about 40 minutes – 40 minutes of intense isolation and frustration.
This was the main part of my assessment. I was perched on the edge of my chair, 2 metres away from her desk, trying to position my ‘good’ ear as close to the doctor as possible. Unfortunately, through the two layers of face-coverings, her speech reached my ear as a series of unintelligible scrambled tones and fragments of muffled words. After every piece of dialogue, I asked her to repeat herself (usually more than once) for me to gain some understanding of what she was asking me.
I answered every question, unsure as to whether my answer corresponded to her topic of inquiry. As she adjusted her visor, which kept sliding down her forehead, I was unable to gain any reaction or informative clues from her eyes.
I was finding the experience draining. I was too far into the consultation and didn’t have the energy to explain to another person that I was having trouble communicating through the face coverings. Actually, I assumed this was obvious. The reason I was there was for hearing-related issues – it was the main subject of discussion. I left the final consultation feeling deflated and defeated.
I hadn’t been prepared for the degree of difficulty I would experience in engaging in prolonged communication through the face mask barrier. I should have asked the doctor to remove her facemask. Even though it feels like an effort and even when it seems obvious, it is important to inform people of my communication difficulties and of ways they can offer support. People can only help if they know how to do so. Now I am more aware of my limitations. Next time I will advocate for myself. Next time I will ensure that I convey my needs.