|Posted on:||Friday, 2nd March, 2018|
Ned Carter is a Programmes Officer at CBM UK supporting the new Ear and Hearing Care Scottish Government-funded project in Zambia. He is also an audiologist and previously worked in Cambodia for an Ear and Hearing Care non-governmental organisation.
World Hearing Day
On World Hearing Day, 3 March, civil society, businesses and governments from around the world raise awareness about hearing loss and deafness. This year’s theme is ‘Hear the Future’, drawing attention to the fast-rising number of people who are deaf or hard of hearing, the importance of preventive action, and the need to ensure access to rehabilitative services and the right to communication.
Globally, the World Health Organization estimates that over 466 million people have disabling hearing loss. Estimates have almost doubled since the turn of the century, and are set to reach 630 million people by 2030 unless urgent action is taken now.
The chances are you know someone who is deaf or hard of hearing. In the UK, for example, this group represents one in six people, with aging explaining much of why 70% of people over 70 are hard of hearing.
In countries like Zambia, the situation is slightly different.
CBM’s Ear and Hearing Care initiative is gaining strength
Zambia’s population of 17 million is young and growing quickly. People are more likely to become deaf or hard of hearing at a younger age than in the UK, due to higher rates of maternal infections, birth complications, childhood illnesses, and treatments and complications of TB, malaria, cancer and HIV/AIDS. Hereditary and age-related hearing loss add to the count. Poorer living conditions lead to serious ear infections, and noisy industrial and military work takes its toll on hearing too. The effects on the lives of Zambian people are greater still.
In Lusaka, the capital of Zambia, CBM has partnered with Beit CURE Hospital to bring much-needed specialist Ear Nose Throat (ENT) and Audiology services to a country with alarmingly few health care workers and surgeons trained in this field. Large rural provinces surrounding Lusaka such as Central Province are reached through mobile outreach clinics, or long patient journeys, if at all. CBM UK’s new Scottish Government-funded project will see permanent community services established in three Central Province districts, 100 miles from Lusaka.
The project, called ‘PrevENT’, places emphasis on prevention, rehabilitation, community awareness, and universal access to primary ear and hearing care.
Prevention and early intervention
An estimated 75% of disabling hearing loss is preventable among Zambian children, who make up 40% of the population. In other words, the potential for prevention and mitigation is very large indeed. Nurses and community health workers are being trained in health promotion, prevention and identification to do just that.
The adage ‘put nothing smaller than your elbow in your ear’ is good advice. However, more comprehensive preventive measures and treatments are needed.
Local nurses, trained at Beit Cure Hospital, will be able to respond to discharging ears, for example, which are all too common in Zambia. Left untreated, this can lead to permanent hearing damage. The ear lies close to the brain and timely referral can also prevent life-threatening complications.
Early intervention is especially important for deaf and hard of hearing children because language is fundamental to children’s development. The sooner that diagnoses can be made, the sooner children can develop sign language and speech, and thrive at home and school. Even babies can be screened.
Poverty reduction and inclusion
CBM UK is training and equipping Zambian hearing instrument specialists so that people can access hearing aid and rehabilitative services in their own province. Emerging evidence suggests that hearing aid use in developing countries is associated with poverty reduction. This is hardly surprising.
Rehabilitation, assistive devices and support can help children to learn, adults to work, older people to stay active, and people of all ages to access information and services, and maintain networks and relationships.
However, there is considerable stigma facing people who are deaf or hard of hearing, whether using hearing aids, sign language, both, or neither.
Discrimination may come from sources of government, employers, colleagues, friends or family, and in overt or insidious forms. Service providers frequently lack the right information, skills and tools. Respect from community members can diminish, who may confuse hearing loss and deafness with other stigmatised conditions such as mutism, learning disability, and mental illnesses per se. Or even bewitchment.
Communication is an integral part of what it means to be human. Too often, difficulty communicating causes frustration, anxiety, isolation and depression. It reduces independence, reshapes personality, and harms wellbeing.
CBM UK is training Zambian community health workers to reach out beyond the clinic to break down communication barriers and stigma, facilitating improvements to quality of life for people who are deaf or hard of hearing. And deafblind people too. Working across sections of society to change attitudes and behaviour is a powerful means to promote social inclusion.
Collaboration and national planning
CBM collaborated with the Zambian Ministry of Health and stakeholders to develop the National Ear Nose Throat Strategic Plan. This project puts the plan into action. For the people of Central Province, with a population of more than 1 million, it marks the availability of formal, integrated community and specialist ear and hearing care services for the very first time.
Nurses from the first cohort recently completed their training in ear and hearing care. Graduation will take place this during a Zambian Government event that aims to raise awareness for a very special day – World Hearing Day.
Images: Top - Balika (12) has been fitted with hearing aids at Beit CURE Hospital, in Zambia. Second - Audiologist, Alfred Mwamba, examines Chimya (4) at Beit CURE Hospital, in Zambia. Third - Patson Sakala, hearing instruments specialist at Beit CURE Hospital, creates ear moulds for Balika's new hearing aids. Fourth - Edson (6) is doing a hearing test with Patson Sakala. Bottom - Tomaths (9) at home with his friends, after being fitted with new hearing aids at Beit CURE Hospital.