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Hearing loss a growing problem – unless we act

Inauguration of the National Conference on Empowering Deaf through Indian Sign Language, organised by Indian Sign Language Research and Training Centre (ISLRTC), in 2017. Image credit: Ministry of Social Justice & Empowerment (GODL-India) [GODL-India (]. This file is a copyrighted work of the Government of India, licensed under the Government Open Data License – India (GODL). This file or its source was published by Press Information Bureau on behalf of Ministry of Social Justice & Empowerment, Government of India under the ID 100034 and CNR 94646. (direct link)
Today we marked World Hearing Day, an observance which comes at a time when the number of people affected by hearing loss is poised to increase significantly worldwide unless action is taken.

“Globally over 430 million people experience disabling hearing loss, a number that could grow to nearly 700 million by 2050,” explains the World Health Organization (WHO). “When unaddressed, hearing loss poses a significant challenge for all age groups, hindering language development, communication, cognition, and limiting access to education, employment and social interactions.”

Aptly, the WHO stresses that “the number of people living with unaddressed hearing loss and ear diseases is unacceptable” given that “many causes that lead to hearing loss can be prevented.” For example, it “estimates that sixty percent of hearing loss among children is due to preventable causes; and that over a billion adolescents and young adults are at risk of avoidable, irreversible hearing loss due to the common practices of listening to music at loud volumes and for prolonged time.” 

A school for the deaf in Baghdad, Iraq. There are just 388 schools for the deaf in India. Image credit: Peter Rimar.

In India, the plight of those affected by hearing loss goes unheard. Efforts to support them are impeded by a sizable data gap, lack of access to resources, and social stigma. As previously reported by Health Issues India 

“Exact figures as to the number of people living with hearing impairment in India vary. The Joshua Project estimates that more than ten million Indians are deaf. The National Association of the Deaf, meanwhile, posits the number of deaf India to be eighteen million. 

“A 2016 study estimated that 63 million Indians experience significant auditory loss. It goes on to state that more than 100,000 Indians are born with hearing deficiency every year….The 2011 Census estimated 1.3 million Indians to be living with hearing impairment – a significantly lower figure than other estimates, accounted for in part by outdated statistics but arguably also indicative of the chronic underreporting of a number of conditions.

“Many challenges stand in the way of India’s hearing-impaired individuals fulfilling their potential. India’s hearing-impaired population faces much by way of social stigma and discrimination. This is a challenge also encountered by those living with a plethora of other conditions, such as mental health disorders and infectious diseases such as leprosy. This highlights the extent to which prejudice can act as a barrier to many Indians accessing support for their health. 

“Meanwhile, the lack of facilities for the hearing-impaired in India makes everyday life difficult, from lack of signage in public spaces to challenges in school and the workplace. Taking education as an example, there are just 388 schools for the deaf in India and the absence of sign language interpreters in many classrooms highlights how much of a struggle schooling can be for deaf children. Consequently, as YourStory reported in 2016 that “99 percent of hearing-impaired people are either uneducated or drop out after Class VI or VII, because they are not able to cope.”

The new figures released by the WHO are abominable in terms of their scope and the failures they represent. Its first World Report on Hearing outlined that “nearly 2.5 billion people worldwide ─ or one in four ─ will be living with some degree of hearing loss by 2050, warns the [WHO’s] first World Report on Hearing, released today. At least 700 million of these people will require access to ear and hearing care and other rehabilitation services unless action is taken.”  

Such numbers are staggering, appalling, and heartbreaking. For the individuals, the magnitude of the effects are sweeping as WHO Director-General Dr Tedros Adhanom Ghebreyesus points out. 

“Our ability to hear is precious. Untreated hearing loss can have a devastating impact on people’s ability to communicate, to study and to earn a living,” he said. “It can also impact on people’s mental health and their ability to sustain relationships. This new report outlines the scale of the problem, but also offers solutions in the form of evidence-based interventions that we encourage all countries to integrate into their health systems as part of their journey towards universal health coverage.”

Diagram of a cochlear implant. Image credit: BruceBlaus [CC BY-SA 4.0 (]
This is not to say those affected by hearing loss are incapable – those affected are more than capable of achieving great things across a broad spectrum of fields from science to the arts. But it is important to note that ensuring those affected by hearing loss are given the opportunity, without the hindrance of discrimination and lack of resources. For India, this is a message it must take home. As the WHO states

“Lack of accurate information and stigmatising attitudes to ear diseases and hearing loss often limit people from accessing care for these conditions. Even among health-care providers, there’s often a shortage of knowledge about prevention, early identification and management of hearing loss and ear diseases, hampering their ability to provide the care required. In most countries, ear and hearing care is still not integrated into national health systems and accessing care services is challenging for those with ear diseases and hearing loss. Moreover, access to ear and hearing care is poorly measured and documented, and relevant indicators are lacking in the health information system.”

The report outlines how lack of routine immunisation is a major preventable cause of hearing loss among children. As the WHO outlines, “almost sixty percent of hearing loss can be prevented through measures such as immunisation for prevention of rubella and meningitis, improved maternal and neonatal care, and screening for, and early management of, otitis media – inflammatory diseases of the middle ear. In adults, noise control, safe listening and surveillance of ototoxic medicines together with good ear hygiene can help maintain good hearing and reduce the potential for hearing loss.” Yet despite the fact that such causes are preventable, health systems such as India’s languish with inadequate health infrastructure being a major impediment to tackling hearing loss.

The objective is not to denigrate those who are affected by hearing loss, nor is it to suggest they cannot lead meaningful, fulfilling lives. But it is important to note that, as Dr Tedros states, “our ability to hear is precious.” Where that gift can be preserved, we must take every route. 

Fundamentally, ear health – as with so many conditions – is about access. Inequitable access to health services and health workers is going to fuel the nearly 700 million who could grapple with hearing loss by 2050. India, among others, must strive towards universal health coverage now. We are more vulnerable than we often care to admit without it. 

The World Report on Hearing can be accessed here.

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