Hearing is an ability we all take for granted.
Imagine the euphoric feeling of hearing the first notes of your favourite song play on the radio. Or the harmonious collapsing of waves, the lively laughter bubbling in a friend’s voice, the fragile crackling of a fire or the crunch of rusting leaves on an autumn day. Hearing is one of our most important senses, connecting us to the world and to each other.
Unfortunately, there are 466 million people worldwide afflicted with a disabling hearing loss. 34 million of these are children. Eighty percent of people with disabling hearing loss live in low- or middle-income countries. When did hearing become something one had to be privileged to experience?
A major cause of hearing loss in the developing world is chronic ear infections. Countries in Africa, Southeast Asia, and the Western Pacific bear over 90% of the hardship of chronic ear infections. Ear infections are likely to cause discharge from the ear. If left untreated, this can lead to hearing loss and could cause meningitis or brain abscesses to occur. Chronic otitis media affects 65 to 330 million people with ear discharge globally. This ear infection is easily treated with the right medical care. However, many people from the developing world do not have this luxury.
Hearing loss can also be caused by the use of ototoxic medicines. Ototoxic medicines are drugs which cause hearing or balance problems and include anti-malarial treatments which, when taken without medical advice, can cause permanent hearing loss.
Regarding hearing loss, children in the developing world are suffering detrimentally. In fact, a child living in sub-Saharan Africa is twice as likely to be deaf as a child living in the developed world. Causes of disabling hearing loss in children include maternal infections like rubella, meningitis, measles, mumps, severe jaundice at birth, birth anoxia, chronic ear infections, low birth weight and exposure to loud noises. These causes can be prevented; 60% of childhood hearing loss cases are preventable.
The quality of life for these children is severely diminished. Children with deafness will have issues developing speech, language and cognitive skills and their learning abilities will be limited. However, even in developing countries, 90% of children with disabilities do not go to school. Although sign languages in these countries exist, they are ultimately inaccessible as they are not taught in schools. Therefore, deaf children and adults are often illiterate and struggle to access information about their rights, leading to high unemployment rates in the deaf community, thus meaning most deaf people live in poverty.
In some developing countries, cultural and superstitious beliefs associated with deafness can also add to the marginalisation of deaf people, posing a barrier to prevention and treatment of deafness. Often, they are thought to be ineducable and are, therefore, exposed to a life of stigma and stereotypes.
Due to their vulnerability and lack of human rights, deaf people are often brutally exploited. Deaf slave rings are known to exist in France and Mexico. Deaf people from developing countries are enlisted to become street ‘peddlers’ where they sell keychains and other products alike. The leaders of these slave rings confiscate any money made by the deaf slaves and then imprison them.
The suffering deaf people in the developing world do not deserve this life. They deserve to be respected, to be a part of an accepting deaf community where their disability is not perceived as a contamination. They deserve to be protected, to have basic human rights and the right to medical attention.
Another major issue facing the deaf population in the developing world is the lack of access to professionals. There are no audiologists in Sierra Leone and Malawi. In Zambia, there is only one audiologist for a population of 14 million people. Comparatively, in the Republic of Ireland, there are 76 qualified registered audiologists across a population of 4.9 million. When comparing a developed country like the Republic of Ireland with any developing country on the concern of deafness, the contrast is overwhelming.
The Health Service Executive (HSE) offers almost all babies a hearing screening within the first month of birth. They do this to ensure that any defects associated with hearing can be treated as soon as possible and the threat of hearing loss is minimised. However, in developing countries, there is no mandatory hearing screening for new-borns and, therefore, deafness is not usually diagnosed until age two. Additionally, many births in developing countries may not even take place in a hospital setting; the majority of births in India are not performed by a trained health care worker.
According to the HSE, approximately one or two in every 1,000 babies born in the republic of Ireland will be diagnosed with hearing loss in one or both ears. In India over 100,000 babies are born with a hearing deficiency every year, approximately 4 in 1,000.
Hearing loss can be both prevented and treated. Hearing aids which are efficiently fitted can improve communication in at least 90% of people with hearing loss. However, in developing countries, less than one in 40 people who would benefit from a hearing aid have one. It is evident that there is a shortage in hearing aids worldwide as the World Health Organisation estimates that the current production of hearing aids is reaching less than 10% of the global need. If we have the capacity to give the ability of hearing to someone, then why isn’t that a primary focus?
Providing affordable and adequately fitted hearing aids will benefit many people with hearing loss in developing countries. However, alongside this, follow-up services, maintenance and batteries must also be provided.
The distribution of vaccinations against diseases such as measles, mumps and rubella which cause deafness would also greatly contribute to preventing deafness in the developing world. Effective care for pregnant mothers and hearing screening of new-borns would also minimise the chances of childhood deafness.
The provision of safe medicines across all developing countries to treat chronic ear infections would also abundantly decrease the number of people suffering with hearing loss. Additionally, the spreading of awareness among health care workers about ototoxic drugs would combat permanent hearing loss.
Hellen Keller said deafness separates people from people. There is a plethora of actions we can take to ensure that deafness in the developing world is minimised. Likewise, there are ways to improve the quality of life of those who have permanent hearing loss. Each person suffering from hearing loss should have the opportunity to learn their sign language, to be a part of an accepting community and have access to an education.