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This is a subject that is dear to my heart since my grandmother was born Deaf. For most of her life she relied on family members to make her calls and convey her thoughts accurately. She ultimately acquired a TTY (teletypewriter), which gave her some independence in making phone calls via an operator who could read and then relay her comments to the person she was calling. Still, this lacked some clarity because as with many Deaf people, Sign Language was her first language not English. With the advent of Video Relay Service, Deaf people are now able to clearly state their purpose by means of their "mother tongue" through a camera system which connects to their television or PC. This has opened up a whole new world to the Deaf Community, they are now able to make plans, appointments, and have conversations without having to wonder "Was I really understood?" after they hang up.
So the next time you are looking at a phone bill or a telecom tariff, remember the freedom these services bring to people who cannot use the phone in the traditional manner.