Dr Desai wrote at the request of the District Governors of India Rotary District 3050 & 3060
Deafness is one of the commonest congenital disabilities in the world. It is estimated to be 30 times more common than other congenital defects, such as sickle cell anemia, cystic fibrosis, hypothyroidism, etc.
As reported by WHO, there are about 250-300 million deaf people in this world, 2/3 of them live in the underdeveloped nations, of these India has the largest share.
From a recent report in the India’s leading daily newspaper, The Times of India, Jan 23, 2007;
“That one out of twelve (1/12) persons in India has hearing loss. The problem is receiving political attention. The health ministry has launched its project to focus on The Prevention and Early diagnosis of deafness and not the least, treatment of ear infections and other diseases causing hearing loss ………”
This campaign was introduced at the end of Jan 2007 in 25 districts and 12 states of India.
If the above is implemented by the Health Dept., i.e. MMR vaccination and early detection of Newborn Hearing loss and intervention (EHDI), India will have a great reduction in Deafness, Blindness and other congenital defects within 10 years.
EHDI will also result in the marked improvement of the EDUCATION of the child with hearing loss, along with the treatment of the Deaf, providing them with hearing aids and other treatments as indicated.
As the subject of Deafness and prevention is so large, including the care of the ear and ear infections, Project Deaf India plans to focus on:
1) MMR vaccination to reduce Deafness and Rubella vaccination to prevent CRS syndrome (congenital Rubella syndrome) in their offspring.
2) EHDI= early detection of newborn Hearing loss and Intervention. During the past few years, accurate computerized equipment for newborn screening is available.
MMR Vaccination for India:
The introduction of MMR vaccination in developing nations results in definite benefits—A great reduction in deafness, blindness and other congenital defects. MMR vaccination is given in two doses, the first at 12 months and the second dose at 4-5yrs of age, before entering school.
Early Newborn Screening of Hearing Loss and Intervention (EHDI):
Historically, EHDI was implemented in the USA, by Dr. Marion Downs, as early as 1964. Dr. Karl White and others made it a universal project since 1994 and pushed for mandatory legislation throughout the USA.
Why is the Early detection of Hearing Loss so Important?
Initially, babies who are born with hearing loss do not look or behave any differently from babies who are hearing. However, undetected and untreated hearing loss has serious consequences on the acquisition of language skills as well as cognition and emotional and social development. Deafness separates people from people. The first 6 months of a baby’s life are very crucial for the development of speech and language. Evidence shows that to be most beneficial, screenings should be done before discharge from hospital with diagnostic evaluation completed by 3 months of age. Intervention should be started by 6 months of age.
According to Kalyani, a Pune audiologist, these screenings can be synchronized with the national vaccination plan of India. Infants identified with hearing loss can be fitted with amplification devices (hearing aids) as early as one month of age. These children can then attend mainstream schools.
There is tremendous financial liability to society if the hearing impairments are untreated and undetected.
How can Newborn hearing be checked?
As a result of advances in technology, a newborns hearing can be checked shortly after birth. There are two main techniques for screening hearing in newborns: AABR (automated auditory brainstem response) or OAE (evoked oto-acoustic emission). Both these methods are safe, simple and painless. It takes only a few minutes to complete a screening.
In India, EHDI is being implemented in Mumbai, Chennai, Mysore, Trivandrum and now Goa. It should be started in all cities and villages in India. It is the villages, where most of the population of India resides, EHDI is best coordinated under the national immunization plans for India. In developed countries, every hospital has a screening machine for newborn hearing loss detection before the mother and baby are discharged from hospital. The screening machine is a small handheld, battery-operated machine kept in the nursery.
For India, where the mother and child are kept in hospital for 5-7 days after delivery, we have introduced a screening method suited to the country. Namely, and audiologist or Anganwadi health worker trained in the screening of newborns transports the screening unit from hospital to hospital for screening (the unit is the size of a laptop computer). This way he can screen about 100 babies a day. Those who fail the test are then referred to an ENT doctor for further confirmation of hearing loss and treatment; surgery, hearing aids, or cochlear implants.
India has a great shortage of audiologists and more so of pediatric audiologists, however an Anganwadi health worker can help fill this gap.
Suggestions for Improvement of Deafness in Gujarat:
The state of Gujarat has about 60 million people, with most of this population residing in villages, with agriculture as their livelihood. They have fewer facilities of the modern lifestyle, medical/hospitals, schools, pure water & better hygiene and sanitation. It is estimated that deafness is diagnosed at 4-6 years of age, resulting in the loss of the ability to learn language or communication skills. The child is called DEAF AND DUMB. No special deaf educational facilities are available in the villages. The deaf child lives an isolated life, does menial jobs or is given to an orphanage. In the cities the deaf often beg on the streets.
If Gujarat’s female population is vaccinated with Rubella or MMR (measles, mumps and Rubella) vaccine then deafness and blindness can be drastically reduced, (50% reduction!).
In India, both vaccines are locally produced in Pune, and are available for Rs 30 for Rubella and Rs 50 for MMR per vaccine. Although, it is most desirable that the National or State Governments take the responsibility for vaccination, an alternative is that we, as Rotarians undertake the task and achieve success, as we have done for Polio.
It is my desire that all Rotary Clubs of Districts 3050 & 3060 combine their efforts and apply for a 3H Grant from Rotary International. I will also seek the cooperation of several clubs in my District in the USA (District 5320).
The realization of the above projects (vaccination and EHDI) in Gujarat will be an example for the rest of India for the reduction and intervention of deafness.
“EVERY CHILD MUST BE ENSURED THE BEST START IN LIFE—THEIR FUTURE, AND INDEED THE FUTURE OF THEIR COMMUNITES, NATIONS AND THE WHOLE WORLD DEPENDS ON IT”