S.T.O.R.E. MODEL

MALAWI, AFRICA

In 2010, EARS Inc volunteer audiologists Peter and Rebecca Bartlett moved their young family to the African Bible College (ABC) in Malawi, Africa, to establish a Hearing Clinic and Training Centre.  The ABC is located in Lilongwe, the capital of Malawi. When they arrived, there were no audiologists in Malawi, a country with a population of 14 million (19 million in 2020). In only six years, the Bartletts: 

• Services: Built a tertiary-level audiology facility offering a wide range of clinical services and devices

• Training: Began teaching audiology subjects to ABC students, and developed and introduced a Bachelor of Science in Audiology curriculum

• Outreach: Regularly visited outlying areas in Malawi to provide audiology services

• Resources: Developed a committed team of staff members and students, and established partnerships with supportive organisations which helped fund and provide vehicles and equipment, which the program needed

• Evaluation & Promotion: Regularly evaluated and reported on the efficiency and outcomes of the training and service programs and made changes based on this as well as conducted media interviews and presented at a number of international conferences.

The clinic is now run almost entirely by Malawians – seven clinical staff, an office administrator and an earmould maker. Since 2012, there have been four separate intakes of ABC audiology students, with the first 10 students across the first three intakes anticipated to graduate from the Bachelor of Science in Audiology degree program in 2021.

Although Malawi is one of the poorest countries in the world, the success of the EARS Inc. Malawi audiology service and training program demonstrates that it is difficult but not impossible to deliver quality hearing care despite seemingly impossible circumstances.

© Hear The World Foundation

FIJI

Services: Since beginning our project in Fiji in 2014, the services provided by our partner Frank Hilton Organisation’s (FHO) Audiology department have expanded. Now all the services that are available in a paediatric audiology clinic in Australia are also offered in Fiji. These include:

• Audiometry (behavioural hearing assessment)

• Visual reinforcement audiometry for babies and young children

• Objective hearing tests for infants including Auditory Brainstem Response (ABR) and auditory steady-state response (ASSR)

• Impedance audiometry which assesses the function of the middle ear system

• Hearing device fitting and verification

• Parent and community education

• Distortion-product otoacoustic emissions (DPOAEs) which are an objective indicator of normally functioning outer hair cells in the cochlea (inner ear).

• Speech detection and discrimination assessment

• Ear mould laboratory.

Training: The increase of services is only possible by training local staff. We are still developing local training courses, but we have increased the paediatric assessment and device fitting skills of the Fijian audiometrist and are supporting a FHO employee to complete the Diploma of Audiometry run by TAFE NSW. All FHO staff members have a training and development plan and attend regular training sessions to continue their professional development. These local staff are also responsible for training of local medical professionals, teachers, families of children with hearing impairment and communities.

Outreach: Apart from the training provided to other services, we also conduct regional screening programs and community awareness screening programs. We do this to help increase access to services in Fiji. We have also screened all the children in special schools in Fiji as well as monitor their ear health for any sign of ear pathology that requires treatment.

Resources: As well as assisting with the selection and purchase of audiology equipment, we have donated equipment to Frank Hilton Organisation in Suva and Advanced Ear and Eye clinic in Ba, including screening audiometers, tympanometers, diagnostic audiometers, real ear measurement units, hearing aid programmers, hearing aids and remote microphone/FM systems. We also supply books and toys regularly to the audiology clinic and teaching centre.

Evaluation & Promotion: Evaluation of the project’s progress and standards is very important to ensure we stay on track and adjust the program if needed, especially in the current environment of the COVID-19 pandemic. EARS board members have visited the program and our partner organisation also conducts departmental reviews. Donna has presented talks and posters and also participated in several expert panels at a number of international conferences.