Health

Why Nigerians neglect auditory health, stigmatise deaf people’

•Urges governments to establish newborn-hearing screening programmes

•Local research shows strong link between early onset of dementia, hearing loss

•Warns health professionals on how indiscriminate use of antibiotics fuel condition

You emphasised the need to enhance the drive for the implementation of auditory health in Nigeria and Africa and you want policymakers to change the narrative of hearing loss and deafness, can you tell us more?

Definitely, Nigeria is a very noisy place. I believe Africa as a whole is very noisy and we do not take good care of our hearing health, let alone our health in general. People do not understand the effect and impact of hearing loss and noise pollution to our hearing. Meanwhile, noise pollution causes permanent hearing loss. Noise pollution comes from honking of cars, generators, people that work in factories, construction workers, civil electrical and mechanical engineers as well as the vulcaniser by the roadside that are not using hearing protection.

Prolonged exposure to noise pollution leads to permanent hearing loss that cannot be reversed with medication. When you have a hearing loss, not just in terms of noise pollution but hearing loss as a whole, it is like when you cut an egg, you cannot put it together again because it is broken. That is how the ear is, once you damage your ears, taking medications cannot repair them but they could be managed by using hearing protection and aids among other things. The situation can only be managed; it cannot be healed completely.

Now, we know noise pollution does cause hearing loss not just in adults but also in children. In children, you are already creating an environment whereby they miss out on education, good jobs and they will actually lag behind compared with those that have good hearing. Most children that are not doing very well in schools, could probably be due to a particular type of hearing loss. There is a need to educate ourselves that hearing health is very important. Hearing is as important as any sense organ of the body. I saw a clip where they asked a blind and deaf lady which of her senses she would rather have back, her sight or hearing? She said she would rather have her hearing back because without hearing one becomes very isolated and as such can easily fall into depression. Whereas, with sight people can see that you are blind but when you are deaf people cannot see it. Hearing loss is a hidden disability.

What is your primary aim of spreading hearing awareness?

I actually moved to Nigeria in 2014, for my National Youth Service Corps (NYSC) and I saw the impact of hearing loss. Going to places like Coker in Aguda Local Council, Makoko and even in NYSC camp at Ipaja. I saw that people do not understand what it is and deaf people are stigmatised. We need to change that term deaf and dumb, they are not dumb they are just deaf. In Western world they don’t use the word dumb anymore, it Is only deafness or out of hearing.

I met a medical doctor in Lagos some time ago, who introduced me to a family that needed hearing aids for their child and obviously they couldn’t afford them because they are very expensive. They didn’t know what to do, nor did they know where to start.  I gave them free hearing aids and from there I met other people, and started going to different local councils, educating people about hearing and from one person, several persons started speaking out about those who are faced with such challenges. They started asking questions about what can be done to prevent it. So, I felt the need to do something not just within Nigeria but in Africa because of the huge gap between those with hearing loss and those with good hearing.

I feel the community of the deaf is being neglected and isolated by everybody. Once we hear someone is deaf, we automatically just ignore them and feel like they are less important than we are, whereas when we see someone that is blind, we are a bit more compassionate because we can see it and that is how I actually birthed Earcare Foundation.

My Uber driver had a hearing loss, he was like I am the first person that ever noticed. His speech was blurring. I gave him a hearing aid because I knew he couldn’t afford it. I was doing that for a few years. I was trying to lobby the Lagos government at that time between 2014 and 2017, but Nigeria politics played out and I couldn’t do much, so I went back to England.

I felt I needed a strong backing and that was when I approached the World Health Organisation (WHO). I partnered with them on Earcare Foundation. We are not just looking at Nigeria, we are looking at Africa as a whole. We want to help, we need a middleman which is what I am between WHO, Nigerian government and other Africa governments as to how we can help, and how to make sure that it is not a short term help but long term. We want it to be sustained by government and self-sufficient so that when we withdraw, you can actually continue as a nation. That is how Earcare Foundation came to be.

How has the journey been?  
The journey has been very difficult, a beautiful roller coaster and in terms of Nigeria, I had to put a pause because I was not getting anywhere. It broke my heart because I am a Nigerian first and that is when I started reaching out to other African nations like Kenya, Malawi, Zambia among others and I formed a good bond with other clinical audiologists in those nations. For example in Zambia, for a long time they had only one audiologist, I was able to push the agenda within Zambia. I have colleagues in Rwanda that we discuss how we can help our people to bring this to the fore. The governments are responding more, I believe it is easier to work with the Eastern Africa than it is to work with the Western Africa policymakers. I submitted proposals to the Federal Government to help but it ended up being that someone else has hijacked it for selfish interest.

What have been the challenges in meeting the objectives of establishing Earcare Foundation?
Financial definitely, because most bills were coming from my personal pocket especially when I was not employed. Secondly, one of the major equipment that I use to assess patients was stolen at a community event I hosted. So, that was a huge setback because that was the main equipment I needed to assess people. When I thought I had good Samaritans around me, someone actually stole it, so I couldn’t do anything for months. Yes, you have people that appreciate what you do within the community, but you also have people that want to take advantage of the situation.

So, what has been the response of Nigerians in terms of giving help?
The response has been amazing. All in all, I can say in the last couple of years that I have been doing it, I have impacted over 100 people. The joy is not just for the hundred people but their families. The response personally has been emotionally overwhelming because I feel like as much as I am meeting with brick walls with the government, those little impact makes me believe that I am in the right way and path. So, I feel I need to keep pushing, and keep doing what I am doing, and when you know it is not all in vain. The responses I get from the communities have been overwhelming for me and I just feel like I am actually achieving the purpose right now even though I am not receiving any financial gains but I am actually doing what I am meant to be doing, regardless of the backlash, delay, and politics.

You have been talking about government and policies, what are the policies you want the government to look into?
There is a need for government to establish the concept of newborn-hearing screening programmes. This is a programme whereby every new born in Nigeria has to be tested for hearing, the way they test if a child is jaundiced and things like that. A child needs to be tested for hearing and if a child has a hearing loss, what next? How do we empower the parents to understand that there are managements for their child and he or she has a bright future ahead? So, if a parent is being told now that his or her child has a hearing loss, then there is a gradual step, the primary healthcare goes to the secondary healthcare, going on to the tertiary healthcare, going to Ear Nose and Throat (ENT) expert, have follow ups, have hearing aids and the child is able to adapt from learning speech development. When a child has a hearing loss, there are lots of speech delays, but with learning speech development the child will be able to speak and will be able to hear because when you cannot hear, you cannot speak. Once a child can speak and hear, then they can actually go to Nursery, Primary and Secondary schools and proceed to the University, independently. This makes a lot of people employable because if they are not employable, it has a financial effect on our economy. Once someone is employable, taxes are taken and that also goes back into the community but if we have lots of unemployed people, then the economy is not going to grow.

Another factor is accessible hearing health. We have the right people that can actually see these patients and provide the needs that they want in terms of hearing assessment, fitting of hearing aids. The other factor is the elderly ones because not just noise pollution, but the older we get our body ages, the hearing ages. In Nigeria, whereby there is noise pollution, you are sleeping and by your bed side there is generator outside your window, that alone adds to the impact of you having hearing loss and then imagine if you work in a construction environment and you are not wearing ear protection, that also adds having earlier onset of hearing loss and lots of other factors.

So, how do we address these factors, how can we help the elderly people to hear well? With the research that we have done, there is a very strong link with early onset of dementia and hearing loss. So how can we help our ageing population, for them to still be able to relate with their loved ones? Also, we have to look at industries that are associated with noise. For instance, construction and manufacturing industries, are their staff members having annual hearing assessment (those that actually are exposed to noise), are they wearing hearing protection and are they of good standard? Is the company taking responsibility for its staff members that have direct exposure to noises? What they doing? And that is also another way for the government to generate funds.

Governing bodies would go to construction companies unannounced to ensure that all the staff members that are working in the factory are being protected. Meanwhile, people need to know their rights with their employers.

Is there statistics for those that have hearing loss and those that do not?
The WHO (2017) estimates that approximately 360 million people worldwide suffer from severe hearing loss and approximately 1.1 billion young people (aged between 12 and 35 years old) face hearing loss due to noise exposure. We are using earphones more often and making them very loud.

You mentioned that there should be a difference between those that are deaf and not dumb and those who are deaf, can you talk more on this?
A deaf person is not dumb, they just cannot hear. It is just like saying a blind person is dumb because they cannot see. A deaf person cannot hear but they can still communicate. What we fail to understand is that within the deaf community they have sign languages, so they can still communicate. But dumb means you have no understanding of anything, you cannot communicate, just like someone who is incapable of doing anything. Whereas, a deaf person can still go to work, if they are given access to work; they can still do things, they can’t just hear you. But if you write it for them, they can read and understand what you are asking them to do. So, deaf and dumb is to be taken away because they are far from dumb. Lots of them are even more intelligent than some of us that can hear. It is a derogatory term, and it is just to suppress them.

You mentioned noises from generators and other noises we are used to in Nigeria, but these are things we cannot do without. If we don’t have power, we need to use the generator. Is there anything you think the government can do to address all these challenges.

What is your advice to the government and the public on how to protect and improve hearing?
Our parties (Owanbe) need to be regulated because few people have high hearing loss from the noise from the speakers. That needs to be managed by the government, if you do not abide by the WHO recommended noise level (decibel), there will be sanctions. Lagos State for example is doing well on regulating noise pollution. Its programme, headed by Dr. Dolapo Fasawe, is actively trying to ensure that things like that are being implemented and they do shut down venues, when people complain. Many people don’t know that they can report such parties and sources of noise pollution to the state government and they will shut them down.

Nigerians need to be accountable, we can’t just rely on our government alone. We need to speak out, we need to be able to go back into our laws and understand our rights and push to enforce them and that will probably enable the government to do what they ought to do as well.

And in terms of the private sector, those that their industry actually generate noise pollution need to provide the right devices for their employees, because there is no how they are not going to be exposed to this noise. They need to provide the right devices for their staff members, hearing protections for their staff members to protect them while they are in that environment. This is where the government comes in, in terms of making sure that it is enforced as well as accessing hearing aids. Pilots, for instance because of the job they do, they have hearing tests regularly; they also have hearing protection. So, why can’t it be enforced in the construction, engineering or manufacturing industries?

Healthcare providers need to understand that there are side effects in the abuse of antibiotics that cause hearing loss. For example, in one of the outreach programmes, which we did at Coker-Aguda in 2015, we educated the health care workers- the doctors, nurses and healthcare assistants about the abuse of antibiotics and the effects. They need to understand that antibiotics should not be recommended for every disease because they have damaging effect to hearing.

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