A Note from Malawi

Remember my post about those two Malawians who received cochlear implants?

Well, Helen Brough, a clinical scientist in Audiology from Cambridge, England, who is currently volunteering in Malawi, found my blog post and wrote me a wonderful note in response to it. It’s a perfect validation that my husband and I made the right choice to go with Med el for our family. Here is her message:

“I just read your post about the 2 children who received cochlear implants last year in Malawi.  I am currently volunteering at the African Bible College Hearing Clinic and Training Centre (ABC HCTC) in Lilongwe, where the CI switch-ons were carried out, and follow up is being done.

I was here for 3 months last year, and was present at the appointment where Richard’s implant was switched on.  Now I’m back for a further 3 months.

Firstly, thank you for raising awareness of the exciting development that 2 children now have cochlear implants in Malawi, and also thank you for raising some very valid concerns.

Internet access isn’t great here, and I can’t access the Med-El article properly, however I think I’ve seen the picture you are referring to.  You are absolutely right that the children were swathed in bandages initially, and thanks to visa problems for the tech support staff coming in from South Africa, the duration between operation and switch-on dates was closer to 3 months (I’m sure this won’t surprise you as you know Malawi!).  I think the comment about the “all smiles” must have been journalistic licence.  Peter also told me that the children were very excited because they knew that there was the chance that they would be able to hear again.

I too was concerned about follow up support, and also realistic expectations.  The staff at ABC HCTC are doing a fantastic job at providing regular follow up, wonderfully supported by the Med-El team.  Richard is from Lilongwe, and Joyce is from Mangochi.  Like you, I was concerned that there was no speech and language therapist available to offer follow up, however I am amazed and incredibly happy to see the progress they are making.  Both children were selected by the audiologists here as having a good prospect of success – they sought candidates who had not been deaf for very long, had good speech prior to the illness that caused their deafness (malaria), and have supportive and motivated families.  Both Joyce and Richard are now in school and doing very well.

There have been problems – dust and humidity being of significant concern.  Med-El rather optimistically sent electric dehumidifying kits for the devices, although neither of them have electricity.  We found a jar of rice works, more or less.  Any tiny crevice gets clogged with dust very quickly, so they switched to Rondo devices, which have fewer pieces to go wrong.  Batteries are provided free of charge on a regular basis.

The clinic has to pay for and organize transport to get the children to clinic appointments.  For Joyce and her mum, they also have to provide accommodation and food.  The staff at the clinic go far beyond anything you would ever expect of a clinic in the UK, and I have the highest respect for them.

The outcome has been so successful that the implant team are set to carry out 2 further operations in February next year.  Again there are no guarantees about successful outcomes, but the audiologists are experienced and have sought hard to find children who are likely to do well.

A quick overview of a challenging situation:

  • There are currently only 3 permanent audiologists in Malawi, all from overseas
  • Rebecca and Peter Bartlett, Audiologists from Australia, designed and built the ABC HCTC and have worked here for over 5 years, providing the first (and currently only) purpose-built audiology facility in the country.
  • The Bartletts trained 6 Malawian Assistant Audiologists, 3 of whom are now in the UK taking their MSc Audiology.  Two will return to ABC, the other will go to Blantyre.
  • Another 6 ABC students are currently in training, and it is hoped they will graduate with a BSc Audiology
  • ABC HCTC staff, and also Courtney Caron (the 3rd audiologist) from Queen Elizabeth Hospital in Blantyre, carry out regular village outreaches providing primary ear care and audiology support for the entire country.

I’m very impressed with the ethics of Med-El from what I’ve seen.  The whole situation is a massive international collaboration, with the surgeon coming in from the UK, an equipment specialist from Germany, the implants and technical support being supplied from Med-El and of course the ongoing work of the HCTC here, all provided free of charge.”

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