Six-year-old Samuel used to live in a world shrouded in silence. He didn't react to a knock on the door or the television set. He remained silent as others chatted and laughed nearby and he didn't dare raise his hand in class. His two siblings Loammy (16) and Misael (10) couldn’t help him either as they also suffered from hearing loss. Although their aunt knew what was wrong, they had no money for hearing aids. This is unfortunately all too common in Peru where some people do not have access to healthcare, meaning that many hearing impairments remain undiagnosed. For example, screenings for newborns or schoolchildren are practically non-existent, there are only ten audiologists in the entire country and the equipment costs are beyond the means of nearly every center nationwide. About 532,000 of Peru’s population of 32 million suffer from hearing loss.
That’s why the hearing screening campaign conducted by the Hear the World Foundation and its partner, World Wide Hearing Foundation International, is a boon to Samuel. The campaign aims to prevent and identify hearing loss and support those children who suffer from it, such as Samuel.
It all started in 2016 when the Hear the World Foundation, an initiative of the Sonova Group, which is dedicated to helping people worldwide affected by hearing loss, particularly children, started working with the non-profit organization World Wide Hearing Foundation International (www.wwhearing.org). This non-profit organization develops innovative solutions to ensure children and young people in developing countries and disadvantaged regions have access to high-quality, affordable hearing solutions.
Alejandro Linan, Technical Audiology at Sonova Ibérica in Spain, adjusts the hearing devices for Samuel. Then a whistle sounds. “Can you hear that?” asks Alejandro. “Yes, here!” cries the boy, pointing to his ear. He laughs out loud. For the first time in his life, Samuel heard a sound as loudly and clearly as someone with normal hearing. His two siblings were also diagnosed with hearing loss and provided with Sonova Phonak hearing aids.
Now the three of them can communicate with each other and better understand lessons at school. “Our dream came true,” says Samuel’s aunt, who is raising him.
The key to Samuel being able to hear lies in training the local people – building capacity lies at the heart of the campaign: the two foundations work with Peruvian speech therapy students and teachers, thus making them an important element of healthcare. This is the first time Peruvian professionals have been enabled to conduct screenings themselves and, by doing so, contribute to improving audiological support in the country. For example, the students can ask Sonova audiologists questions – and become experts themselves, free of external involvement. They perform the screenings and learn to identify the warning signs of hearing loss. Teachers, for example, should be aware that a child may suffer from impaired hearing when he or she does not participate in class.
The campaign operates through mobile technologies to perform the screenings quickly and easily: the Sonova volunteers not only conduct hearing tests but also provide advice and suggestions to their Peruvian counterparts. The latter are mainly speech therapists, and they received hearing-test training with the iPad app Shoebox and an introduction to examining the external ear canal and eardrum through an otoscope. During the missions, the Peruvian volunteers are able to rely on the knowledge of the Sonova experts, ask questions or obtain an expert opinion. These assignments allow an exchange of points of view on a professional and social level.
To date, 31 Sonova employees from 13 countries have done volunteer work for the Hear the World Foundation. During their one-week assignments, they carry out hearing tests for children, as well as sharing their valuable knowledge with their Peruvian colleagues and being available to provide an expert opinion when asked to do so. “The cooperation between World Wide Hearing and Hear the World is very important. We can discuss various technical aspects of audiological support and be mindful of cultural differences at the same time,” says Jordan Varillas, a project coordinator at World Wide Hearing Foundation International.
Donations from Hear the World enable World Wide Hearing Foundation International to employ Jordan Varillas and Rosario Urdanivia as instructors at Universidad Nacional Federico Villarreal state university. The speech therapy course contains an audiology module, although audiology is not a course of study in itself there, or at other universities. Some students still complete their studies without having any experience of audiometry, having to rely on luck as to whether they gain some practical experience with patients.
That is what makes the training so valuable for many students, as it is their first and often only opportunity to practice using otoscopes and audiometers. Jordan Varillas is also confident that the screenings during the assignments are only the first step towards regular audiology seminars.
However, the testers also have some minor obstacles to contend with: it's so noisy in the schools that the tests are challenging, says Laura Meng, Program Manager at Hear the World Foundation. “Children playing in the schoolyard, the loud school bell and music lessons often make it noisy!” If a hearing impairment is diagnosed, the audiologists know what to do. The first step is to perform a second check – in quieter surroundings.
Over 430 of the 31,000 children examined so far in Lima and the surrounding area have been diagnosed with hearing loss – that equates to about 1.5% of children tested. That may not sound a lot, but it is considerable bearing in mind that these tests used to be non-existent. Moreover, the hearing test offers the children a new start in life: they receive hearing aids that allow them to hear voices and sounds and the opportunity to have an education and independent life. Children with untreated hearing loss find it hard to learn how to speak and to follow in class.
When the first team of Sonova volunteers went to spend a week in Lima in April 2017, they tested about 1,000 children. However, the volunteers consistently improved the hearing test processes and procedures during the project, enabling them to hold over 4,400 screenings in one week in September 2018.
The procedure is highly efficient: the volunteers start by monitoring the auditory canals to check for ear wax blockages. Following the simple hearing test using the Shoebox iPad app, those children who do not pass the test are examined by an audiologist who conducts a second test.
If children do suffering hearing loss, they are given customized Sonova hearing aids (Unitron or Phonak) plus aftercare. The devices donated by Sonova help the children connect with the world and escape their social isolation, thus realizing their potential.
Vibes also supports the aid project (http://www.discovervibes.com/). Vibes produces high-fidelity earplugs and has partnered the Hear the World Foundation since 2016. Vibes regularly donates a portion of its profits to hearing-improvement projects launched by the foundation. This has led, for example, to the construction of an aftercare clinic for children in Lima – another first for the country.
The plan for 2019 is to roll out the successful hearing screening campaign to regions outside the capital Lima. In addition to the screenings in schools, World Wide Hearing Foundation International collects data on the spread of hearing loss. That should help the progress of related research in Peru. The screening training modules are to form an integral component of the university curriculum – an additional contribution towards building capacity. The data surveyed is added to the Global Hearing Loss Database and made available to the World Health Organization (WHO) plus researchers and practitioners worldwide.