Accessible services for deaf immigrants and refugees in the United States: Exploring the capacity of deaf-serving organizations

Abstract

In an era of climate change, war, economic crises and grave political and social challenges, migration and resettlement are increasing in unprecedented numbers. Deaf immigrants and refugees entering the United States resettle as a result of war, persecution, human rights violations or migrate as a result of economic necessity. Yet, deaf and disabled migrants face unique and often little understood barriers that mainstream refugee resettlement agencies may be less equipped to tackle. Deaf serving organizations and deaf refugee serving organizations are well positioned to fill in the gap in providing accessible services taking into account language deprivation, sign language of the countries of origin, educational considerations, mental health needs and deaf community support. Furthermore, such efforts to elevate the well-being of deaf refugees can foster resilience, empowerment and a sense of agency. This manuscript explores the capacity of key organizations serving deaf immigrants and refugees in the United States, including deaf refugee non-profits as well as deaf organizations that have specific programs for deaf refugees. Organizations include one that is founded, led by and staffed by deaf refugees, a model that highlights the benefit of leadership by those most impacted. Findings can benefit large scale immigrant and refugee non-profits targeted to specific immigrant demographics aiming to improve their services for deaf immigrants and refugees. Deaf immigrant and refugee-serving organizations are well-positioned to be advocates agitating for deaf and disability rights in the midst of accessibility hurdles in the immigration legal system, healthcare, housing and social service systems.

Introduction

The global refugee crisis has been a persistent and complex issue, with millions of people fleeing their countries of origin due to persecution, conflict, violence, human rights violations and events significantly disrupting public order (UNHCR, 2022). Among these forcibly displaced individuals, there is a significant number of refugees who are disabled, adding an additional layer of challenges and barriers to their already difficult circumstances. According to the United Nations High Commissioner for Refugees (UNHCR) 2022 report, there are approximately 108.4 million forcibly displaced people worldwide, with 35.3 million people classified as refugees (UNHCR, 2022). Within this refugee population, there are deaf and hard-of-hearing (DHH) migrants from various countries who share unique experiences and challenges. In 2020, roughly 12 million forcibly displaced people were individuals with disabilities (Migration Data Portal, 2023).

When considering the diverse experiences of refugees and migrants worldwide, the challenges faced by Deaf refugees stand out as particularly complex and multifaceted. Deaf refugees, who already face hardships related to fleeing conflict and instability, encounter additional challenges related to systemic ableism. The complex interaction of their refugee status, deafness and various intersecting identities contributes to their struggle for survival and integration. The experiences of Deaf refugees emphasize the critical need for comprehensive support systems that address their unique challenges. The International Rescue Committee highlighted instances of Deaf individuals fleeing conflict zones without understanding the gravity of the situation or due process due to their deafness. This vulnerability highlights the challenges faced by Deaf refugees - the stress of fleeing conflict and the uncertainty of effective communication (IRC, 2022). This communication barrier can compound their hardships and sustain a cycle of exclusion from essential services.

The journey for disabled asylum seekers and refugees striving to reach the US can be intimidating due to the challenges they face (McAuliff, 2021). Disabled refugees and asylum seekers represent some of the most marginalized and economically disadvantaged individuals within society, given generally lower levels of employment and economic mobility (King et al., 2013). These individuals encounter a complex immigration system made even more challenging by their disabilities. Navigating the immigration process with limited accessibility and inadequate accommodations poses significant barriers, and can lead to being turned away for resettlement or denied the chance to immigrate. Furthermore, some nations have designed exclusionary immigration systems with processes in place that intentionally limit the immigration of people with disabilities (Crock, Smith-Khan, McCallum and Saul, 2017).

This is true even though the U.S. Department of State's guidance for integrating disability inclusion across foreign policy notes that respecting the human rights and freedoms of people with disabilities supports economic growth, political cooperation and innovation (U.S. Department of State, 2024). The unique barriers deaf migrants and refugees face in the immigration and resettlement process highlights the need for specialized assistance and tailored legal support during reintegration after their disproportionately difficult journey.

Background

This project sheds light on the predicament of deaf and disabled refugees and the unique issues they face in their journey to safety and economic mobility. One of the critical issues faced by deaf refugees in the United States is the communication and language barriers they encounter upon entering countries. Often, deaf individuals may have limited or no formal education due to the lack of accessible educational opportunities in their home countries (Schwartz et al., 2022). As a result, when they seek refuge in foreign lands, they face immense difficulties in accessing information, services, and resources as they struggle to communicate effectively with service providers. Deaf refugees in the United States face difficulties accessing the education system, which fails to provide them essential English reading and writing skills necessary for employment (Schwartz et al., 2022).

Furthermore, these deaf refugees may have linguistic deprivation, coming from home countries that did not provide access to education prior to migration. The communication needs of Deaf refugees are complex and public educational systems often fail to have supportive systems in place (Schwartz et al., 2022). Deaf migrants and refugees often resettle with other sign languages as their primary language, or may be language deprived and therefore need appropriate support systems in place beyond formal schooling. In the United States, the Individuals with Disabilities Education Act (IDEA) caters to people aged 3 to 21, and upon reaching the age limit, many Deaf refugees may no longer be eligible to receive essential educational services. While the Americans with Disabilities Act (ADA) mandates effective communication which may include ASL interpreters in classrooms, this approach is not enough since Deaf refugees' needs for formal education goes beyond the need of ASL interpretation and in any case, may not be sufficiently met through an interpreter not fluent in the sign language of their home country (Schwartz et al., 2022).

In light of these challenges, it is crucial that governments, refugee and immigrant-serving non-profits, schools and civil society adopt comprehensive strategies that prioritize the unique communication needs of Deaf refugees. This includes providing culturally sensitive environments and providing specialized educational support. By addressing these gaps in education, societies can enable DHH refugees to not only enhance their employability and self-sufficiency but also to fully participate in and contribute to their new communities. Through these efforts, we can bridge any language or educational gaps that may exist and empower Deaf refugees to overcome the barriers that limit their integration and success.

The UNHCR notes that Deaf refugees and migrants often encounter stigma, discrimination, and multifaceted barriers when seeking assistance and protection (Tingle, 2021). Communication barriers during key interviews may lead to being turned back or deported in error. These challenges expose them to increased risks of exploitation, violence, and other protection concerns (Tingle, 2021). Moreover, Deaf refugees from minority backgrounds often share a strong sense of unity with other minority group members due to their common experiences of discrimination (Iyer and Emery, 2021). This unity highlights the complexities of intersectionality, as they navigate intersecting identities related to race, ethnicity, gender, and disability. According to a study focusing on two Black Deaf African migrants from London, there are enormous challenges faced by Deaf refugees migrating to a host country. Their experiences with the border control process highlights the intersections of racism, gender oppression, and discrimination against Deaf individuals (Iyer and Emery, 2021). Communication barriers left a deaf refugee not only isolated but also exposed to further marginalization as a woman, a Muslim, and a migrant. Challenges comprehending interactions within the immigration system further highlights the need for effective communication support tailored to the needs of Deaf refugees. This project emphasizes the need for inclusive policies and awareness to ensure equitable treatment and integration of Deaf refugees in humanitarian assistance and protection.

Background on deaf refugee organizations

To our knowledge there are few organizations in the United States with dedicated programs and services for deaf refugees. Since 2021, a National Deaf Refugee Provider Coalition was established so that organizations nationwide providing services to deaf refugees could partner and better communicate their national agenda (Diana Pryntz, personal communication August 14 2023).

Background on deaf-refugee serving organizations in the United States

Organizations assisting deaf refugees are not limited to but include Deaf Access Services a program of People Inc., ThinkSelf, Deaf New American Advocacy Inc., Deaf Refugee Advocacy, DeafCAN!, the human service arm of Christ the King Deaf Church and the Deaf International Refugee Center. Deaf New American Advocacy and Deaf Refugee Advocacy are organizations specifically run by deaf people with the mission and intent solely to serve deaf immigrants and refugees, whereas other organizations serve the deaf community more broadly and have created specific programs for deaf refugees.

Deaf Access Services (DAS)

Deaf Access Services (DAS) was established in 1983 to provide support services to the deaf community and merged with People Inc in 2022 (Deaf Access Services, 2024). DAS began serving deaf refugees before the implementation of the travel ban. The organization aims to assist Deaf refugees and immigrants from various parts of the world as they undergo the process of cultural integration in Western New York and the Rochester region. DAS offers educational programs, case management services, and American Sign Language (ASL) classes. Through their collaboration with Jewish Family Service of Buffalo and Erie County, they created a program to help newly arrived Deaf refugees learn American Sign Language (ASL), ensuring a smoother transition into the community (HIAS/Jewish Family Services , 2017).

Deaf Refugee Advocacy (DRA)

Established in 2017, Deaf Refugee Advocacy is a Deaf-led organization based in Rochester, New York. Their mission is to address the unique needs of Deaf refugees, asylum seekers, immigrants, and individuals from US territories by providing direct services including legal support, promoting advocacy for full language access, and offering outreach services to existing community service organizations and agencies (Deaf Refugee Advocacy, 2024). Their goal is to assist this population in becoming a self-sustaining community while preserving their cultural identity, language, and religion. DRA provides advocacy services through referrals from local resettlement organizations with a direct link to the Office of Refugee Resettlement (ORR), which is under the Administration for Children & Families under the U.S. Department of Health & Services. Additionally, DRA aims to foster the inclusion of Deaf refugees into both the Deaf community and general society. Their work is supported by the American Rescue Plan Act from the federal government as well as from the Refugee and Immigrant Assistance (RIA) Program, and the bulk of their work is with deaf refugees rather than asylum seekers. “Since 2017, we have provided services to mostly language deprived deaf refugees from Bhutan, Thailand and other parts of Asia. More recently we are seeing refugees from Africa who are more educated and have some level of language and are able to understand things better” (personal communication Diana Pryntz, Aug. 2023).

Deaf New American Advocacy, Inc

Deaf New American Advocacy was established in 2012 and is based in Syracuse, New York. This refugee-led organization received official non-profit 501c3 status in 2022 and is dedicated to empowering Deaf new Americans (Deaf New American, 2024). To our knowledge, this is the only organization led by deaf refugees aiming to serve deaf refugees in the United States. The founder and CEO is a deaf Bhutanese Nepali refugee, and the co-founder is a deaf refugee from Myanmar who fled to Thailand due to civil war, and the administrative assistant is a deaf Nepalese immigrant and a key mentor is another Bhutanese Nepali refugee. The majority of refugees receiving services are from Burma, Nepal and Bhutan.

Their mission centers on offering a secure environment for education, leadership, and life skill development, all while preserving their cultural heritage. The organization is committed to addressing the unique needs of Deaf refugees and immigrants, enabling the community to create a future free from barriers and limitations. In 2022, they ran a conference called the Deaf New American National Conference in Syracuse, NY (sponsored by the Global Deaf Refugee Network, New York State Office for New Americans, Aurora of Central New York, United Way Registry of Interpreters for the Deaf and the Syracuse Nepali church among others). They have received funding from among others, the USDA, other refugee agencies, Central New York Community Foundation as well as Syracuse University Impacts (Central New York Community Foundation, 2024). In 2023, they received support from the Food Justice Fund at the Syracuse-Onondaga Food System Alliance enabling the establishment of the Asha Laaya Farm, a 10-acre income generating farm with an USDA-certified greenhouse. This was developed with the recognition that many deaf New Americans have a rich experience in traditional agriculture and medicine from their home countries. This farm is now a site meeting multiple needs for deaf refugees and immigrants: work and economic mobility through partnerships with farmers markets, healthy eating and cooking community workshops, as well as a social and community gathering space with outdoor group activities (Syracuse-Onondaga Food Systems Alliance, n.d.)

DeafCAN!

DeafCAN! is an organization based in West Chester, Pennsylvania and Northeast Philadelphia also serving Harrisburg, and merged with St. Philips Church of the Deaf in 2016 (DeafCAN, 2024). Established in 2010, it focuses on supporting new Americans in obtaining deaf interpreter (DI) certification. Their primary programs cater to DHH immigrants & refugees, Deaf-Blind individuals, and those who are Deaf/HOH within the criminal justice system. The organization is dedicated to offering diverse community assistance to individuals who are Deaf, Hard of Hearing, Deaf-Blind, and Late-Deafened, with a focus on those who face communication challenges. DeafCAN! receives support from various foundations and grants for their refugee and immigrant initiatives.

ThinkSelf

ThinkSelf founded in 2017, aims to offer resources, education & support to Minnesota Deaf, DeafBlind and Hard of Hearing adults seeking full access to options for learning, safety, justice, employment skills, and community” (ThinkSelf, 2024). They provide adult educational classes and support in the following areas: English, American Sign Language, computer skills, preparation for citizenship and driver's education. They have supported deaf immigrants and refugees from over 16 countries, including Somalia, Myanmar, Ethiopia, Korea, Bhutan, Thailand, Liberia, Afghanistan, Ghana, Djibouti, Yemen, Morocco, Cambodia, Mexico and Laos.

Deaf International

Deaf International, located in Olathe, Kansas, operates as a refugee center, focusing on aiding DHH refugees from various countries like Burma, Vietnam, Bhutan, Nepal, India, and Brazil (Deaf International, 2024). Their approach involves teaching American Sign Language (ASL), English literacy, life skills, and promoting self-worth and equality among Deaf, Hard of Hearing, and Deaf-Blind individuals. The organization extends its support to finding employment, citizenship, and providing essential resources such as food and hygiene products. Deaf International's mission centers around advocating for human rights for Deaf individuals worldwide, regardless of diverse backgrounds, and educating both Deaf and hearing communities about their experiences.

All six organizations play a wide variety of roles in supporting the Deaf refugee population in the US. By offering a range of services, educational programs, and advocacy efforts, they strive to ensure that Deaf refugees have access to the resources they need to thrive and integrate into new communities while preserving their unique cultural backgrounds. These organizations demonstrate the importance of community-based support and collaboration in helping vulnerable populations navigate the challenges of resettlement and integration.

Positionality statement

This study foregrounds and prioritizes insights both from individuals who are deaf or have disabilities during emergency situations, including the experience of immigrants and refugees with disabilities. The first author identifies as deaf and descended from first-generation immigrants and refugees in New York City. The second author identifies as a first-generation immigrant from Peru.

Research questions

How are organizations serving deaf refugees in the United States filling gaps in essential services that mainstream refugee organizations may lack the capacity to undertake? How can mainstream humanitarian organizations learn from deaf immigrant and refugee-serving organizations and their efforts, struggles, and successes? What are the unique benefits of a deaf refugee-led and staffed organization?

Theoretical framework

Disability justice is a movement and framework that seeks to challenge and reshape societal perceptions of disability, emphasizing the importance of equity, inclusion, and the dismantling of ableism (Sins Invalid, 2019). Deaf refugee and immigrant scholars in mobility studies also centers the voices and experiences of deaf individuals, especially those from marginalized communities, and aims to address not only social barriers but also systemic injustices that perpetuate linguistic and educational inequalities (Kusters et al, 2024). By advocating for social change, disability justice envisions a more just and accessible world. As the perspective of disability justice continues to evolve, this analysis is guided and draws inspiration from two concepts: the social model of disability and empowerment theory. These frameworks are crucial concepts that shed light on principles and strategies for improved services for and by deaf refugees and migrants.

Deaf refugee organizations play a crucial role in addressing the multifaceted challenges faced by this unique demographic, ideally integrating the principles of social and empowerment frameworks into their core mission. By examining the frameworks, we gain insight into the efforts made by these organizations to promote inclusivity, community collaboration, cultural sensitivity, and amplifying refugee and migrant voices.

The social model of disability framework sheds light on the institutional and social barriers confronted by people with disabilities. The social model recognizes that barriers stem from deficiencies in social organization and environmental design rather than the person's impairments or conditions (Disability in Public Health, 2016). In its core, this model emphasizes the crucial role of societal structures in either facilitating or hindering the full participation of disabled individuals.

The empowerment theory places people with disabilities as the primary decision-makers, allowing them to determine their life trajectory, treatment and services. This model repositions professionals into the role of service providers in which they support clients by implementing their decisions (Retief & Letšosa, 2018). The empowerment model empowers individuals to take control of their own journey, transforming them from passive recipients into active participants in shaping their goals. This framework emphasizes a sense of autonomy and self-empowerment, enabling individuals to support their own well-being.

Deaf refugee organizations ideally strategically use the principles of the social and empowerment models to effectively address crisis situations. When deaf refugees face challenges like civil unrest, economic instability, the effects of climate change, or wars, deaf refugee organizations are well-positioned to promote autonomy and empowerment. Implementing such an approach enhances their ability to address the unique needs of their community, creating a strong framework that not only prioritizes safety and accessibility but also amplifies the voices of deaf refugees and immigrants fleeing crises and going through the resettlement process.

Methods

Our sampling frame comprised of deaf-serving organizations catering specifically to the needs of deaf refugees in the United States. IRB approval was received from California State University, East Bay. Survey and structured Zoom interview instruments were developed focusing on needs assessments, gaps, key experiences, challenges, and successes as well as collaborations with mainstream nonprofits and funding. Questions were based on prior instruments (Engelman et al 2022, Ivey et al., 2014). Our questions for the organizations explored the ways in which they accommodated deaf immigrants and refugees linguistically and otherwise during the resettlement process. We utilized a snowball sampling strategy, recognizing that deaf people and allies working in the social and human services organizational space often have strong connections with others doing similar work. In the summer of 2023, surveys and follow-up interviews were conducted with 12 key personnel and leaders from five NGOs (roles ranged from Vice President, Founder, Executive Director, Program Director and various support staff including social workers or case managers). Interviews were conducted largely in American Sign Language via Zoom, and the majority of interviewers identified as deaf or hard-of-hearing while two identified as disabled. In order to maintain anonymity, respondents are not identified by name. Rather, themes and quotes illustrate common themes and are reported in the aggregate.

Regarding the achievement of data saturation, we employed an iterative process to ensure that the data collected were sufficiently comprehensive. We conducted follow up interviews after surveys were completed and triangulated our findings to see if data in the survey and in the interviews were redundant. Data saturation was determined not by a rigid numerical threshold given the small sample size, but by a qualitative assessment of when new data no longer contributed novel insights to the themes under exploration. We conducted continuous comparisons of the emerging themes and categories across interviews and surveys. We revisited key areas of inquiry during follow-up interviews to confirm that we had fully explored the critical themes of interest.

Findings

Open-ended responses highlighted the following themes: financial and practical challenges in providing accessible aid for deaf refugees, the need for advocacy and partnerships with mainstream organizations, and unique barriers deaf refugees and immigrants during the immigration process face prior to arrival, including language deprivation and lack of access to information about the resettlement process. Many of the KIs interviewed stated they would like to encourage refugee resettlement agencies, nonprofits, medical providers and the government to tap into the wealth of knowledge and trusted connections that deaf-refugee CBOs and community leaders have formed in specific communities of people with disabilities and older adults.

Organizational profile and demographics

All of the CBOs surveyed and interviewed are nonprofit 501C(3) organizations reported providing a wide range of refugee support services, including ESL or ASL language classes, immigration of refugee services, housing, educational services or job training, food and nutrition education, information and referral services, case management, domestic abuse or violence services, welfare benefits, chronic disease management, mental health support and emergency preparedness prevention services. Some organizations specifically partner with Refugee Resettlement agencies authorized by Office of Refugee Resettlement (ORR), while others provide life skills, case management and employment advocacy services. On average organizations reported serving between 50-200 people. The majority of organizations reported serving particular sub-group of deaf immigrants and refugees, including those who are low income or homeless with severe language deprivation, low written literacy or English or American Sign Language (ASL) as a second language. This includes deaf immigrants facing additional barriers in addition to deafness, including those facing chronic illness, developmental disabilities, cognitive impairment, blindness or vision loss, low or restricted mobility or unable to drive and having mental health conditions. (Fig. 1 Social Demographics of Deaf Immigrants Served)

Fig 1.

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The majority reported the deaf immigrants or refugees they serve were fleeing civil unrest or humanitarian crisis. Countries where deaf immigrants or refugees came from include Albania, Bhutan, Brazil, Cambodia, Colombia, Costa Rica, Dem Republic of Congo, Dominican Republic, Egypt, Gabon, Greece, Guatemala, Haiti, Honduras, India, Iraq, Jamaica, Jordan, Mexico, Nepal, Pakistan, Palestine, Nigeria, Puerto Rico, Philippines, Russia, Rwanda, South Korea, Syria, Taiwan, Ukraine, Venezuela, Vietnam, Somalia, Sudan, Burma, Peru, Cuba, Myanmar, Ethiopia, Thailand, Liberia, Afghanistan, Ghana, Djibouti, Yemen, Morocco, Laos, and Thailand.

War, persecution and discrimination

In particular civil unrest and conflict was a driver of resettlement for deaf refugees from Syria, the Congo, Iran, Afghanistan, Yemen, Angola, Somalia, Bhutan, Liberia and Ukraine.

Deaf refugees have faced discrimination in their home countries based on their disability status with one respondent noting “there's often greater poverty, less education and job opportunities, and few to no accommodations.” (Fig. 2 Which types of hazards or disaster risks have your deaf refugee and immigrant clients faced in their country of origin?)

Fig 2.

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One respondent noted that the range of communication skills among deaf refugees upon arrival varies widely depending on level of education and geographical location: “more educated refugees can function better and understand what is happening and know how to figure out life in a new country.” One respondent noted that language deprived Deaf refugees from Bhutan, Thailand and some Asian countries have struggled more while more educated refugees from some African nations have had a smoother transition.

Deaf refugees have faced persecution and poor treatment in their countries of origin from family, employers and communities due to their deafness, religious beliefs and/or sexual orientation. One respondent noted that these refugees continue to face challenges in the US: “Many experience discrimination in the USA as well due to race, disability/communication needs, gender identity, LGBTQ status, etc.”

Navigating UNHCR camps and immigration systems prior to arriving

One respondent pointed out that United Nations High Commissioners for Refugees (UNHCR) camps or other refugee sites are often inaccessible and may inadvertently lead to insurmountable barriers to deaf people being able to resettle in the United States or elsewhere. A complex immigration process can often take years while people languish in refugee camps; deaf migrants might stay longer as a result of language and communication barriers. One respondent said:

During the screening, the deaf person follows whatever the hearing family member says in terms of preferences of where to go, paperwork, medical or other procedures. This screening may not be accessible to the deaf refugee, sometimes the hearing family members hide the fact that their family member is deaf out of a concern that they may not be resettled. Or they are mislabeled as not being able to speak or learn. (Responding Organization 1)

The combination of inaccessible paperwork processing, interviews and limited communication with hearing family members can lead to domino effects. Some deaf refugees or migrants who presumably have made it through the paperwork process and are able relocate may not even know their status and where they are going when they board an airplane: “When a family is finally approved for resettlement, sometimes the deaf person is kept in the dark. Deaf refugees often talk about being shocked while they are in transit, as no one explained what it means to leave, go on a plane for the first time, and live in a new country. It's possible often refugees need to transfer and take a second plane to their final destination, and no one might have explained to them that when the first plane lands that's not their real destination and they need to get on another plane. Mainstream non-profits might not be aware or fully recognize that deaf refugees have the full information on where they're going, the name of the city, etc.” A deaf refugee leading their organization concurred: “Before I was able to emigrate to the United States they had this process with an orientation with many lectures, I saw white Americans from Europe the US and Canada. At the orientation I did not know what was going on because it was inaccessible due to it being in English without ASL interpreters.”

Accessibility in refugee camps

One respondent noted “sometimes these camps give hearing aids and assume everything is fine even though accessible communication is more complicated.” (Responding Organization 2) Another respondent who is a deaf refugee and spent almost two decades in refugee camps before relocating noted: “the school at our refugee camp had no interpreters and they threw in both deaf and disabled people in the same class so it was hard to get an appropriate and accessible education. There was no Americans with Disabilities Act.” (Responding Organization 2)

Challenges faced in providing accessible aid to deaf refugees

All respondents noted financial and practical challenges in providing accessible aid, including ableism, lack of accessible communications and lack of accessible shelter. Key financial challenges include a lack of funding for American Sign Language classes (ASL) as only usually ESL classes are covered, which are inaccessible because they are in spoken English and may not provide sign language interpretation in a language that deaf refugees know. In addition, according to one respondent resettlement agencies almost always pick hearing family members to focus on for job opportunities so the Deaf are almost forced to be dependent on and apply for Social Security, which requires a lot of support in the application process. This is particularly challenging because immigrant and refugees are not eligible for assistance after a relatively short transition period, however are often not able to work due to immigration status or disability. One practical challenge noted by one respondent “industries that are ‘welcoming’ to people with minimal English proficiency are in rural areas with few or no services or community resources for DDBHH (deaf, deaf-blind and hard-of-hearing).” (Responding Organization 3)

One deaf refugee serving organization noted that the first 90 days are critical in which resettlement agencies are responsible with assisting with medical screening, paperwork, ESL training, counseling and housing support. However, hearing resettlement agencies are often not able to accommodate deaf people in terms of accessible ESL classes and job training. They noted “agencies like ours tend pick up after the 90 day period, however I have asked them to contact us in day 1 so we can meet refugees at the airport so that accessible resettlement can begin immediately.” (Responding Organization 1)

Lack of accessible communications

Respondents pointed out that deaf immigrants and refugees “using other sign languages (there are over 200 worldwide) can't understand our ASL interpreters so they are ‘disabled’ by their circumstances not by their abilities.” One respondent noted: “Our Deaf staff and DI's have the ability to navigate language barriers with people from other countries and who have language deprivation. Hearing people in mainstream organizations do not understand the specialized approach to communication that is required. We are seeing misdiagnoses like ID/DD or schizophrenia.” (Responding Organization 3)

Severe language deprivation among some deaf refugees who never learned their native sign language in their country of origin makes communication challenging even with interpreters. In order to access services, certified deaf interpreters (CDI) play a critical role in ensuring that deaf refugees can access information, however, another respondent noted that there is a shortage of CDIs and difficulties finding interpreters who are bilingual and culturally competent. One respondent noted:

I was part of a deaf refugee client's interview connected to refugee services. The ASL interpreter asked the refugee when they were born and the client didn't understand the question. It wasn't even just that the client didn't understand the question, but also that the client was so language deprived that they were unable to understand they needed to respond and answer the question. So what we had to do was to demonstrate a question-and-answer process. After the deaf client watched us for some time finally they understood what was being asked of them. (Responding Organization 1)

The simple act of asking a deaf refugee a question, particularly if they are language deprived, is a very difficult and fraught process. This could prevent legal action or paperwork necessary for a deaf refugee to go through the process of receiving services or even being repatriated from their home country. Language deprived deaf refugees are at risk of not even making it through the refugee process or being deported back to their home countries if they cannot communicate their circumstances, which can include war, violence, persecution, famine or other traumatic events necessary to make a case for refugee resettlement.

One deaf refugee founder shared barriers to access upon arrival to the U.S., which inspired her to create a deaf-refugee serving CBO:

It was a strange experience when I first moved to America, there was a welcome sign and probably a social worker who finger spelled hi. I asked social workers if I could take classes but they wouldn't provide an interpreter because I was over 18 at the time. I also went to a new orientation that provided good services to hearing refugees but it was not accessible to me. We learned how to make a 911 phone call that I couldn't even do in an accessible way. I was completely isolated for 6 months without interacting with another deaf person. I ended up connecting with a deaf organization and for the first time took an 8-week ASL class. (Responding Organization 2)

As a result of this experience, she was inspired to pursue higher education and create her own non-profit serving deaf refugees. “I realized that I could bring positive benefits because of my own experiences in inaccessible refugee camps where I was a leader helping others. I am now a leader, a job coach, providing job readiness training, a deaf interpreter (DI) helping deaf refugees understand American Sign Language. I was a social worker.” (Responding Organization 2) As a deaf refugee who only recently became a US citizen, leading a deaf refugee nonprofit has been a process of continual learning about the American system, particularly in terms of grants and foundation giving: “It was a very complicated process to be welcomed to the workforce in America, it took me a long time to really understand how businesses and nonprofits worked. I'm not here to compete with other non-profits I'm here to value the safety, comfort, needs and communication and cultural differences of deaf refugees. I am here to build a bridge.” (Responding Organization 2)

Lack of accessible shelter

Deaf immigrants and refugees in crisis often struggle or refuse to go to mainstream shelters: “deaf people in crisis or trouble often refuse typical shelter or transitional housing (domestic violence shelters for example) because of their fear of being misunderstand misdiagnosed or mistreated.” (Responding Organization 4) Furthermore, “housing services are not designed to meet the needs of DDBHH immigrants with financial challenges.” (Responding Organization 3) To fill the gap one respondent explained providing video phones, closed captions as well as visual alerts for doorbells and fire alarms, and another respondent partners with video relay services for phone related communications.

Two CBOs support deaf immigrants facing domestic violence. As one respondent stated “we partner with many domestic violence shelters around the state to provide co-advocacy and toolkits to promote a more welcoming environment. Otherwise there are many challenges to ensuring long-term and short-term housing options are available and accessible.” (Responding Organization 3)

Overcoming communication barriers

All the immigrant-serving CBOs had linguistic strategies for overcoming communication barriers, including having deaf employees with native level ASL skills, utilizing certified deaf interpreters (CDIs) and staff interpreters who have extensive experiences working as CDIs. One respondent offered: “We teach citizenship and integration classes at two sites in the region, also obviously teach use ASL so they can begin to use our interpreters and slowly begin to make some sense of some limited English.” (Responding Organization 4)

In addition, these deaf immigrant-serving CBOs staffed by deaf employees employ strategies for fostering trust: “We stay with those we serve across multiple services, sometimes being direct provided and something playing essential supporting role as advocates, trusted friends and witnesses to stay with them for housing, healthcare, family challenges, work or benefits, finances, and legal matters. The continuity is critical for the trust, understanding and encouragement new folks need.” (Responding Organization 4)

In addition, CBOs advocate for refugee serving organizations and government agencies such as USCIS as well as hospitals to be more accessible, including hiring interpreters: “We provide community navigation supports. We also do advocacy in other refugee serving organizations to help them to provide more accessible arrival and resettlement services. We now have a community task force to address refugees with disabilities and a national group to address the needs of deaf refugees.” (Responding Organization 5) While deaf-serving refugee CBOs welcome efforts towards accessibility on the part of mainstream refugee organizations one respondent noted: “often we need to explain why and how, make the arrangements and mostly volunteer our services.” (Responding Organization 4)

Creative accommodations

Despite these barriers all of the CBOs have creatively accommodated immigrants, refugees and asylum seekers in seeking legal status and citizenship:

We created a task force of providers locally to address systemic barriers. We engage Deaf organizations and trained a doctor to understand language deprivation in order to complete an effective N-648 Medical Certification for Disability Exceptions (an exception to the English and civics testing requirements). (Responding Organization 5)

Most providers, even Deaf-focused, push for Deaf RIAs to seek waivers for the citizenship test because of various barriers. It is a huge amount of work, and require expertise and tenacity, but we have had 12 individuals pass their tests from 9 different counties and are building an in-person and remote classroom to allow move folks to participate for further out. RIAs learn the ASL vocabulary in the classroom and we work with USCIS (United States Citizenship and Immigrant Services) to allow us to also interpret the tests so the same vocabulary signs are used. Otherwise our folks would probably not pass as different interpreters would use different signs and they would be lost. (Responding Organization 4)

Deaf staff at deaf immigrant-serving NGOs can support deaf refugees with language barriers and educational services as well as visual alert and videophone systems.

DDBHH (Deaf, Deaf-Blind and hard-of-hearing) leadership sets high standards for communication access and equity including hiring employees with lived experience, partnering with mainstream organizations to co-advocate and exchange knowledge/resources, and much more. (Responding Organization 3)

Our Deaf staff and DI's have the ability to navigate language barriers with people from other countries and who have language deprivation. Hearing people in mainstream organizations do not understand the specialized approach to communication that is required. we are seeing misdiagnoses like ID/DD or schizophrenia. (Responding Organization 3)

We provide direct teaching access in our educational program; we are experienced with the impact of language deprivation. W also provide mentoring which is critical to their success. We also do advocacy. One example - a deaf patient was provided a language translator for years. When our NGO sent an advocacy to figure out why the patient's medical needs were not being resolved, we realized what was happening. We were able to educate the medical team to use ASL terps with CDIs. The problem was resolved. Both the medical team and patient were appreciative.(Responding Organization 1)

Helping people get set up with videophones and other visual devices and alarms for home safety (Responding Organization 5)

Success stories

Major success stories of deaf-immigrant serving CBOs include the following:

Deaf Sudanese refugee has been in the US for over ten years and has used a DI/ASL interpreter team which was partially successful. We found an Arabic sign interpreter from Sudan and relocated him to our community and now the Deaf people from Arabic countries have adequate interpretation. (Responding Organization 5)

Rescued, sheltered, got benefits for, resolved multiple immigrants issues, found employment for two immigrants woman coaxed into marrying Deaf men from the US, only then to be physically and sexually abused. (Responding Organization 4)

One of our participants has lived in the country for over 20 years without documentation. Her partner/family is not supportive and consistently isolated her and interfered with efforts to obtain citizenship. She began attending Adult Education classes and connected with resources. She was able to get an attorney and file for VAWA U-Visa. It has been a long process but her dedication to school created the opportunity for her to connect with resources and build a support system of peers she met in the classroom and at events. She now has employment authorization, will soon have her green card and her own home with her children! (Responding Organization 3)

We worked with Social Services to prevent the separation of the parents and their kids due to misunderstandings. (Responding Organization 1)

In 2023 there are two deaf refugees from Venezuela who came to the United States. A deaf couple brought them to their farm near Western New York, however the couple did not live on the farm; they lived in a home 3 hours away from the farm. These deaf refugees are working on the farm for very little money. They're hungry, afraid and don't have work permits but only one of the owners is not nice. They hope to make enough money to send back to their family in Venezuela. We are working with them to get legal aid and assistance secretly. If it was not for me and my organization these people would not have anybody helping them. (Responding Organization 2)

Deaf Middle Eastern man is a refugee and he really wants to bring his family to the US. However, because he is language deprived, the lawyers who are trying to help his case cannot process his paperwork until they are sure he understands what is going on. They are looking for a certified interpreter. You can be certified but may not be qualified to do so. I'm in the role of being a CDI to help with the process of getting his family to the US. (Responding Organization 2)

Working with stakeholders

Deaf immigrants serving CBOs had a wide range of experiences working with mainstream refugee resettlement agencies, health providers, clinics and employers, including local independent living centers and local Deaf schools:

Most mainstream providers are enthusiastic about referring people to our programs, but sometimes they are not aware our programs exist until weeks or months into the process, especially if they are working in a specific community or rural area. (Responding Organization 3)

We collaborate with the local branches of USCCB, USCRI, CWS, and HIAS. we advocate to receive a referral before the arrival so we can be present at the airport to assist language access and language assessment. We also enroll refugees in our ASL and cultural orientation class. I'd say we provide partnered services, in tandem with resettlement services. (Responding Organization 5)

Refugee Resettlement agencies and others who serve this population - the main barrier is their lack of understanding of how vital it is to use deaf role models and how discriminatory their practices are. (Responding Organization 1)

Because of language barriers that are unaddressed, they may not have offered the same services. Most important for mainstream NGOs to understand about deaf immigrants is that no one interpreter fits the bill for all – how do we find the right interpretation? (Responding Organization 5)

We provide legal support and often consult with lawyers who may not understand the impact of language deprivation. The decision-making process is impaired due to language deprivation. Often it's the case that lawyers must be sure to apply for asylum for their clients within a year and if you don't do it within that time frame the refugee could be deported and have to go back. Many of these language deprived deaf refugees didn't know or understand this. Some lawyers believe that lack of knowledge isn't am good enough reason to request an exception to a one-year time frame. So we have to explain what language deprivation means so they can better defend their client. Teaching about the impacts of language deprivation is part of our process so that the lawyers are empowered to make an impact on the deaf refugee's circumstances. (Responding Organization 1)

One respondent was frustrated by the lack of coordination of efforts in the referral process. In 2023, when there was an influx of asylum seekers in New York City, there was an attempt to reach out to the state government to request that deaf refugees in New York City be referred to their organization, and no response was received. This respondent said “we are not giving up on trying to get to them….but we need to figure out who makes the decisions here? We have the expertise to take on and support these refugees.” (Responding Organization 1)

Emergency preparedness and response for deaf immigrants and refugees

Deaf immigrant-serving CBOs provide access to emergency information and warnings where applicable, including providing information in accessible formats, sign language, videos captioning, video alerts and providing accessible emergency preparedness and education materials. Furthermore, the majority of organizations verify and check the well-being and care of deaf immigrants during and after a disaster.

Emergency preparedness and response efforts by these deaf immigrant-serving CBOs included the following:

The broadest example was reaching out during COVID in multiple ways (videophone, email, homes visits...), educating, contacting to shot clinics/drive bys, interpreting, often by Facetime, at doctor's offices, pharmacies.... (Responding Organization 4)

We are at the table in planning for how services will be administered and the county uses tablets to access VRI in emergencies. (Responding Organization 5)

I'm thinking mostly of the COVID pandemic and the 2020 uprising in Minneapolis; we made contact with existing and recent participants, made follow up contacts (calls/VP/email/text/social media/etc.) with information about what is going on; provided food and transportation/transportation vouchers by dropping off care packages; provided masks and information about masking/distancing; worked with our participants to transition back to in-person while maintaining safety.(Responding Organization 3)

Capitalizing on deaf refugee and immigrant strength

One deaf refugee non-profit founder emphasized that it is essential that deaf refugees feel a sense of power and control given their circumstances and being in positions where they are disempowered, linguistically isolated, exploited and deprived of education both prior and during to arrival. Due to not knowing American systems, she noted the importance of supporting deaf refugees by navigating cultural differences even in complex situations:

We had a situation where a family was experiencing abuse or violence, the other nonprofit called 911 and involved the police and CPS system. This was very upsetting for the family because of the domestic dispute they are now in fear of deportation or being sent back. Some of the mainstream nonprofits don't understand the cultural differences. Before calling CPS, I would explain counseling, some have never talked about counseling in their culture so it would be a slow process. More often people would turn to a religious leader to help resolve family conflicts such as a preacher. The other nonprofit intervened in a way that was disruptive to this family's life and did not think about the consequences of calling 911. In some cultures, we have to work within the constraints of where they are coming from which may not align with what we personally believe is right. (Responding Organization 2)

Deaf refugees have skills and a support network, however mainstream social workers may focus only on hearing refugee family members when doing intakes: “We found out either hearing agencies didn't know what to do with deaf refugees, ignored them or focused only on hearing members who were considered the ones “taking care of” the deaf family members. Deaf refugees were perceived as not having agency, skills or capabilities. This means that the deaf refugees were isolated and needed more access.” (Responding Organization 1)

One organization invited American-born deaf professionals to give presentations to show off their skills and capabilities, and not only invited deaf refugees but also their hearing families to come and watch.

It was eye opening for hearing refugees’ family members come with a deaf person to see that their deaf refugee members could be productive members of society, they could work and learn a new sign language We had mechanics, a cook, someone who taught CPR, a deaf RN and some other professionals but the point was made that deaf people could be successful and productive. This was not a message that these families necessarily received from the country, society or country they came from. So this was very empowering. (Responding Organization 1)

One organization's future goal for improving support for refugees included accessing “sustainable funding that will allow our Deaf organization to provide direct resettlement and a world where the federal government has standards for placing a Deaf refugee upon arrival in the US.” (Responding Organization 5)

Discussion

Findings support previous research documenting significant barriers before, during and after migration, including housing, citizenship application processing, educational gaps and barriers accessing medical care and the lack of accessibility of ESL or availability of ASL classes (Schwartz et al., 2022). The language and cultural needs of many deaf refugees are far too complex and diverse for hearing providers to appropriately assess needs and help individuals personally identify and navigate culturally appropriate community resources. According to key personnel interviewed at CBOs, there are a complex array of factors contributing to successful integration and inclusion of deaf and/or disabled refugees in their communities. First and foremost, many emphasized the need for refugee and immigrant resettlement to recognize that cultural orientations delivered straight from deaf people, without interpretation, is best whenever possible. In addition to being optimal, it is cheaper.

One organization emphasized the need for both deaf refugees as well as mainstream NGOs and health providers to fully engage with deaf organizations, deaf clubs and deaf schools. Cultural connections with a deaf community and language access to mainstream services are critical. This research exploring the capacity and experiences of deaf immigrant and refugee-serving organizations builds on literature both in deaf refugee studies and in deaf mobility studies (Kusters et al., 2024). Middle Eastern asylum seekers in Finland faced similar communication barriers (Sivunen, 2019). The linguistic experiences of deaf immigrants arriving to Sweden has also been explored (Holmström et al., 2021) There have been critical explorations of the experiences of forced migration in the Kakuma Refugee Camp in Kenya as well as labor and marriage migration in the UK. As addressed in prior literature on deaf refugees primarily focusing on educational and linguistic systems, it is critical to understand where deaf refugees came from, their experiences, what they have left behind and their process of migration in order to best meet their linguistic and educational needs (Duggan & Holmström, 2022, Moers, 2017, Prawiro-Atmodjo et al., 2020, Fishbeck, 2018, Reimers, 2011, Akamatsu & Cole, 2000).

Deaf immigrant-serving non-profits can empower deaf refugees and their families and educate refugee-serving organizations by demonstrating what is possible with accommodations available in the United States.

Policy Recommendations

Schwartz et al (2022), advocates for compliance with existing federal disability legislation to ensure that deaf new Americans who were deprived of formal education in their home countries have the opportunity to obtain an accessible education in order to enable them to successfully contribute to American society through employment and linguistic integration. This includes the Individuals with Disabilities Education Act (IDEA).

Furthermore, we encourage immigrant and refugee-serving organizations to increase their familiarity with applicable laws in order to integrate deaf immigrants and refugees in mainstream immigrant and refugee assistant services, including the Americans with Disabilities Act (1990) and Section 504 of the Rehabilitation Act of 1973. Of particular importance is communication access to legal, housing, financial, educational and related social services and programs. Related to language and educational access, deaf immigrants and refugees should, wherever possible, be connected to American Sign Language (ASL) courses in their resettlement area. It is important to recognize that deaf immigrants and refugees come from home countries with different sign languages or may be linguistically deprived.

There are small steps that organizations could take to welcome deaf immigrants and refugees. Policies could be developed at an organizational level to ensure that deaf immigrants and refugees are connected to existing deaf immigrant and refugee-serving organizations. Deaf immigrant or refugees going through the resettlement process often face communication barriers. At every step of the process there should be standard screening questions about any disabilities, accommodation needs or communication preferences. As a matter of standard practice, we recommend that agencies and organizations refer deaf or hard of hearing clients to deaf refugee-serving organizations and partner with them to provide effective assistance.

Deaf immigrant and refugee-serving organizations continue to support finding accessible legal services. Yet, obtaining the right to stay in the country is often an uphill battle in a system that favors the medical model of disability rather than recognizing the immense value disabled immigrants and refugees can add to the United States, according to deaf immigration lawyer Alison J. Ecker:

In immigration cases, when disability is considered at all, it is contemplated purely as a medical "hardship" which will help tip the discretionary scales in favor of the applicant. Unfortunately, many immigration attorneys continue to emphasize the debilitating effects of any medical condition in order to portray their client as dependent and deserving of pity so that immigration officials might grant them the right to stay in the U.S. This is largely because many applications for relief themselves ask for this evidence, showing that immigration law continues to reinforce an outdated medical model of disability. I have worked with many immigration lawyers who do not realize this, because they do not come from a disability background and are focused only on achieving a specific objective for our clients - the right to the stay in the U.S. There is a great lack of understanding of the intersection between disability and immigration, or more specifically, what benefit a disability-rights perspective has for our clients, when the current system is set up to benefit a medical model understanding (A. Ecker, Personal communication, Jan 5, 2025).

Refugees with disabilities are resilient yet at-risk for being underserved, and there is a need for further research about deaf refugee needs and barriers to achieve better wellbeing. Resettlement agencies, disability service organizations and policymakers could benefit from concrete recommendations for designing and tailoring services that meet the intersectional needs of deaf immigrants and refugees (Rfat et al, 2023).

This is especially critical at a time when shifting political landscapes affect the immigration court system and foreign policy (U.S. Department of State, 2024). Deaf immigration lawyer Alison J. Ecker's professional experiences highlight the need to work within the limitations of the judicial system to support deaf immigrants and refugees:

The immigration court system is designed to serve the needs of whichever administration is in power and their immigration objectives. As such, the rules tend to fluctuate a lot and there is not a lot of consistency. It is an overburdened system that is trying to push cases through as quickly as possible. Judges have a backlog of cases on their dockets and attorneys have many clients to help. There is an overwhelming need for legal services everywhere. This makes it very difficult to provide consistent and adequate disability access in a system that is already biased against immigrants and routinely denies due process. Throughout U.S. history, immigrants have frequently been viewed as "outsiders" and not deserving of the same rights as U.S. citizens. In fact, immigration law still refers to some immigrants as "aliens." If they are barely even viewed as humans or deserving of the same treatment as U.S. citizens, it goes without saying that disability rights all but disappear. (A. Ecker, Personal communication, Jan 5, 2025).

Importantly, deaf-refugee serving organizations, as advocates, are playing a pivotal role in educating hearing immigration lawyers, healthcare providers and mainstream immigration and refugee-serving organizations.

Limitations

Deafness is a low-incidence disability and the number of deaf refugees in the US is even lower, when considered as a subset of the population of deaf people. As a result, we had a small sampling frame. Further, these deaf immigrant and refugee-serving organizations are not large both terms of staffing and operations. We believe that this reflects the unique and specialized nature of the deaf population being studied. Yet, each organization and their staff provided a diverse set of perspectives, and we took great care to ensure that the participants either provided direct services or were in leadership roles, which contributed to the richness of the data.

Conclusion

Providing optimal services to deaf refugees currently migrating, navigating an often complex immigration and asylum process and also adjusting after they arrive requires ingenuity. Successfully resettling deaf refugees and immigrants fleeing conflict or persecution includes foregrounding the leadership and knowledge of deaf-led refugee serving organizations with a deep understanding of the financial, practical and communication challenges at hand. This includes developing partnerships and fostering inclusion in every step of the process and taking steps to enhance the accessibility of services received at various sites: refugee camps, resettlement and/or humanitarian agencies, food aid distribution centers, non-profit and social service agencies as well as at educational institutions. The accessibility of existing services for refugees with disabilities need to be examined, as well as legal frameworks or policies in place to protect the rights and ensure the safety of deaf and disabled refugees or immigrants. Deaf immigrant and refugee-serving organizations are well-positioned to be advocates agitating for deaf and disability rights in the midst of accessibility hurdles in the immigration legal system, healthcare, housing and social service systems. Capacity building and partnerships with deaf-refugee and immigrant-serving CBOs can foster the resilience of deaf refugees and immigrants.

Funding declarations

This study was funded by the California State University, East Bay Department of Public Health as well as the Research Scholarship and Creative Activity (RSCA) 2023-2024 Grant Program. The authors have no competing interests to declare that are relevant to the content of this article.

CRediT authorship contribution statement

Alina Engelman: Writing – review & editing, Writing – original draft, Methodology, Funding acquisition, Formal analysis, Data curation, Conceptualization. Alexia Izquierdo: Writing – review & editing, Software, Methodology, Data curation.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.