By Emma Emeozor
Hearing loss specialists have expressed concern over the failure of the Federal Government to implement the National Policy and Strategic Plan for Ear and Hearing Care Policy.
At the time when the policy was being formulated, the government stated its Mission as: “To provide comprehensive, serviceable, evidence-based interventions in preventing, diagnosing and treating ear diseases and hearing loss and also to habilitate/rehabilitate Nigerians with hearing loss in accordance with global best practices.”
But close to three years after the policy was put together, it is yet to be implemented. Hearing loss is the second largest form of disability in Nigeria. Meanwhile, the number of hearing loss cases has continued to increase annually. Experts spoke during the public presentation of Nucleus 7 Sound Processor by Cochlear in Lagos recently.
Consultant Ear, Nose and Throat (ENT) Surgeon, Aminu Kano Teaching Hospital, Kano, Professor Emmanuel Kolo in his contribution said, “a national survey of hearing loss in Nigeria conducted between 1999 and 2001, reported the prevalence of hearing loss was 17.9 percent of which 6.2 percent (approximately 7.3 million persons) were estimated to have disabling hearing loss based on World Health Organisation (WHO) criteria.”
Cochlear said as a stakeholder, it was introducing the hearing aid as part of its contributions to addressing the problem of hearing loss in the country. It said its “implants are designed to mimic the function of a healthy inner ear (or cochlea). They replace the function of damaged sensory hair cells inside the inner ear to help provide clearer sound than what hearing aids can provide.”
The company believes that with the Nucleus 7 Sound Processor people can take control of their hearing and connect with the technology. Though hearing loss experts applauded the contributions of companies like Cochlear, they were quick to express worry over the failure of the three tiers of government: federal, state, and local governments to address the plight of Nigerians suffering hearing loss.
They insist that the deaf community in Nigeria has continued to suffer government’s neglect. The National Policy and Strategic Plan for Ear and Hearing Care Policy advocates ‘New Born Hearing screening,’ according to the national president of the Otorhinolaryngological Society of Nigeria (ORLSON) Dr Abiodun Olusesi.
He told Daily Sun that if implemented, the policy will reduce the number of deaf people in the country to the minimum. Highlighting the importance of the New Born Hearing Screening, Olusesi said: “The whole idea is that rather than wait for a new born to reach nine months when the child is suppose to start talking but is not talking, then the parents now come to the hospital after the age of one year . . . rather than all those delay, we can actually pick hearing loss or hearing impairment at birth through the neo-natal hearing or new born hearing screening.
“Usually within the first 24 or 48 hours of birth, using equipments that are not very expensive we can determine whether the hearing of the new born is optimised for speech or whether it is poor. Those who fail the new born hearing screening test will be given a second chance, six weeks later to repeat the test. If they still fail the test, they will be referred to the audiologist to carry out the diagnosis test, having failed the screening test two times.
“When a child is born, through pre-natal hearing screening, the status of the hearing can be ascertained and the parents of the child can be guided on the right way to handle the problem. So, this is where the rural area comes in. It is suppose to be a test that we should be able to perform within the primary health care center which is the level at which most of our rural areas are.”
General Secretary, Speech Pathologist and Audiological Association of Nigeria (SPAAN) Dr Simeon Afolabi agree with Olusesi. He explained that there are provisions in the National Policy and Strategic Plan for Ear and Hearing Care Policy that make it mandatory for the Federal Government to provide hearing aids, cochlear plants for people suffering hearing loss as well as be involved in the new born hearing screening plan. “But these are just written documents, nothing has been done about it.”
Afolabi who is also the Chief Executive Officer, BSA Hearing and Speech Centre and Cochlear authorised distributor in Nigeria said the predicament of the deaf in Nigeria has been further worsened by the failure of the Federal Government to include provision of medical instruments like hearing aids in the nation’s health insurance scheme. This is even as the rural areas lack medical facilities specially designed for the deaf, he added.
He wants the government to know that there are Nigerians “in their adulthood that have become useless to the society because they are deaf, as a result they are not helping themselves.” He was however confident when he said: “But the story can be turned around if these individuals were to be helped early enough to overcome the disability of hearing loss, they could become productive to the society, they could have become independent in the society if something had been done to address the problem of hearing loss in the early stage of their life.”
As part of measures to reduce the cases of hearing loss in the country, Olusesi and Afolabi in separate interviews called for more training of professionals (specialists) in Ear, Nose and Throat (ENT). Afolabi said: “We need to train more professionals in hear care: doctors, audiologists and other specialists. When qualified specialists are available in the hospitals, cases will be better handled as they will be rightly directed to the professionals. And as if to worsen the situation, the government is not employing qualified personnel as it ought to.”
Olusesi lamented the loss of Nigerian doctors to the Middle East and Europe, describing the development as “revised brain drain.” “We do not have enough ENT specialists in the country. By available statistics we have one specialist to one million patients, that is quite a small ratio and on top of that we are losing members at a fast rate to hospitals in the Middle East and the United Kingdom.”
Both experts also blamed the cash crunch and poverty in the country for the increase in the number of hearing loss cases. They explained that the cost of hearing aids is high and continues to rise as Nigeria’s currency depreciates in the global market. Therefore, the hospitals and patients find it difficult to buy hearing aids as they are imported from abroad.
They urged the federal, state and local governments to intervene and come to the aid of Nigerians with hearing loss. It was suggested that in the interim, a dedicated fund should be established to reduce the financial burden of people seeking treatment for hearing loss.
According to Afolabi, majority of Nigerians who have acquired hearing aids either for themselves or their children was through personal effort.
He said the Federal Ministry of Health has not put any programme in place to assist those who have need for assistance. “The national health insurance scheme we are talking about does not cover special cases like hearing aids but they need to be covered, they need to be provided for the people,” he stressed.
Also highlighted was the challenge of training of specialists to enhance their knowledge. Olusesi noted that “with the economic downturn, the funding of hospitals has shrinked. And that has further put pressure on doctors to fund themselves. So what we usually do is to leverage on technology and organise update once in every two months, using the Zoom platform. We get specialists to address the forum in their pet areas. The forum is a bigger form of inaugural lecture that professors give in the universities.”
Cochlear supports the calls for government intervention. In a report made available to Daily Sun, the company said it has carried out no fewer than 83 successful implants in Nigeria since 2010 just as it noted that the harsh economy has made it difficult for people to pay for the equipment.
In addition, the company has held 50 training courses attended by 625 people.
The training programmes include: Surgical training for ENT surgeons, Professional and educational product training for healthcare professionals and KOLs, Master classes in collaboration with ORLSON, Audiology training and workshop (online and offline), Rehabilitation seminar for Speech therapist (online and offline) and Rehabilitation seminars for parents and recipients.