The World Health Organisation put out a hard fact recently—2.5 billion people will have some degree of hearing loss by 2050. That’s one in four people. There are several things at play here but what has emerged as one of the biggest is the burden of stigma around hearing-related disorders.
It’s a cultural thing
The many attempts to destigmatise hearing loss have been in vain. “People see it as a personal failure. Because of the negative attitudes expressed by others, one feels judged. Hearing impairments are met with laments. This keeps people from reaching out to an audiologist in time,” says Dr Sanjay Gupta, a Delhi-based otolaryngologist.
He once had a patient, a 13-year-old boy, who refused to take treatment for his hearing disorder. Aarav Mehrotra (name changed) couldn’t hear sounds below the range of 25-40 dB. This had led to a speech delay when he was younger. He was constantly teased in school. “Mehrotra’s father brought him to see me but he howled every time I tried to check him. He was inconsolable when I suggested corrective surgery. Aarav denied having any hearing issue. His parents took him back, helpless.”
They returned eight years later, reporting a further deterioration, shares Gupta. The boy was taken into surgery but the damage was irreversible. The best way to avoid situations such as these is to get infants screened as early as possible, Gupta suggests. “It should ideally be done before they turn a month. If required, a hearing aid should be placed before three months. By age one, corrective interventions can be looked at,” says Gupta.
Stigma is a parasite that feeds on people’s insecurities. “It keeps them from an early detection and hence, prevention,” says Kochi-based sociologist Kanchan Nidhi. “There is a deep fear of isolation, of being shunned. This is what happened with Aarav. The bullying in school got the better of him. He felt he needed to resist any attempt at getting better because by denying that he had a problem, he felt ‘normal’.”
Let’s get down to the matter
There are three operating tools for hearing-related stigma. The first is self-perception. “People think of themselves as ‘incomplete’ if they cannot hear. The second is media projections. People with
all kinds of disability, including hearing, are underrepresented. Their issues are swept under the carpet, they are disenfranchised and they never make it as the face of big brands or labels. The third is the growing culture of judgement. Deafness is compartmentalised and mocked, leading to criticism and shame,” says Gupta.
You need to hear
Hearing loss is one of the most common sensory deficiencies. More than 900 million people will have a permanent disabling hearing impairment by 2050. But is the Indian healthcare infrastructure ready to tackle this challenge? The short answer is no. “Rural areas are grossly underprepared. There aren’t enough treatment centres and the ones that are in existence have outdated testing apparatus. Shockingly, the ratio of audiologists and audiometricians to the population is 1:500,000, according to the Indian Journal of Community Medicine,” says Gupta. The instruments for screening are expensive, which is why hospitals in tier two and three cities don’t stock them. The commonly used ones cost anywhere between `4-20 lakh.
Way forward
“The focus needs to shift to early identification. Ear care services need to be provided more rampantly. We need technology to speed up interventions. We need solutions to equipment-related shortages. Training personnel to effectively rehabilitate persons with hearing disorders is imperative,” says Mumbai-based ENT specialist Ritu Mahajan.
We simply need more manpower to tackle the epidemic of hearing loss. India doesn’t have enough audiology infrastructure at the district and village level. “There just aren’t enough ear health check- ups either. Screening facilities are few and far in between and most of them are for newborns. Even the awareness drives need to be imaginative so they can drive in traffic,” says Mahajan.
Hope someone is really listening.
BE ALL EARS
One in four people will face hearing loss by 2050 (WHO)
Lack of human resources is one of the biggest concerns with regard to the healthcare system.
At least 700 million will require access to ear and hearing care and other rehabilitation services (WHO)
Among low-income countries, about 78 percent have fewer than one ENT specialist per million population; 93 percent have fewer than one audiologist per million; only 17 percent have one or more speech therapist per million; 50 percent have one or more teacher for the deaf per million (WHO)
The ratio of audiologists and audiometricians to the Indian population is 1:500,000, according to the Indian Journal of Community Medicine
Close to 60 percent of hearing loss can be prevented through measures such as immunisation in children but early detection is not done given the stigma around the subject
“People think of themselves as ‘incomplete’ if they cannot hear. People with all kinds of disability, including hearing, are underrepresented. Their issues are swept under the carpet, they are disenfranchised and they never make it as the face of big brands or labels. ”
Dr Sanjay Gupta, otolaryngologist, Delhi