Hearing a problem, and solving it

Air Mercy Services has provided doctors with essential transport and support to deliver specialist outreach services to remote regions in Kwa-Zulu Natal and through-out the country for over 50 years.

By Ntsiki Mpulo

Nombulelo Sojina* cradles her baby close to her chest in a kangaroo mothering-style of skin-to-skin

contact. The child’s tiny head is barely visible under the blanket in which she is swaddled. Two nursing sisters, tasked with conducting hearing screening tests on newborns, enter the maternity ward in which Sojina and her baby are resting. They explain that they need to insert a scope into the baby’s ears to determine whether she has any impairments.

‛Sojina’s baby was born prematurely, at just 30 weeks, and so the screening for hearing impairments is all the more crucial,’ says Ayanda Gina, an audiologist who is pioneering the newborn hearing screening programme at the Newcastle Mother and Child Hospital. The programme, which will help to identify hearing defects in children at birth, is part of Gina’s research towards her doctoral thesis.

She is working with Doctor Yougan Saman, Head of Discipline: Otorhinolaryngology and Head & Neck Surgery at Nelson R Mandela School of Medicine, University of KwaZulu-Natal. Although her training is in audiology, Gina dreams of following in her mentor’s footsteps and becoming an ear, nose and throat specialist.

Dr Saman has been involved with the KwaZulu-Natal Department of Health outreach programme since its inception. He regularly flies with Air Mercy Services (AMS) from Durban to support the doctors based at regional and district hospitals throughout the province. As head of the department, his main focus is to develop the services at these hospitals in order to alleviate congestion at tertiary hospital level.

‛When we started the outreach programme, I travelled to Newcastle Hospital by car,’ says Saman. ‛The three-hour journey was arduous and time consuming. I would drive up in the evening stay overnight, see patients for the day and drive back the following day, taking three days out of my schedule.
‛Now I’m able to make the trip in one day,’ he says. ‛With the support of AMS, we are able to give specialists the ability to work immediately and to develop skills in local doctors.
‛Essentially, this is what I have done with Ayanda. She has assumed more and more responsibility not only because she is keen to learn but because I have been able to impart on her the skills to enable her to drive this programme,’ says Dr Saman.

Gina supervises two enrolled nurses, three in-service personnel and a community service therapist within the hospital’s premises, and conducts outreach missions into the surrounding villages regarding hearing health for children. The World Health Organisation (WHO) estimates that there are 360 million people (328 million adults and 32 million children) worldwide with disabling hearing loss.

The WHO makes a distinction between congenital and acquired causes of hearing loss and describes congenital causes as those that may lead to hearing loss being present at or acquired soon after birth. These include maternal rubella, syphilis or certain other infections during pregnancy (low birth weight or a lack of oxygen at the time of birth) and severe jaundice in the neonatal period, which can damage the hearing nerve in a new-born infant.

In its latest fact sheet, the WHO states that half of all cases of hearing loss are avoidable with primary intervention. It is at this level that the teams hope to make an impact. The aim of the research is not only to identify potential hearing loss at an early stage but also to provide support for families whose children are identified to have hearing disabilities, including psychologist support and school assessment options.

‛If children are screened early enough, they may not need special schools,’ explains Gina. ‛With the right treatment, which may include hearing aids and speech therapy, we are essentially giving children the ability to communicate, which is crucial for their development.’
*Not her real name