MakSPH supports the World Health Organization's World Hearing Day on March 3rd. The day promotes ear and hearing care across the world and raises awareness of how to prevent deafness and hearing loss.
In Uganda, more than 5% of the population have some degree of hearing loss. This tantamounts to over 2 million Ugandans. Hearing loss is a common cause of sensory disability globally. It can limit a person's participation in daily life, limit opportunities for employment, cause spiritual, social, and emotional problems and, early in life, it can delay child language and educational development
In this episode, we tackle hearing loss as one of the public health concerns with our partners, Family TV.
Show Host: We know that hearing is quite significant to all of us. How beautiful it is to wake in the morning and you can greet someone and they can respond, and you hear their response. Have you ever imagined how it feels when you wake up, you look at people, you see them talking and laughing but you can’t be part of their conversations? It hurts, right?
Now, 3rd March every year is World Hearing Day, this year's World Hearing Day was yesterday, Thursday. The theme this year is very simple "Hear for life, listen with care." We need to come back and talk about these days because they are special days to us which is why we are here today.
I welcome you to Health Pot. My name is Edrine Osteen Mukalazi together with Mable Murungi our sign language Interpreter and Mr. Mukaaya Eddie, one of the directors of Hear His Voice Uganda (HHVU), a parents' initiative to promote early intervention among children with hearing loss using cochlear implants & hearing aids to hear.. Last week, we were with Mukaaya Eddie taking us through the importance of having a cochlear implant. Today, we are delighted to have Mr. Mukaaya Eddie share with us the details of why this day should be celebrated, and why we should talk about it. Mr. Mukaaya we are delighted to have you this evening kindly greet our viewers and we proceed.
Mr. Mukaaya Eddie: Good evening viewers. Thank you Edrine for having me on this talk show. I am honored to be here with both of you and speaking of World Hearing Day. Just as the theme says 'hear for life,' the world we live in is a world full of sound. The birds singing in the tree, the wind blowing over the leaves of the trees, everywhere we are surrounded with sound, and again like you ably put it 'if you don't have this it should be a form of urgency'.
Something is lacking in life, there is a part of life that has been taken away from you, and again the brain will realize that this is not happening. The hearing day is a day that the World Health Organization set apart to create awareness globally about the issues of hearing loss and also to find solutions. When you create awareness, we have to find solutions for what this is, and again hearing loss is one of those invisible disabilities.
Show Host: How long has this day been celebrated? We imagine there has not been a lot of publicity about this day in our country and there are things we are just coming to know about recently that even the media has not done enough to talk about some of the things, why do you think it is like that?
Mr. Mukaaya Eddie: Honestly, I first heard of World Hearing Day when I was staying elsewhere, so in 2017 I got an opportunity to work with different partners especially the Ministry of Health and KCCA to begin working on commemorating World Hearing Day in Uganda. We first officially started commemorating it in 2017 but elsewhere it’s been going on for years, actually for a decade if you can look at the World Health Organization page or facts.
The Government came and was very helpful in terms of embracing the day because without the system helping the little effort being put into the awareness becomes hard to go any mile. So, you need to work both with the government and the structures available to bring about a lasting solution for the people in the country.
Again, the reason why World Health Organisation set aside World Hearing Day is to make sure that there is awareness about this but also to bring the government which was a signatory to the World Health Organization act, and think about hearing loss. This is because it is quite daring and it is frightening to even think about it. 20 years ago, it was 1 in 1,000 people who used to have a hearing loss, 10 years ago it came to 3, and right now we are talking about 5, so it is a problem that we just can’t keep a blind eye to. We need to do something about it and again the World Health Organisation has systems and structures in place to help governments to think about it because we are thinking about hearing loss but you will be surprised Edrine that 60% of the cause of hearing loss among children is preventable-facts presented by the World Health Organisation. So, if you are saying that 60 % can be preventable then we need to get involved to find out exactly what are the causes and what can we do about them for our people.
Show Host: That takes us to the next point of discussion. Now that you have gotten an opportunity to interact with several parents with children who are victims of hearing loss and the children themselves, what are some of the common causes of hearing loss? The World Health Organization assumes that almost 1 billion people aged between 12 and 35 years are at risk of having hearing loss shortly, what are some of these common causes so that we can talk about them and maybe save, reduce this 1 billion to probably manageable number?
Mr. Mukaaya Eddie: I will begin from what you have quoted. That number among the young adults and again Uganda becomes very critical because it has the youngest population. When you are talking about the World Health Organisation you are talking about the ages between 15 and 35, that is Uganda. That means we are actually at risk as a nation. One of the common causes is called noise-induced hearing loss when there is a lot of noise that is being made.
When you are exposed to a lot of noise your ears begin to your hearing cells are called hair cells in the cochlear, they will begin to fail. So, I will use an example of rain, right now it has started raining so if the grass is available and there is a sudden huge downpour and the rainwater is moving, you realize that after the rain all the grass will be in one direction. But for your ear to perform, those hair cells need to be moving. You know sound comes in and it turns from sound into mechanical energy by the ossicular chain in the middle ear, then when it comes into the inner ear you are talking about hydraulic energy because it is now working with the fluids in the inner ear. It is very beautiful how hearing happens.
So, when you induce a lot of noise sometimes it can impair the middle ear. Just imagine the ear drum it’s elastic, but it’s being impounded with a lot of energy. So, by the time you are 2-3 years in the same environment, the hair cells begin to...... You will suffer progressive, severe sensorineural hearing loss which is long induced, so that is one of the major causes among that age group. character traits like using headphones or maybe you have gone dancing, you know that loud music which young people like most.
Again, I am talking about that group because it is who we are. Then the other cause among adults could be age. As you grow and have different experiences in life, and health issues you can also lose your hearing. But among children we also need to think about ear infections, there are common causes of hearing loss. For example, otitis media or otitis media effusion where you have fluid in the ear which is not treated, it rests a lot on the tympanic membrane and when you don't see the specialist in time, this will end up causing hearing loss. The first person to identify hearing loss is a member of the family, either a mother, a father, or a sibling while in other cases hearing loss is detected at birth.
Show Host: How is it detected at birth?
Mr. Mukaaya Eddie: You don't leave the hospital unless they have done a hearing screen, which will send signals to your ear and they see how your ear is responding. So, depending on how it's responding, you either pass or fail, that's in basic screening. If a child has failed then he is given another appointment to go back for further ENT evaluation, and further evaluation, you can do audiometry, play audiometry, and otoacoustic emissions, and the investigations gradually become complicated to narrow it on where it is.
Show Host: Wow, we are shortly going for a commercial break and when we come back, we shall continue with the discussion
Show Host: Thank you for watching Health Pot, and I welcome you back from the commercial break, Edrine Osteen Mukalazi is my name. This program is brought to you by Makerere University School of Public Health, we look at early childhood development, maternal health, and other public health concerns. What we are looking at today is an aspect of early childhood development which is hearing loss, and yesterday we all know that it was World Hearing Day and the theme was "Hearing for life listen carefully," so here we are with Mr. Eddie Mukaaya taking us through a lot of things that you people need to know because of the reason this day is commemorated. It is not a matter of talking about it and coming up with a theme but creating awareness and checking what can we do to save the next generation.
Eddie, we are back and you told us about some of the common causes of hearing loss. Now we want to look at what parents and caretakers can do when they detect a challenge, a problem, or when they detect it coming. I am talking about hearing loss, and what they can do or even prevent it because, in the first session of this show, you told us that 60% of these causes are preventable, and we are interested in the preventive bit of it.
Mr. Mukaaya Eddie: Thank you again, I would begin from the preventive side of it. But when we are talking about awareness, information is key, we need to be aware of what hearing loss is and what the causes are. Generally, the causes can be categorized, some causes are prenatal, other causes are perinatal and other causes are within childhood to adults, to adolescence, and the bigger portion is adults that we talked about.
Now let me talk about the perinatal and the prenatal. Prenatal, that's when the child is within the mother's womb. Research has shown that the cochlear fully develops, the cochlear is a hearing organ for a human being and fully develops after 24 weeks. There are congenital issues that may cause this cochlear not to develop and again we will not go much into those terms but when such happens you need to go and obey the routine visit to the hospital when you are expecting. Even taking that folic acid that they give is very critical, it plays a big role in the hearing cells.
Show Host: Does that mean that mothers should not take antenatal for granted?
Mr. Mukaaya Eddie: Mothers should not take antenatal for granted, actually if I have the audacity, I would say mothers have the full responsibility of taking care of the children's hearing. So, that is prenatal and when it comes to perinatal the child is just born, again go for immunization because some of the causes of hearing loss are immunizable diseases like meningitis and all those eight killer diseases. Take your child to be immunized, you need to make sure that you are on the routine and as you go there, they are checking other things.
Other causes can be viruses. Earlier on talked about middle ear infections, so a middle ear infection, when the child is playing out there and after 6 months when the child is begun doing that and after putting things in her mouth and all that, that's when preschool and all that, the ear infections begin to kick in. So, if you don't take care of those early, they can eventually cause hearing loss, so that's why it comes back to the family, when you manage your routine well and you can check with the child, even wax impacting on the tympanic membrane can cause hearing loss that can become permanent, and just imagine wax, just accumulates, so if you are a parent who is not taking care of certain things so this can be, becoming aware of the dangers of all the causes of hearing loss and again, the other critical thing is identification.
You need to be able to identify that actually, I am dealing with hearing loss here because if you identify and intervene early, you can save a lot of time. Again, you were quoting World Health Organization before but they say "almost $16bn are saved per annum by intervening either with technology or with forms of different communications and all that" so you will be saving a lot as regards relegating it to whom it may concern.
When you have identified hearing loss, you know which kind of hearing loss your child has suffered or your mum has suffered then you have appropriate interventions from the different professionals that help in the hearing and hearing care services.
Show Host: Well, I understand Hear His Voice Uganda has organized a commemoration here at your offices, what are some of the activities that you are going to carry on in the commemoration?
Mr. Mukaaya Eddie: I told you earlier that we started in 2017 and we walked on the streets of Kampala. We did that for two consecutive years then, in the following years, we have now been scaling it down from public to where it matters most. We want to empower people, communities, professionals, and families, so for this year, we are commemorating World Hearing Day uniquely.
We are hosting a conference that is spreading across East Africa. We have campuses in 5 cities in East Africa, we have a campus in Nairobi, Nilo Depot, the city of Hoima, and Butare in Rwanda. We are demonstrating that you know listening is important just as the theme is. It is critical. We don't teach deaf children how to talk we teach them how to listen. When you were growing up, they never told you "Gwe toyogela" but they told you "gwe towulira,". You need to listen〜"kirabe kino tekiwulira," Do you see the negative derogatory that comes with it?,
Now we are saying "we want to bring you to a point and say children with hearing loss need to be helped especially when they are given technology like hearing aid or cochlear implant." They need to be able to listen, to learn to listen, and to learn to talk. By the grace of God, we have been honored to host two renown World Cochlear Implant Audiology speakers, we are hosting Dr. Carol Flexer.
Dr. Carol Flexer is a renowned audiologist who doubles as an AVT certified. She talks passionately and believes that nobody should be left behind because of hearing loss. Right, we also have Professor. Tom Roland whose name is as far as cochlear implants are concerned. He is a professor in New York and we have another lady coming from Northern Ireland, she is also a certified Auditory Verbal Therapist and our very own Eddie Mukaaya who is going to speak about what do families need in this journey of hearing loss.
Now you will ask me, "why are you bringing these whites from the US, Northern Ireland, and all that? The thing is this approach is new to us and we cannot start from scratch, we need to start from somewhere. I do believe developing countries like ours have a lot of opportunities to adapt research and study it and apply it in our situations. So, when I bring Professor. Ronald for example he is been coming here several times he is responsible for the start of the cochlear implant program in Uganda, and he is been training surgeons at Makerere University. He knows the ins and outs as far as Uganda ear and hearing care services are concerned. The only way to get there is by keeping back ride on such people so that we can get there.
Show Host: Are people invited or they will watch this over zoom?
Mr. Mukaaya Eddie: Thank you, thank you, that is good. I talked about campuses, people are invited, this is a conference to be attended in person. Again, thanks to God and the government, we can be able to meet. People are invited and I want to appeal to those who want to be interested in the better ear and hearing care services in our community to come to Hear His Voice in Ntinda. We are here the whole day starting from 10:00 AM-4:30 PM, we have different programs and you know we had a training of some Masters university students who are training in this area of hearing loss, and they had never seen a child who is deaf talk, they had never what a cochlear implant is.
There are so many opportunities when you come as opposed to when you stay home and watch TV or join in the zoom meeting. We are giving people an opportunity to come and see, to come and touch, learn, and network. It is open to the public to come for this unique, it is unique, we want to start small and grow..
Show Host: Wow! Thank you so much, Eddie. We are delighted that you have shared with us and just in case you are interested, please feel free to come here at Ntinda. Please share with them your location.
Mr. Mukaaya Eddie: Hear His Voice Uganda is located off Magambo Road, Magambo Road is in Ntinda, the main benchmark there is Shell Ntinda opposite Hard ware so once you get to Magambo Road you can locate Hear His Voice Uganda.
Show Host: Thank you so much Eddie once again. We promise you we shall move with Hear His Voice and our big theme of hearing loss the whole of this month, so expect a lot from Hear His Voice. I believe by the end of the month, you will have been blessed by these messages. Edrine Osteen Mukalazi is my name, Mable Murungi, the sign language interpreter, and we meet again next time. For now, goodbye.
Contact Persons:
Dr. Christine Nalwadda (Team Lead) | 0772495169 | cnalwadda@musph.ac.ug
Mr. Davidson Ndyabahika (Comms MakSPH) | 0706765767 | dndyabahika@musph.ac.ug
