Jumla 12/2014

Family with infections and hearing loss in mother (25) and daughter (5), and profound loss in her son (8).


This delightful family shocked us with their hearing problems. Mum Asa (which means hope) was 25 years old. She has moderately severe nerve deafness in both ears and for that reason had not been able to go to school. Her young daughter Sonam aged 5 years not only had a similar hearing loss from birth but also had a history of frequent episodes of ear discharge on both sides, starting in infancy. Her older brother Sunil, aged 8 years was in a worse state, he appeared to have no hearing at all in either ear from birth and similarly also suffered regular attacks of otitis media and discharge. His only speech was the word ‘mummy’. For him we could only recommend a deaf school, but we could see that the family would not have the resources for the travel and boarding that would be needed. They came with Grandad, who had good hearing for his age, and dad was off in India working, we were told that he could hear. We were able to fit Asa and Sonam with hearing aids, at first Asa was reluctant to be fitted, as even in remote Nepali mountain villages, girls do worry about their appearance! But seeing her daughter’s response she asked to have an aid herself. The children were a delight to watch playing. We gave them some knitted teddy-bear toys and they immediately strapped them on their backs as the locals do when carrying their babies to the fields. There was a lot of laughter and giggling, we just wished we could do more.

Their records with audio results:



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.