... we make you hear better.

... we make you hear better.

Information for Physicians


Helping persons with hearing loss


The primary healthcare provider is the hub of any effective intervention for persons with hearing loss. A major challenge in delivering timely services for persons with hearing loss in developing countries is the widespread perception that the condition is not serious because it is not life-threatening. Unfortunately, it is difficult to adequately quantify the emotional, psychological and economic burden of hearing loss in the affected persons and their families. The burden of this condition is greatest in infants who were born with or acquire sensorineural hearing loss shortly after birth. The priority to save every child in developing countries is unquestionable. However, it offends the oath of a physician’s calling to ignore the consequences of efforts to save a child’s life.

Consequently, Phonics Hearing Centre in partnership with Hearing International Nigeria (a local non-governmental charitable organisation) has since 1999 embarked on local, regional and global initiatives to raise the profile of hearing loss prevention and management in and for developing countries. In November 1999 we organised the first and highly successful international workshop on occupation noise jointly with the Federal Ministry of Health and with support from world-renowned experts drawn from UK, Canada and Sweden. More recently, in June 2005 we supported the first pilot programme in West Africa on early detection of hearing loss in newborns and infants formally launched by the Federal Health Minister and Lagos State Commissioner of Health. Details of our activities in this area can be found on a related website: www.soundstartforall.com. Excellent research materials addressing the many important dimensions of hearing healthcare in sub-Saharan Africa especially for infants and young children are also available at or accessible through this site.

Our engagement in this course is underpinned by a firm belief that as an ear care provider we must not only treat (secondary/tertiary prevention) but curtail the burden of the condition through primary prevention. We in fact consider this task more important for the simple reason that hearing once lost can never be restored not even by the best of technology currently available. And as Helen Keller who was both blind and deaf from meningitis in early childhood succinctly noted: blindness disconnects from things but deafness disconnects from people.

Supporting persons (especially children) with hearing loss therefore takes much more than simply providing them with hearing devices. It is in fact a life-time journey that requires skill, understanding and passion to make things happen. These are the hallmarks of what to expect from Phonics. We therefore invite you to consider hearing tests for all children who may be at risk of hearing loss as a result of an illness or the treatment of an illness with ototoxic drugs such as chloroquine and gentamycin as soon as possible. Similarly, persons who are constantly exposed to excessive noise should be encouraged to have their hearing tested. Click here for common risk factors for hearing loss.

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The need for multidisciplinary approach to case management


Evidence from around the world has clearly shown that the interests of persons with hearing loss are best served by a combination of well-coordinated professional skills delivered in a multidisciplinary setting. For example, hearing loss in infancy affects all major areas of development in early childhood [1,2]. Effective case management would therefore require professionals drawn from paediatrics, otolaryngology, audiology, speech and language pathologists, special education and clinical psychology working closely with the parents coordinated by a paediatrician where possible [3]. In adults, the required combination of skills are less complex because the patients themselves are active participants in the management process and can easily evaluate the effectiveness and quality of the services being provided [4].

In a developing country setting, the availability of certain skills may be constrained by manpower shortages but efforts must be made to minimise potential gaps in case management as a result of this situation through functional training and effective referral system. We are aware of and indirectly involved with on-going global initiatives to rapidly build relevant capacity for the efficient and effective delivery of hearing healthcare services in this region spearheaded by the World Health Organisation and other stakeholders including persons with or affected by hearing loss. These efforts in the long-run will facilitate an approach that serves the best interests of persons with hearing loss in line with the practice in developed countries.

References:

  1. Olusanya BO. Priorities for early hearing detection and intervention in sub-Saharan Africa. International Journal of Audiology 2008;47 Suppl 1:S3-13. Review.
    Link to online publication

  2. Olusanya BO. Can the world’s infants with hearing loss wait? International Journal of Pediatric Otorhinolaryngology 2005; 69:735-738. Reprinted in Audiology Today 2005;17(4):10-11.
    Link to online publication

  3. Joint Committee on Infant Hearing (JCIH). Year 2007 Position Statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics 2007;120;898-921.
    Link to online publication

  4. Olusanya B. Self-reported outcomes of aural rehabilitation in a developing country. International Journal of Audiology. 2004 Nov-Dec;43(10):563-71.
    Link to online publication