Cape Town-based HearInAfrica is leveraging the advances in audiology technology to reshape the way hearing tests and services are delivered in remote and under resourced areas of Southern Africa.

HearInAfrica was founded by Audiologist and Speech/Language Pathologist, Shannon Kruyt, as an audiology consultancy, private practice and dedicated tele-audiology facility that aims to bring both public and private healthcare under one roof.

HearInAfrica’s mission is to address the growing burden of hearing loss in Africa and improve the delivery of audiology services across the continent. HearInAfrica’s facility allows audiology students and qualified South African audiologists to share their skillset without having to travel to project sites. It also provides an opportunity for students to observe gold standards for audiology in action within an African context.

The latest estimates from the WHO indicate that there are currently 360 million people globally living with disabling hearing loss and approximately 80% of these people are those living in developing countries. However, according to Kruyt, these estimates only take into account people who have moderate, severe or profound hearing loss. If one takes into account those people with mild hearing loss, the broader estimate is 1,019 million. About 3 million people in South Africa suffer from permanent disabling hearing loss.

“Hearing loss that goes untreated can be crippling to individuals, families, communities and countries. If left untreated, hearing loss can lead to poor speech and language development, limited or non-existent education, a lack of vocational opportunities, stigmatisation, as well as massive economic effects on individuals and societies,” said Kruyt.

In addition to the population growth, people living longer and a growing incidence of hearing loss caused by conditions such as prolonged noise exposure, Africa’s shortage of ENT specialists, audiologists and speech/language pathologists is contributing to the growing challenge in hearing loss. A study conducted in 2009 by Professors Johan Fagan and Marion Jacobs of UCT revealed a shortage of over 20,000 audiologists in Southern Africa.

HearInAfrica has addressed this issue by using Tele-audiology – the use of telehealth to provide audiology services remotely. This is achieved by using telephonic/video communication, internet-based programs such as Skype or TeamViewer, and specialised audiology hardware such as the eMoyo Kuduwave audiometer and mHealth platforms like hearScreen.

“By implementing tele-audiology services, qualified audiologists in any country can assist local healthcare workers by testing the hearing of patients and programming hearing aids, without needing to travel to the project site,” said Kruyt.

Kruyt has extensive experience as an audiologist. Before setting up HearInAfrica in 2014 she ran a community-based, mobile audiology project in the underserviced areas of the Western Cape with support from UCT and UK-based charity, Sound Seekers. Since 2013, she has been working with Sound Seekers and Dr Alfred Mwamba – Zambia’s only audiologist –  to set up a tele-audiology programme in Ndola, which allows audiologists at HearInAfrica to assist the local team with complex patient cases and training. Sound Seekers also support Dr Mwamba’s audiology training institute in Lusaka – their support has included the provision of visiting lecturers, equipment, text books and sponsoring students to do the course.

In 2014 Sound Seekers successfully completed the first remote hearing aid fitting in Ndola, Zambia – a 14 year old girl with severe hearing loss was fitted with a set of hearing aids donated by Sound Seekers and the hearing aid was switched on and programmed by Kruyt in Cape Town.

HearInAfrica is currently working to improve its current model to ensure that patients always receive a top-quality audiology experience, regardless of their location and available resources. This involves ensuring that the tele-audiology facilities at the test site are competent in setting the patient up, explaining the procedures and results, as well as ensuring that the recommended management takes place.

To date, HearInAfrica has successfully tested over 20 patients remotely and has completed five remote hearing aid fittings. Regular tele-audiology sessions are now available to the team in Ndola, Zambia.

Despite the programme’s success, their biggest challenge has been finding the best internet service. At the moment they are exploring the most stable internet connections or satellite connection. HearInAfrica also requires increased financial and IT support to reach more underserved communities and distribute more hearing aids.

There are plans underway for HearInAfrica to collaborate with hearScreen to use their mHealth platform to equip teachers with the necessary tools and training in order to test school children. The cloud-based results will be assessed by HearInAfrica audiologists and children who fail the audiology test will be provided with the necessary hearing aids.

“We are very excited about the hearScreen device and are in the process of piloting it as a screening device for schools and outreach missions in Zambia and Malawi. We are hoping to start implementing it at various Sound Seekers project sites during 2016,” said Kruyt.

“This has huge implications in Africa as it proves that we can provide high standards for large numbers of people, even in countries where there are no audiologists,” concluded Kruyt.

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