On August 12, 2025, The New Times reported a groundbreaking moment in Rwanda’s health sector: the successful first cochlear implant surgery performed on a young child at King Faisal Hospital. This historic procedure represents a profound commitment to innovation and inclusion, full of promise for the future. Yet, it is precisely at this moment of technological achievement that we must pause and ask the most pressing important questions, not about the surgery itself, but about the long and complex journey that follows.

What do families and the Rwandan society understand? What do they expect?

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For this programme to fulfil its promise, its rollout must be guided by a participatory communication approach, rooted in clarity, accessibility, and, most importantly, respect for deaf children, their families, and the deaf community. Otherwise, even the most amazing programme can gradually close the very doors it hopes to open.

Deafness is not a deficiency; it is a way of being

Before we talk about surgery, we must talk about identity.

Deafness is not something to be corrected. It is a different way of experiencing the world: visually, physically, and expressively. For many in the deaf community, connection is not built on sound, but on sign language, eye contact, facial expression, and shared culture. It is not a loss. It is a way of life.

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I have found it helpful, especially when navigating new conversations around disability and inclusion, to reflect on the difference between two ways of seeing disability: the medical model and the social model. One sees the problem inside the person. The other sees it in the context of the environment in which the person operates: in systems, in attitudes and other social factors that influence a person’s thoughts and experiences. And often, it is the latter that shapes people’s day-to-day experiences.

Let’s break it down this way; a child who cannot hear is not inherently disabled.

But when people in their surroundings don’t know sign language, the school curriculum is only designed for hearing learners, and public services assume speech is the only valid form of communication. That is when the disability is created.

And for those of us working in communication, whether in health, education, development, or advocacy, I think there is a related idea that is just as important: the difference between deficit framing and asset framing.

Over time, I have observed how often we talk about people by describing what they lack. "Children who cannot hear.” "People living with a disability.” It is subtle. It often comes from a place of compassion. But it can subtly reinforce the idea that something is wrong when, in reality, what is needed is recognition, access, and inclusion.

On the other hand, when we start from what people already are; when we recognise that deaf children already communicate, already belong to a culture, and already have things to teach us, we tell a more complete story. We shift the tone. We invite dignity in. Indeed, deficit framing makes people the problem. Asset framing makes them part of the solution.

For those seeking a place to begin in understanding deafness and deaf culture, it may help to turn to storytelling. Films such as La Famille Bélier, CODA, and Sound of Metal, do not represent the full experience of being deaf, and they should not be taken as definitive. However, they offer a glance into deaf identity, deaf culture, and the many ways deaf people navigate the world. They can open a door to empathy, and remind us that deaf lives are complete lives, full of meaning, creativity, and connection.

Cochlear implants: What they are and what they are not

Cochlear implants are often seen as a breakthrough, and for some children, they can indeed open new ways of accessing sound.

However, they are not a cure, and they are not a guarantee. Rather, they are one possible tool on a much longer journey.

The implant works by bypassing damaged parts of the ear and sending signals directly to the auditory nerve. This does not bring back natural hearing; it introduces the brain to sound in a different way, which takes time and support to interpret and use meaningfully.

Whether or not the implant provides benefits depends on many factors. A child’s age, language exposure, access to sound and speech therapy, family involvement, and educational support all play a role. Surgery is only one part of the story.

Equally important is the preparation before surgery. Families need time, information, and support to understand what the implant can do and what it cannot. It is not enough to be informed, it is the "right” choice. Families need space to ask questions and learn from various perspectives, including deaf adults.

In some places around the globe, families have embarked on this process with high hopes, only to eventually feel unprepared to deal with the demands of the next phase. That is why communication must be transparent, elaborate, honest, and accessible. Consent should not be a formality. It should be a conversation.

We also need to be careful with how we talk about cochlear implants in public. If we suggest they "fix” deafness, we risk making sign language seem like a second choice. But for many children, sign language remains central. Some use both speech and sign. Others may not benefit much from the implant and rely fully on sign language. All of these paths are valid.

In the end, what matters is that families are informed, children are supported, and no one is made to feel incomplete because of their means of expression.

Sustaining political will through inclusive communication

The cochlear implant programme is not emerging in isolation. It is building on a foundation Rwanda already established through the development and distribution of the Rwandan Sign Language Dictionary, through inclusive education efforts, and through policy frameworks that increasingly recognise the rights and dignity of persons with disabilities. These actions point to one thing: a strong political will towards inclusion for all, and this commitment is commendable and is working.

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As the cochlear implant programme grows, it is important to maintain the same level of dedication; not only in advancing technology and services, but also in how we communicate. Communication is NOT just the exchange of information; it is a tool for inclusion. It ensures that everyone is informed, involved, and able to make decisions with clarity and access.

This is a call to all responsible agencies, including the Ministry of Health, Rwanda Biomedical Centre, professional associations, and implementing partners to keep the same energy and openness that made this progress possible. Let us ensure that information about the programme is available, accessible, and participatory. Let us prepare families, educators, and service providers not only for what is possible with the cochlear implant surgery, but also for what to expect and what to prepare for.

We must listen carefully, communicate honestly, and work together, with humility. Inclusion is not a one-time goal; it requires ongoing commitment and consistent practice.

Indeed, deaf children are not waiting to be changed. They are waiting to be heard and respected, and more than anything, they are waiting to be included in every step of the journey on their terms.

The writer is a communication practitioner and disability rights advocate.