|
|
|
May 19, 2002
REVIEW: Loneliness of silence
A MAN sitting detached from his surroundings in a lonely world of his own is rarely understood. Is he harbouring a faint resentment against someone? Is he angry or shy? Invariably he is stamped out of the mainstream. But his real problem might be his hearing impairment which is rarely understood. It is essentially a preventable disability, even in a developing country. Since it does not stir emotions in an onlooker as blindness or physical handicap do, the problem is not addressed.
Dr Syed Shabih Haider Zaidi, the founder member of Pakistan Society of Otolaryngology, a fellow of Royal College of Surgeons, American College of Surgeons and Pakistan College of Physicians and Surgeons and a WHO consultant on community noise, is a keen writer. He takes up the subject of hearing impairment in his book Deafness in the developing countries, It is comprehensive and thought-provoking.
Coming at a time when there is urgent need for raising public awareness and addressing the problem of hearing disability, this book is most welcome. The causes of deafness, diagnosis, prevention and management, rehabilitation and ethics in otology are the key issues discussed in it. Since the needs are enormous but the resources are inadequate, this book should be of immense help.
Hearing is the sense which is basic to communication. A child relies on it for the acquisition of language skills. Without the gift of hearing a child can be disabled for life if the problem is not addressed in time. An adult who suffers from hearing loss later in life could find himself socially and economically disadvantaged if he receives no help.
Since deafness and hearing impairment are not readily reported and are latent, unapparent, presymptomatic and undiagnosed their prevalence is not estimated. World efforts are now being made to curb hearing impairment in developing countries and several international NGOs have taken up this problem on their main agenda.
It is, however, essential for every country to develop its own plan of action. WHO has formulated the “national plan” under its “prevention of blindness and deafness” programme. Between 1991-95, WHO’s regional offices organized five meetings to increase awareness by facilitating interaction among health workers concentrating on hearing impairment. Several countries participated in the workshops.
In the developing regions it is common to confuse hearing loss, deafness and mental retardation with each other. The media is partially to blame as it usually portrays deaf and dumb people in its programmes as idiots. This creates the social stigma from which the hearing impaired suffer.
The data available in Pakistan is grossly deficient. As a result, policy makers rely on international data to base indigenous policies on. The need to develop a domestic database can hardly be over-emphasized. It is vital for health promotion, specific protection, early diagnosis and prompt treatment, disability limitation, and rehabilitation.
Deafness and hearing impairment have been neglected not so much on account of the apathy of the powers that be, as much as to lack of interest on the part of ENT specialists — 460 in all supported by two audiologists; one speech therapist and approximately 605 ENT beds in the country.
Dr Zaidi observes, “Our ENT surgeons hardly bother to investigate the very reason for the development of the situation demanding their manual skills”.
Since 1995, Dr Zaidi has been holding ear camps with the help of NGOs. So far 21 camps have been conducted, covering a large population from Karachi to Gilgit. He identifies the causes of deafness and hearing impairment to be a discharging ear, communicable infections, such as typhoid, measles, TB, etc. Ototoxicity caused by some drugs, consanguinity, and iodine deficiency.
Community involvement, public awareness programmes, prompt and timely diagnosis, family support, special education and rehabilitation can go a long way towards addressing the problem. Fortunately a majority of people suffering from hearing impairment can be cured. But this is possible, only if the society came forward to help. For instance, if a quota is fixed in jobs for the hearing disabled many of them would be able to lead personally satisfying and socially respectable lives.
Dr Zaidi hopes that someday science may succeed in cloning the cochlea, so as to replace the damaged one through genetic engineering. Thus he dreams of eradicating deafness from the face of the earth.
This book is a must read for all health professionals and people affected by deafness and hearing loss. It should be available in all medical libraries.
Deafness in the developing world
By Syed Shabih Haider Zaidi
Royal Book Company BG-5, Rex Centre Basement, Zaibunnisa Street, Karachi-74400
Tel: 021-568 4244.
Email: royalbook@hotmail.com
ISBN 969-407-253-0 252pp. Rs595
|
|
|
|
