A New Era for Hearing Aid Donation Programs to Samoa

Le résumé fourni par la source

During the first week of August 2023, the ENT Clinic of Samoa hosted the Bay Audiology “Free to Hear Samoa” program, a humanitarian service provided by New Zealand-based hearing service provider Bay Audiology. The Bay Audiology “Free to Hear Samoa” program aims to provide hearing aids free of charge to the people of Samoa, while also building capacity for ongoing care by local hearing health care providers. The program began in 2016, and the Bay Audiology New Zealand team was able to visit Samoa annually until the outbreak of the COVID-19 pandemic. Given the limited availability of local ear and hearing health professionals during these years, the Bay Audiology “Free to Hear Samoa” program was conducted on a “first in, first served” basis, with the Bay Audiology team performing otoscopy, ear health interventions, audiometry, ear impressions, and fitting hearing aids with a temporary ear-coupling dome.Samoan ENT Clinic Team and New Zealand Bay Audiology “Free to Hear Samoa” Team 2023.Hearing aid recipient receiving a demonstration on the use of his new hearing aids.Hearing aid recipient undergoing audiology assessment and hearing aid fitting.The ENT Clinic was re-established at the national Tupua Tamasese Meaole Hospital in 2017 under the leadership of General Surgeon Dr Sione Pifeleti. Australian audiologist Dr. Annette Kaspar joined the team in 2019 and was formally employed by the Samoan Ministry of Health in 2022. At the time of writing (August 2023), the ENT Clinic is also staffed by five ENT nurses. The growth and development of the ENT Clinic presented an opportunity for close collaboration with the Bay Audiology team during the 2023 “Free to Hear Samoa” visit to optimize hearing aid fittings for all attending participants. PREPARATION OF ADULTS REQUESTING HEARING AID FITTING Routine practice at the ENT Clinic for adults presenting with hearing loss is initial assessment with ENT nurses, followed by audiometry and medical clearance for hearing aid fitting. Adults are then referred to SENESE Inclusive Education, a non-government organization whose mission is to support students with disabilities in Samoa; SENESE has also received basic training in supplying hearing aids provided by overseas donors. In preparation for the 2023 “Free to Hear Samoa” visit, Bay Audiology supplied the ENT Clinic with material for taking ear impressions, and this was included in the routine ENT practice. Adults were advised about the “Free to Hear Samoa” program and also referred to SENESE should they wish to obtain hearing aids sooner. At the end of June 2023, impressions for 188 adults were sent to New Zealand for earmold manufacture (N.B. Adults continued to be assessed during the month of July, and ear impressions were kept for collection by the Bay Audiology team during their visit). A total of 213 adults were prepared and scheduled for the Bay Audiology team visit. There were 119 male and 94 female participants. Ages ranged from 19 to 94 years (mean = 69, median = 71), with 80.3% of participants aged 60 years and older. A disabling hearing loss was measured for 87.7% of participants (N.B. Based on the World Health Organization definition of disabling hearing loss: 4-frequency PTA > 35 dBHL in the better ear). A brief overview found that 111 (52%) were routine symmetrical sensorineural cases consistent with presbycusis, 71 (33.5%) were complex asymmetrical mixed/sensorineural cases for bilateral fitting, 15 (7%) were suitable for monaural fitting only, 11 (5%) were young and/or working adults, and 5 (2.5%) were eligible for a CROS-Aid fitting. A Samoan translation of the Revised Hearing Handicap Inventory was successfully completed by 210 participants, and overall group results found that hearing difficulties had a significant impact on activity participation and socio-emotional well-being for this cohort (mean = 55.7 and median = 64 out of highest possible score 72). The benefit of preparing participants for the Bay Audiology New Zealand visit was that it was possible to investigate special devices for unique cases. Examples include: 1) a young adult with congenital bilateral high-frequency hearing loss, 2) a middle-aged man enquiring about amplification with Blu-tooth capabilities to improve hearing during work Zoom meetings, 3) a senior court judge with high-frequency hearing loss only needing improving hearing for the courtroom setting, and 4) a Reverend Mother needing a hearing device(s) compatible with a wimple. Following ENT Clinic practice, all adults (or their support person) were contacted personally, and an appointment was scheduled for their review with the Bay Audiology team. Given the age group of most of our participants, a scheduled appointment aimed to limit their waiting time. This was also an important infection control measure for this vulnerable age group as the Bay Audiology team visit took place in the hospital environment during influenza season. BAY AUDIOLOGY NEW ZEALAND TEAM VISIT (JULY 31-AUGUST 2, 2023) Over three days, the Bay Audiology Team was based at the ENT Clinic, where 157 people were fitted with custom-fitted earmolds and hearing aids, and 113 were walk-ins. The total number of people helped with hearing aids during the visit was 270. There were also an additional six hearing aids pre-programmed for people unable to attend their scheduled appointment. Three audiologists performed hearing aid fittings and another two team members performed care and management of hearing aid sessions; they were supported by the SENESE team. The Samoan ENT nurses worked alongside the ear nurse from Bay Audiology who saw 97 people for a variety of services including ear hygiene and impression taking. This collaboration created numerous training and capacity-development opportunities: Upskilling on current best-practice techniques and instruments for common ear pathologies (i.e., earwax removal, foreign body removal, aural toilet). Taking ear impressions to enable hearing aid fitting with earmolds. Training in the use of a suction machine that had previously been donated to the ENT Clinic (but had remained unused). Different sterilizing techniques for various ENT instruments. Discussed the option of triaging patients during ENT outpatient clinics (i.e., patients seen based on the severity of presenting complaint rather than “first in, first served”). Routine swabs for patients with chronic otitis media and active discharge to improve diagnosis and management. FOLLOW UP The decision was made that, as per previous years, SENESE would follow up with all participants in the 2023 “Free to Hear Samoa” visit. The visiting team from Bay Audiology NZ provided all the resources required for the ongoing care of program participants, including hearing aid batteries. An estimated additional 200 hearing aids were donated to enable free hearing aid fitting for adults who had been unable to attend the Bay Audiology New Zealand visit, including both people who had been prepared by ENT Clinic as well as new presentations. Numerous resources were also provided for the ENT nurses to improve their daily management of presentations to the ENT Outpatient clinic. FUTURE DIRECTIONS The relationship between the ENT Clinic of Samoa and Bay Audiology New Zealand has been strengthened from the 2023 visit. The Bay Audiology team will continue to support the people of Samoa in the future where possible, and the ENT Clinic will be equipped to fit, maintain, and do basic repairs for hearing aids throughout the year. Acknowledgements: The authors would like to acknowledge the ENT Team (Dr. Sione Pifeleti, Head of Department; Dr. Maria Ah Kuoi, ENT Registrar; Abraham Fatupaito, ENT RN; Marjorie, ENT RN; Annie Lilo, ENT RN; Serita, ENT RN; and Faith, Administrative Officer), the New Zealand Bay Audiology Team (Jasmine Gibbins, Audiologist; Shantelle Chandra, Audiologist; Chloe Allen, Audiologist; Cherie Hawkins Yoi, Ear Nurse; Serra Fisher, Support; Nicola Sullivan, Support; and Ki

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.