16.6 percent of Nepalis suffer from hearing problems, one of the highests in Asia
Helen Keller, an author, political activist, and the first deaf-blind person to earn a bachelor of arts degree, once said that “blindness separates people from things; deafness separates people from people”. Unlike other disabilities, hearing loss is an invisible disability. It is so invisible that March 3rd is not even marked as the World Hearing Day in the Nepali official calendar. Until you speak to a person with hearing loss, you don’t realize that they are differently-abled. In a conservative society like ours, other disabilities are viewed with compassion whereas people with hearing disabilities are frequently insulted, discriminated against, and referred to as stupid or “Lata” in Nepali.
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The World Health Organization (WHO) states that the impact of hearing loss is not just social, but also emotional and financial. Hearing impairment is particularly serious in children because it can lead to delayed speech development, communication difficulties and slow educational progress. In developing countries, children with hearing loss and deafness rarely receive schooling, resulting in a much higher unemployment rate later in adulthood. Among those who are employed, a higher percentage of people with hearing loss are in the lower grades of employment compared with the general workforce. Nearly 90 percent of the people with hearing loss live in low and middle income countries. Limited access to services and exclusion from communication can have a significant impact on everyday life, causing feelings of loneliness, isolation and depression. In addition to the economic impact of hearing loss at an individual level, it also substantially affects social and economic development of communities and countries. A recent article published in The New York Times revealed that in adults, hearing loss is the largest modifiable risk factor for developing dementia, exceeding that of smoking, high blood pressure, lack of exercise and social isolation.
According to WHO, 466 million people live with disabling hearing loss which is 6.1 percent of the world’s population. About 75 percent of childhood hearing loss is due to preventable causes in low and middle income countries in comparison to high income countries 49 percent. Hearing disability is ranked among 20 leading global burden of diseases. The cost of unaddressed hearing loss globally is around US$750 billion. More than one billion young people are at risk of hearing loss due to recreational exposure to loud sounds. Hearing loss is one of the world’s leading causes of morbidity in terms of years lived with disability (YLD).
In Nepal, 16.6 percent of the population suffers from hearing problems, one of the highests in Asia. Hearing disability is the third most common disability, only after physical and visual disability. The main cause of hearing loss is ear infection, which could easily be prevented by early diagnosis and treatment. In about 55.5 percent of the school-going aged children, ear infection is the main cause of hearing loss. The predominant factors that lead to ear infection are recurrent untreated common cold, installation of oil and other traditional herbs inside the ear, poor nutrition and hygiene, and ignorance about the disease. If left untreated, ear infection not only causes hearing loss, it can also cause life threatening conditions like meningitis, brain abscess, and even death. More than half of all cases of hearing loss in children can be prevented by healthy ear and hearing care practices, and early identification and appropriate management of ear infections. Hearing loss which can’t be treated by medical or surgical management can benefit from early use of hearing aids and from speech therapy.
To cater to this need and to reach out to the unreached, Ear Care Nepal (ECN), a voluntary organization, was established in 2013 with the aim of “Prevention of Deafness and Conservation & Promotion of Hearing in Children in Nepal” by a group of dedicated ENT surgeons and philanthropists. ECN is the only organization in Nepal conducting purely school-based ear health programs in government schools from the lower Terai to the high remote Himalayan regions like Dolpa, Humla, Jumla and Mustang where medical team has to walk for days to reach out to the children. ECN’s school-based ear health program consists of three integral parts: Screen, Treat and Educate. All the children are screened and also treated for minor ear and hearing problems at their respective classrooms. Those children who require further interventions are referred to hospital and are managed by a team of ENT doctors associated with Ear Care Nepal for medical/ surgical intervention, hearing aid fitting and speech rehabilitation. They are also educated about ear and hearing problems using education materials like animated booklets, posters and power points for prevention of ear and hearing problems. Within a short period of six years, ECN has screened and treated 78,850 children from 505 community schools of Nepal. The data gleaned by us revealed that in over 80% of children with hearing loss, the main cause of hearing loss is an avoidable one – ear infection. That leads us to the conclusion that deafness in Nepal can be overcome if the saying “Prevention is better than Cure” is heeded and followed.
