Basanti Nepali

At the ear camp in Jumla in November we saw a 21 year old man, Basanti Nepali, who had suffered with ear discharge and deteriorating hearing since the age of 5 years. His hearing became so poor that he had to leave school after the 7th grade, aged 12, as he was unable to manage in class. His hearing loss was of great concern to his family who were unable to afford medical care. He was teased at school and in the local neighbourhood and would be in trouble for throwing stones at his tormentors. His profound hearing loss led to deterioration in his speech and his family would resort to sign language to communicate. In addition to his hearing loss he suffered with repeated ear infections which led to chronic disease in the mastoid bone. These infections have the potential to be life threatening and certainly contributed to Basanti’s hearing loss.

The family had in the past sought medical help in Nepalgunj but the hearing aid that was provided was not effective and so discarded.

Jumla is a remote small town in west Nepal. Although it has a small hospital that is bigger and more advanced that found in may other districts, access to some specialised medical care such as ENT is poor. The INF ear camp is able to provide the specialist ear care that Basanti Nepali desperately needed. With his brother and mother he walked for 2 hours to be seen at the ear camp. It was clear that he needed surgery to both ears to prevent the infections that he suffered with causing a real threat to his health. It was only possible to offer surgery to one ear at a time and Basanti underwent his first mastoid surgery and reconstruction of his hearing bones. We can be confident that this surgery will reduce his infections but will not know whether the surgery has led to an improvement in his hearing for a number of weeks and unless Basanti is able to travel to a subsequent ear camp in another area, may never know.

In the developed world, patients with such ear disease would require multiple hospital visits and surgical interventions. It remains a challenge to explain to our patients, that with one intervention, our priority has to be to make the ear safe of infections and whilst we will make every effort to improve the hearing that this is not always possible, though a hearing aid may then be more effective than before.

Deaf from birth and bilateral cholesteatoma, postaural abscess scars