Where is the Dominican Republic? This is one of the most common questions we are asked about the project in the Dominican Republic. It’s on the same island as Haiti, near Cuba, in the Caribbean. Santo Domingo is the capital.
In 2001, David Pither met William Hunter of Medical Ministries International and discussed the possibility of Ears Inc. helping MMI to set up a sound proof booth in the DR and train local health workers in audiometry. Later that year, David trained two young men at the Dr Elias Santana Hospital, Los Alcarrizos, in the country’s capital city Santo Domingo, and began setting up a hearing clinic.
In 2002, Melbourne Audiologist Donna Carkeet visited the Dominican Republic to provide further training and assistance to the project. After further discussions with Willie Hunter, she decided to move to the Dominican Republic in 2005 for four years, to help realise the longer term goals of the project, which included the establishment of a high quality hearing clinic, an ear mould making laboratory and technical repair centre, as well as the founding of a two year Audiometric Technician’s Course and a four year Audiometry Bachelors Degree.
“During my first Ears Inc. trip, I felt more like a complete version of myself than ever before. I knew that I would talk to Ears Inc. about dedicating a year to projects in different countries, including the Dominican Republic. After my second trip back to the Dominican Republic, I just couldn’t stay away.” And so commenced Donna’s new life in a very different culture a long way from her home in Sydney, Australia.
UPDATE: January 2014
Seven years after it was established, the project in Dominican Republic is now self-sustainable. All three clinics are running under the management of the local partner and a former graduate or the audiology program is now clinical director of the clinics. The program has experienced ups and downs in the last year but we continue to pray for Donna’s course graduates who work hard in these clinics and on hearing outreach projects.
Donna moved back to Australia from the Dominican with her adopted son late in 2013. She is now working with our partner organization Medical Ministry International on planning and directing the Audiology program in all their centres. After devoting seven years to estblishing and running a high quality audiology service and training program, she was sad to leave DR but continues to provide long distance assistance to her graduates who are now working in Dominican Republic as well as Haiti, Fiji and Ethiopia.
In January, Donna trained a group of hearing screeners to go on outreach teams for Medical Ministry international. These teams will now be able to undertake hearing health screening on all MMI projects.
Donna expects to return to Dominican Republic in the next year to offer support to her graduates and assist on other hearing related programs through MMI.
In November 2012, Bec, Peter and their three daughters returned to Australia to spend two months catching up with friends and family, sharing their journey and needs, and taking a well-earned break. They returned to Malawi in January 2013 to the usual host of challenges and joys.
Six students are still participating in the audiology course which Bec coordinates. Life and financial pressures don’t make it easy for them to remain studying, and assistance for them to continue is an ongoing funding need. The students all did well in their mid-semester exams.
An unreliable car has hampered visits to outreach centres in schools and health clinics, but the Bartletts hope the offer of a new vehicle will come through this year.
Construction of a purpose-built Hearing Clinic and Training Centre continues to consume Pete’s time and energy as he sources materials and equipment and then ensures it is stored securely when it arrives. It has been a difficult process to chase up items, keep suppliers to deadlines and coordinate deliveries. A container load of supplies including audiobooths and cabinetry has arrived from South Africa, so the internal fit-out is able to begin. There is still much to be done, but the Centre is on track to open in June this year.
Pete and Bec’s three daughters are flourishing in their African home and community.
Where is it? Malawi is a small sub-Saharan nation in south eastern Africa, primarily reliant on agriculture. Lilongwe is the Capital of Malawi.
In the beginning: In 2008, David Pither spent 5 days in Malawi, where he ran a 3 day intensive ear mould manufacturing workshop in the SOS Community at Lilongwe. He personally donated the equipment to set up two ear mould labs, one in Lilongwe and the second in the town of Blantyre. Prior to this, impressions had to be sent out of the country and it took up to six months to receive finished ear moulds, which usually no longer fitted properly. The new equipment and trained staff meant custom hard acrylic ear mould made within two hours of an ear impression being taken.
In early 2010, Peter and Rebecca Bartlett were accepted to work with the Africa Bible College in Lilongwe. The College has an established health clinic, a school for the Bartletts three daughters to attend and the local community and country has the need for a permanent audiology service.
In August 2010, the Bartletts arrived in Malawi for 2 years, with the long term goals of establishing a sustainable hearing clinic and ear mould manufacturing laboratory and to establish an audiometry training course, based on Donna’s model in the Dominican Republic.
In January 2013, the Bartletts returned to Malawi for another 2 year term.
In May 2009, David and Sheryl Pither travelled to Cairo, Egypt. During their stay David fitted a behind-the-ear hearing aid to a young man with a severe hearing loss who had travelled 150 km overnight to see him. They also visited the Coptic Hospital and donated an audiometer to an ENT surgeon working voluntarily at the hospital who had previously conducted hearing tests using a tuning fork.
After leaving Cairo, they travelled 200 km south to the city of El Minya. A city slightly larger than Melbourne, they visited a local deaf school run for both Coptic and Muslim children. Ears Inc. donated an audiometer to the school and David trained three volunteers in basic audiometry.
As a result of this visit, David returned to Egypt in March, 2010 with audiologists Carolyn Sigmund and Ian Skipworth on a privately funded Ears Inc. scoping mission. They returned to El Minya and worked hard to expand on the audiometric training of the three previous trainees and also trained two more people from El Minya and three people from the city of Asute. One of the group was a young deaf man, recently married, who is trying to find permanent employment. David taught him how to make custom acrylic ear moulds, to which he responded with immense passion and excitement.
The group additionally visited a gathering of deaf children from the small villages and farms around El Minya. The children were brought by mini-bus to play games, eat and drink together and generally celebrate life.
The success of the visit was only possible due to the generosity of many people donating their time and valued equipment. Ears Inc. was able to provide two clinical audiometers and a screening audiometer to be shared amongst three clinics. Donations also included a tympanometer, a new sound level meter, otoscopes, impression material and syringes, an earmould lab, a new computer and printer, 30 new Widex aids and programmer, several Starkey BTEs, a Hi –Pro, VROA puppets, noisemakers, and a Fonnix FP30 analyser. A huge thanks goes to Carolyn, Ian, David, Pro-Cal, Sonic Innovations, Widex, Starkey, Norman, Hani & Matti for their generosity (and apologies for any missed contributions). There were so many things needed to pull it all together.
In October 2004, Peter and Rebecca Bartlett and their two young daughters travelled to Papua New Guinea to spend six months working on an Ears Inc. project funded by the Aus-Aid Community Development Scheme. The project was in partnership with the Morobe Special Education Resource Centre in Lae, the biggest town outside Port Moresby.
Peter and Rebecca, with assistance from Ian and Lois Grant co-ordinated and delivered training in audiometry, paediatric testing (VROA), ear mould making, hearing aid fitting and evaluation, rehabilitation and organisational management. Speech Pathologist Tamara Jolly visited Lae for three weeks in November, 2004 to run basic speech pathology training for the teaching staff. During the Bartlett′s time in Lae four new clinical staff were recruited and trained, the facilities were improved and more equipment was obtained so that the new Hearing and Speech Clinic could be opened on April 5th, 2005.
In 2007, Lois Grant travelled to the hearing clinic to provide ongoing training and support and Peter Bartlett returned in February 2008 and 2009 to continue training and provide much needed resources, including second hand hearing aids and equipment.
Erick Honenu, a hearing clinic worker trained by Peter and Rebecca in 2005 works at the clinic and confidently performs otoscopy and tympanometry and conducts hearing assessments for both children and adults at the clinic. He is also able to remove ear wax from ear canals and advise on hearing aid suitability.
As the clinic aims to be financially self-sustaining, it charges a small fee for its hearing services. This demonstrates to the community that the services are valuable, without becoming a burden to recipients. A key component of the clinic′s revenue is derived from industries requiring occupational health and safety hearing assessments for their employees. Performing these assessments allows Erick to be funded for other non-financed work he performs, such as school and rural outreach visits.
In 1999, Rebecca Bartlett on behalf of Ears Inc. travelled to the port town of Kakinada, Andhra Pradesh, India to set up a hearing clinic. In partnership with Christian Outreach Missions the project involved training four pastors in hearing testing, impression taking, hearing aid fitting and evaluation and rehabilitation.
These four full-time pastors continued to run the clinic three days per week, testing hearing and taking ear impressions for the fitting of hearing aids. The results of the hearing tests were then sent to Australia, via email and recommendations were made regarding medical advice or any required intervention. Hearing aids were then calibrated in Australia specifically by a volunteer and sent over to India with other travelling volunteer audiologists. The Pastors really enjoyed the satisfaction of helping so many people with hearing difficulties.
In 2001, Rebecca returned to India with colleagues Donna Carkeet, Judy Francis and Terry Pamphlett and again in 2003, with Donna, Matthew Gambell and Alison Boorman to provide ongoing training and support.
By 2005, the service had expanded to include outreach hearing services with local staff running audiology camps in other parts of the region and involved the testing of 146 people and resulting in the fitting of 74 hearing impaired with behind-the-ear hearing aids.
In 1999, Peter and Rebecca Bartlett visited the Philippines to provide hearing services and training to local workers. They visited four locations and worked in the following capacities.
In Manilla, they trained four staff in a handicapped orphanage and completed hearing assessments of the children. Meeting with ENT surgeon, Dr Norberto Martinez at Santo Thomas University to discuss the audiology program that he was operating. In Cebu, the Bartlett’s trained several Teachers of the Deaf at a local Deaf school in audiometry, the fitting and use of hearing aids and the making of ear moulds. This visit also included assessing children in a soundproof Visual Reinforcement Audiometry booth. In Davao, Peter and Rebecca attended the Deaf Ministries International Conference. They also assessed the hearing of children living in the DMI orphanage and provided hearing aids. In the city of Bacolod they trained rehabilitation workers at the Christian Blind Mission supported Christian Foundation for the Deaf and Blind, assessed the hearing of the children serviced by CFBD and also provided hearing aids where needed.
An ongoing relationship between Ears Inc. and the Christian Foundation for the Deaf and Blind was established during these trips. This valued partner organisation employed outreach workers to travel into the villages in the provinces of Negros Occidental and Negros Oriental and work with children with blindness and/or hearing loss. Their staff were experienced in providing rehabilitation programs for children with blindness, but required further training in identifying children with hearing loss/deafness and in the provision of subsequent rehabilitation programs.
In 2003, Donna Carkeet, Judith Francis and David Francis travelled to Bacolod to work with the CFDB team. They trained health workers in the identification of hearing loss in children in the local villages and in basic hearing aid use and care. Two hearing-impaired men were also trained to make earmoulds for the hearing aids. Plans had been made for the establishment of a local audiology service in Bacolod, therefore the training at CFDB focussed on developing the health workers knowledge and skills so that they could appropriately refer people to the local audiologist. This allowed CFDB to concentrate on their strength of providing rehabilitation programs in the field.
In January 2003, Emma May and her husband Andrew travelled to Phnom Penh, Cambodia to assist fellow Australian audiologist, Donna Carkeet with an audiology training program. They helped train eight local health workers, working for the Jesuit Refugee Services in different parts of Cambodia.
In the beginning the team were daunted by the varied knowledge and experience of the trainees. A few of the health workers had received training previously from visiting ENT surgeons and audiologists, in aural health care and basic audiology and were running ear clinics. However, some of the workers had little or no knowledge of audiology and one poor fellow had his first day on the job the day the team arrived!
The goal was to provide training in otoscopy, anatomy and physiology, impression taking, hearing testing, history taking, paediatrics, hearing aid fitting and evaluation, rehabilitation and tympanometry – and all in a few weeks! The team decided to split the group into a beginners and advanced group and this worked quite well until Emma and Andrew had to leave and Donna had to handle both groups! Her flexibility, resourcefulness and sense of humour got her through.
Emma found that the most rewarding aspect of the work was the enthusiasm and eagerness of the trainees. They studied diligently throughout the day and night and were always waiting eagerly to begin each morning. They all worked very hard and the team was amazed by how much they were able to absorb and apply.
Emma said, “We were touched by the gratefulness of the students and their warmth and generosity toward us and we were humbled by how much they cared for their patients and by their desire to help others”.
In 1995, David Pither made several trips to Vietnam, establishing an ear mould laboratory in a deaf school outside Ho Chi Minh City. This trip lead to further trips to Hanoi and Da Nang, where Australian ENT surgeons were working. In 1998, David ran a five day ear mould manufacturing workshop in Ho Chi Minh City with twenty-four participants sponsored by Kommittee Twee of the Netherlands. Each deaf school that participated in this workshop received a complete ear mould laboratory. In 2001, David ran a five day hearing aid repair workshop for 27 participants sponsored by Caritas of Switzerland.
At this time in Vietnam the staff from the two ENT clinics in the country would visit each of the 40 plus deaf schools in Vietnam at the start of each year and take impressions of the children’s ears. It would then take the rest of the year for them to gradually make the ear moulds and send them to the schools, as the clinic could only make three or four ear moulds per day. Ear mould impression material shrinks in the heat and children grow in size, so this was not an ideal situation. By the time the children received the ear moulds, they fitted badly, if at all.
By providing these deaf schools with their own ear mould manufacturing laboratory, they could now make and fit ear moulds themselves, within two hours of taking the impressions. This radically changed the nature of hearing aid fitting across the nation of Vietnam.
In 1989, David Pither and his family travelled to Vanuatu as part of an outreach trip by their church. At the time, David was asked to take anything he could in the way of hearing aids. During his stay he discovered that Vanuatu, like most of the surrounding pacific islands at the time had no hearing testing services, clinics or hearing aids available for the deaf and hearing impaired.
In response to this, David embarked on a personally funded campaign to set up a hearing clinic at the Vila Central Hospital and train ‘nurses’ in hearing assessment and hearing aid fitting, including the manufacture of custom ear moulds. This comprised of about seven trips to Vanuatu over five years and included the sponsoring of two trainees who spent several months in Australia. The project culminated in 1994 with the running of a three week ENT nursing course at the hospital for 14 participants.
David’s experience in Vanuatu taught him many lessons in dealing with the development of hearing services in developing countries. The important lessons he learnt in training personnel and dealing with bureaucracies have been transferred to many other projects since.