The number of cases of people with hearing problems is on the rise. The University of Santo Tomas Faculty of Medicine and Surgery said that in the Philippines in 2020, those with moderate to severe hearing loss are at about 15 percent.
Deafness can seriously affect both children or adults, like learning and emotional development for kids, loneliness, stigma and social isolation for adults, and higher risk factors of dementia for the elderly.
So, how do others know if a child, an adult or elderly has hearing problems? Moreso, how should other people act?
During the recent webinar “The Silent Epidemic of Deafness: Dumarami ba ang nabibingi” organized by the University of the Philippines, together with UP Manila NIH National Telehealth Center and in cooperation with UP Philippine General Hospital (PGH), Dr. Charlotte Chiong, Dean of the College of Medicine, University of the Philippines Manila, said yes when asked if there is a rise in the number of cases of people having hearing problems, and this has gone unnoticed because of the still-raging pandemic. “What we wanted to share to everyone is how does deafness happen and what we can do about it.”
A global state of deafness that’s unheard of
The World Health Organization (WHO) said that last 2019, 1.5 billion people globally were having hearing loss problems, and by 2050, this will almost double to 2.5 billion, or about one out of four people. Over a billion young people, on the other hand, are at risk of avoidable hearing loss due to exposure to loud sounds commonly associated with recreational use of devices like music players or game consoles, while about 200 million people have chronic ear infections that can be prevented or treated, based on WHO estimates. In the Philippines, the prevalence of chronic ear infections or chronic otitis media is at 4 percent, one of the highest in the world. “We really need to do something about it today to prevent it from happening because it’s going to be a staggering problem,” Dr. Chiong said.
This problem on hearing loss is also an expensive one. According to a study, Dr. Chiong said, almost US$1 trillion were lost due to unaddressed hearing problems globally in 2020. It was also learned, she said, that an additional annual investment of US$1.33 per capita by governments can increase coverage of ear and hearing care services up to 90 percent that can benefit 1.3 billion people, with a return of about US$16 for every dollar invested in the next 10 years.
So what is hearing loss?
People with normal hearing can hear about 25 decibels, while those with mild hearing loss can hear only about 40 decibels, and the threshold of about 60 decibels is classified as moderate hearing loss, and above that can already be described as suffering from severe or profound hearing loss.
Dr. Chiong pointed to a graphical representation she called “speech banana.” In order for a child to learn how to speak, the child must hear all the vowels and the consonants within the “speech banana,” from the low frequency of about 125 to 250 cycles per second up to about 8,000 to 10,000 cycles per second. “If a child has hearing problems, let’s say in the high frequency, the child cannot hear the ‘s,’ ‘sh’ or ‘th’ sounds, which may result in a mumbling speaking pattern or bulol in Tagalog. So it is important for a child to hear words and sounds so they can develop their own language,” Dr. Chiong explained.
The ear can be examined using an otoscope, others via a simple penlight, or the ear can be pulled outward or backward to straighten the ear canal to be able to see if there’s a discharge, ear wax (“tutuli”), or if the ear drum is punctured. “Back in 2003, we already taught nurses in schools how to use a tuning fork, which produces a specific sound, and how to validate its use so as early as 2006 or 2007, we conducted a mass screening and found out that many children have hearing issues. School children who are not doing good in school may not necessarily mean they are incapable of learning but may have hearing problems and should be supported, especially during this pandemic.”
She also advised against the use of Q-tips or cotton swabs (cotton buds to many) that will push the ear wax further inside the ear, which may cause impacted wax or “cerumen.”
Dr. Chiong also pointed to the “1-3-6 Goal of EHDI” or Early Hearing Detection and Intervention. If an infant fails in the newborn screening, this should be confirmed if a child has mild, moderate or severe hearing problems using an Auditory Brainstem Response (ABR), and there should already be intervention by the time the child turns six months old using a hearing aid or through speech therapy.
For the elderly, Dr. Chiong said age-related damage is the single biggest cause of hearing loss. In the Philippines, more than 50 percent of people 65 years old and above have hearing loss, which is one of the biggest associated factors for dementia and Alzheimer’s Disease.
What do we do now?
She said the high cost of inaction and unaddressed hearing loss issues will cost the world economy about US$980 billion annually. “There’s a need for effective intervention all throughout the life span of people, for newborns, young adults, people who are working, and of course for older people,” she said.
Dr. Chiong also urged people like mothers to learn about Republic Act 9709 or the “Universal Newborn Hearing Screening and Intervention Act of 2009,” which also helped create the National Hearing Screening Reference Center (NHSRC) at the UP Manila. Mothers, she said, should bring their children to an accredited newborn hearing screening facility to check if their child has hearing problems so early intervention can be done.
She also reported that at the PGH, the Philippine Health Insurance Corp. (PhilHealth) provides access to free hearing aids for children from newborn up to 18 years old, where they can also avail of speech therapy services, which PhilHealth pays under the “Z Benefits” package. “This is still under a pilot stage but people who need testing can come to the PGH so they can be assessed by social workers and how PhilHealth can help them.”
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