Global Doc: Listen

Author: Dr. Vincent DeGennaro Jr. ’02

The first time I heard about the work of the Starkey Hearing Foundation, I chortled arrogantly, quite nearly scoffed, saying, “That’s nice,” in a patronizing tone, thinking that I knew better.

They’re giving out hundreds of $5,000 hearing aids to children in poor villages in Africa? Why spend so much money on electronic hearing aids when their siblings may be suffering from malnutrition? There has to be a better way. Then I started thinking about how people deserve access to all health care — like with intensive care units, cancer treatment, emergency medical helicopters and hearing aids — regardless of where they live. I started thinking about all of the people who would benefit from the hearing aids: Children born with hearing impairments who would otherwise be isolated by an inability to communicate with their families and teachers; the elderly whose hearing has faded over the years, increasing the isolation that often occurs with advancing age; entire families with genetic hearing loss who could be ostracized from the community and unable to participate in the local economy.

In a developing country, a school child who cannot hear cannot learn. They are often placed in schools for mentally retarded children, if they attend school at all. A hearing aid can mean the difference between a child finishing high school and never attending school at all.

Electronic hearing aids have been employed for over 100 years, yet vast swaths of the world’s population have no idea that the devices even exist. Despite the massive technology crammed into the tiny frame, hearing aids are a relatively simple fix to a widespread problem. No medication or surgery has such a high success rate, or such a permanent impact.

I recently traveled to Minneapolis for the annual So The World May Hear Awards Gala, learning all about the business of hearing aids in the process. A skilled audiologist using a video otoscope professionally removed copious amounts of wax from my inner ear, a detestable thing to watch on a screen in front of you. They tested my hearing with successively higher frequency tones, decreasing the volume until nothing was audible. Not surprisingly, years of rock concerts and dance clubs have taken a toll on my high frequency hearing, but nothing functionally limiting yet. We toured the factory where teams craft the hearing aids to be sold or donated abroad. A bright light shined over the workshop, illuminating the spotless white workstations of the employees, who were diligently toiling over a device the size of a pea. Down the corridor, the repair shop sat ready to repair any model of device sold or donated in the last decade. In the back, deluxe 3D printers encased in delicate glass doors slowly poured layer upon layer of flesh-colored plastic, making a custom mold for the ear of one specific individual.

Starkey’s goal is to distribute one million hearing aids in poor countries, and poor areas of wealthy countries, this decade. It’s an ambitious target, but they’re already well ahead of the pace. They distribute thousands in short trips to developing countries and have permanent teams on the ground that provide follow up for simple fixes such as replacing batteries, changing cords or turning up the volume. The implementation model has had startling success — a year later, over 90 percent of the hearing aids are still in service without further intervention.

Throughout the gala weekend, I was welcomed into a community that I hadn’t previously known existed. I learned to speak slowly and enunciate in loud environments. Don’t raise your voice directly into the ear of your friend, but look them in the eye and allow them to read your lips, much more useful in a crowd. I may be able to hear better, but without question, they are able to listen better than I do, taking cues from body language, reading lips and facial expressions. The gala was a three-day party, but also a celebration of a lifestyle, embracing the different abilities of each person there. Those in attendance were united not by a deficit, but by a common form of communication.

I spoke to a number of celebrities with hearing loss, people that I never would have suspected before — athletes, actors and politicians. They all support the Starkey cause because, in addition to altruism, they understand firsthand the effect that hearing loss can have on a life or a career. President Bill Clinton has worn hearing aids since 1997 and has been a supporter of Starkey Hearing Foundation for years, accompanying the audiology teams on their missions to distribute devices abroad.

A parade of celebrities, dignitaries and humanitarians graced the stage on the big night. Hillary Clinton, Desmond Tutu and Forest Whitaker all delivered moving speeches. Two gentlemen on opposite sides of the Palestinian-Israeli conflict commiserated on the loss of their respective children and exhorted us all to make efforts to end the carnage. Throughout the night, musical acts Rob Thomas, John Legend and Sammy Hagar serenaded our ears — although Sammy rocked so hard that many people turned down the volume on their hearing aids.

Hearing aids don’t save many lives, but they certainly save patients from a life of social isolation and missed opportunities. I witnessed a child hearing clearly for the first time in Yankee Stadium, at a Starkey fitting for the underprivileged children of the Bronx. Nothing can quite prepare you to bear witness to the moment when a child hears what the world sounds like for the first time. Having witnessed the event dozens of times in person and on videos, the sensation of awe and wonder that I experience vicariously through the patient never fades. I’m proud to be working with the Starkey Hearing Foundation, hoping that together we can reach every man, woman, and child in Haiti with hearing loss.

Vincent DeGennaro is an internal medicine doctor and a global public health specialist at the University of Florida’s Division of Infectious Diseases and Global Medicine and works half time in Haiti with the nonprofit Project Medishare. See his An American Doctor in Haiti blogs.