Across East Africa, healthcare inequality is shaped by colonial histories and ongoing systemic neglect. For Indigenous communities, these inequalities deepen when disability becomes part of lived experience. Clinics without ramps, health services without sign language interpretation, and systems that fail to recognize Indigenous healing practices all combine to restrict access to care.

Yet Indigenous disabled people are not passive recipients of exclusion; they are organizing, resisting, and reimagining care rooted in dignity, culture, and justice. At the center of this story is Sabthio Balcha, a deaf youth from the Rendille Indigenous pastoralist community in northern “Kenya” whose experience reveals how exclusion is built into everyday healthcare.

Sabthio’s Fight for Accessible Care

Sabthio grew up in the Rendille pastoralist Indigenous community of northern “Kenya,” where life followed livestock routes, seasonal movement, and deep ties to land. Health services came through mobile outreach programs and community gatherings, but these spaces rarely considered deaf communication or Indigenous language realities. 

There was no accessible sign language interpretation that reflected her Indigenous community’s language and cultural context, and no healthcare information designed around how she experienced the world.

So she learned to stay outside.

“I would sit outside the meeting hall, watching other girls go in,” she recalls. “It felt like my body, my language, and my community did not matter.”

For years, she carried that silence alone. Then she began connecting with other deaf Indigenous girls from her Rendille community who had faced similar exclusions. Together, they gathered in small circles shaped by their own communication needs rather than institutional rules. Later, in broader peer gatherings with deaf girls from other pastoralist communities, supported by young women allies, she began to hear her own story reflected to her. Girls spoke of being ignored in clinics, of health workers speaking past them, and of information they could see but never truly access. 

But in informal peer gatherings with other Indigenous deaf girls from pastoralist communities, supported by other young women, she found shared experiences among peers living within communities targeted by mobile outreach health programs designed to serve remote Indigenous populations, but that often did not meet their intended goal of accessible and inclusive care. 

Some described sitting through consultations without understanding what was being said. Others recalled being denied opportunities to ask questions about reproductive health because healthcare workers assumed disability meant dependence or incapacity. In many cases, communication barriers forced deaf patients to rely on relatives or strangers to interpret sensitive medical information.

That was when Sabthio realized her exclusion was not individual neglect, it was systemic absence. The healthcare system had never been built for them.