Where There Is No Interpreter

Published: May 19, 2026

By Jay Beaudoin and Eva Botkin-Kowacki

1 min read

In a crisis, clear, timely communication is paramount. Those rendering aid must understand what people need and whether they know of others who also need support. This challenge is especially acute when one person in the interaction is deaf or hard of hearing.

That’s why Jerome Wilcox, director of inclusive excellence at the Geisel School of Medicine at Dartmouth, is teaching students a simplified sign language system for crisis communication. Humanitarian Sign Language draws from American Sign Language and universally recognizable gestures, and is designed to be especially useful in disaster zones, refugee camps, and emergency shelters.

A man sits at a conference table using his hands to teach sign langauge to several students sitting at the table looking at him.

The classroom is silent but far from still. All eyes are on Jerome Wilcox, director of inclusive excellence at the Geisel School of Medicine at Dartmouth, as he makes eye contact with a student and poses a question with his hands and a shrug. She concentrates as she signs back, then laughs as the room fills with questions

Wilcox explains aloud that the American Sign Language sign for “shelter” is different from what he teaches this group of Master of Public Health (MPH) students. Instead, he teaches the students to combine the sign for “safe” with the sign for “place,” which are easier to recognize coming from someone inexperienced in sign language.

The MPH students—members of Dartmouth’s UNICEF Student Chapter—are learning Humanitarian Sign Language, a simplified system designed for communication during crises. The sessions are voluntary and students receive no academic credit. In fact, it was the student-led club that reached out to Wilcox for lessons. He hopes to formalize the curriculum so more students can learn how to bridge communication gaps in emergency situations.

The students know they may never become fluent in sign language. But fluency isn’t the goal. Even limited communication can help deaf or hard of hearing patients feel more welcome and at ease in a crisis. “This is a small step to meeting patients where they’re at,” says Zinne Njoku MPH ’26.

Two women say "thank you" in sign language. — Chiamaka Agali MPH ’26 (left) and Zinne Njoku MPH ’26 say “thank you” in sign language. *Credit: Robert Gill*

Two women smile while they make the sign language sign for "medicine" with their hands — Stephanie Itumba MPH ’26 (left) and Kamryn Thomas MPH ’26 learn the sign for “medicine.” *Credit: Robert Gill*

a woman makes the sign language sign for "food" — Zinne Njoku MPH ’26, making the sign for “food.” *Credit: Robert Gill*

a man laughs with both hands on his chest — Jerome Wilcox, director of inclusive excellence, began to lose his hearing at age 40. One way he has adapted is by wearing multiple smart watches, as each offers better connection to…

A woman makes the number "3" with her hand. — Stephanie Itumba MPH ’26 practices signing the number 3. *Credit: Robert Gill*

Three students hold up their right hands in a fist-like shape while learning the letter "a" in American Sign Language in a classroom setting. — From left to right: Enrico Khu MPH ’26, Stephanie Itumba MPH ’26, and Kamryn Thomas MPH ’26 practice the letter “A.” *Credit: Robert Gill*

Try it Yourself

Jerome Wilcox teaches students the American Sign Language (ASL) alphabet, numbers one through 10, and Humanitarian Sign Language. Humanitarian Sign Language is made up of key signs for emergency situations—such as water, food, medicine, child, shelter, danger, yes/no, and thank you—along with simple phrases.

Learn how to sign a few of them:

Medicine
Hold your non-dominant hand open, palm up. Place your dominant hand above it with your middle finger touching the center of the palm. Wiggle the top hand back and forth, as if crushing a pill with your middle finger.

Help
Place your dominant hand in a thumbs-up on top of the flat palm of your non-dominant hand. Lift both hands upward together to sign “help.” Move your hands in a sweeping arc away from your body to mean “help you.” Move them toward your body for “help me.”

Shelter
“Shelter” combines the words for “safe” and “place.”

For “safe,” make fists and cross your arms over your chest in an X, with the palm side of your fists facing you. Then uncross your arms, bringing both hands apart and slightly outward, turning your fists so the palm sides face away from you.

For “place,” make the letter “P” with both hands: With your pinky and ring fingers folded down against your palm and your pointer and middle fingers outstretched in a V, place the tip of your thumb at the base of the V, then turn your hands so your fingertips point downward. With both hands making the letter “P,” turn them toward each other and touch the middle fingertips together. Tap them, then move the hands apart in a circular motion toward your body, and touch the fingertips together again closer to you.