Today, as part of a 10-day trip across five African nations, President Bill Clinton and Chelsea Clinton joined the Starkey Hearing Foundation in Livinstone, Zambia, to help fit children for hearing aids. Starkey provides free hearing aids to patients around the world and, in 2010, committed through the Clinton Global Initiative to donate 1 million hearing aids to children in the developing world by the year 2020.
Below, Starkey Hearing Foundation Executive Director Steven Sawalich discusses the critical need for increasing access to hearing aid technology in sub-Saharan Africa, his sustainable approach to restoring children's sense of hearing, and the one patient he will never forget.
CGI: How does childhood for young people who suffer from hearing loss compare to the reality for children without an impairment? What special challenges are unique to places like Sub-Saharan Africa, and which are universal?
Steven Sawalich: One of the greatest challenges for all children with hearing loss is communication and connection with the rest of the world. Hearing is the foundation for building relationships, connecting us to the people we love and the world around us. Children with hearing loss often experience delayed development of speech, language and cognitive skills. Listening and hearing are critical to education. Without the ability to hear teachers or classmates, hearing-impaired children struggle to learn and excel in the classroom. However, if these communication barriers are removed early enough, children with hearing loss can perform just as well as their peers.
In developed nations, we have tools and technologies readily available to remove these barriers and give children, even with profound hearing loss, a chance at a mainstream education. Unfortunately in developing nations, like those in sub-Saharan Africa, the resources, education and training simply are not there. Many children lack access to basic medical care, let alone hearing aids. Children with hearing loss are often cast aside by society and thrown into deaf schools when they aren’t actually deaf. They can be helped with hearing aids if they have access to the proper care.
The general awareness of hearing health in sub-Saharan Africa is also low. Many of the cases we see are children who were born with hearing but lost it later on. Oftentimes ear infections go untreated and cause permanent hearing damage. Many of the medicines used to treat diseases in the region cause hearing loss as well. The drug most often used to treat malaria, quinine, is an ototoxin that can result in significant hearing loss.
Add to all of these challenges the limited economic opportunities available for those dealing with disabilities in sub-Saharan Africa, and we are looking at a life of extreme isolation and poverty for the majority of those living with untreated hearing loss.
CGI: What are some of the obstacles that prevent children in sub-Saharan Africa from receiving adequate hearing aid technology? How has the health system in sub-Saharan Africa improved as a result of your commitment?
Steven Sawalich: In many parts of sub-Saharan Africa a vacuum exists in terms of hearing health resources. In Rwanda, for example, there are only three audiologists to serve the entire country, and 90 percent of the population is rural. For the few who are lucky enough to see one of these audiologists, the cheapest hearing aid available is $320, an unimaginable fortune for someone living on less than $1 per day.
Even for those that have money, it can be extremely difficult to access this type of technology in many countries. In Mek’ele, Ethiopia we met a pair of brothers that had traveled in from Addis Ababa because they couldn’t even purchase hearing aids there if they wanted to.
We have committed, through CGI, to delivering more than 1 million hearing aids to people in need around the world this decade, but this entails far more than just fitting people with hearing aids. When we bring a hearing mission to a region, we also bring training, awareness raising, education and follow-up care. We build partnerships with governments, other NGOs, schools, hospitals and others, to ensure our patients will have access to the resources they need to reconnect with the world and become a bigger part of their communities.
CGI: How do hearing-impaired children get by without hearing aids? What are some of the consequences for those who go without?
Steven Sawalich: This depends on when in life their hearing loss occurred. If a child is born with a hearing loss, he or she may develop sign language and/or learn to read lips. However, these children will have no speech. For those who develop hearing loss over time, perhaps as a result of infection or an ototoxic medication, they may have speech, but probably will not have developed the communications and coping skills necessary for someone with hearing loss.
Without hearing aids, these children are both physically and economically vulnerable. They are unable to hear and react to approaching cars or wildlife, making simple trips to the local market or collection of water from the village well dangerous. Some with speech will find employment, but many will be forced to rely on family or begging to survive.
CGI: How did you get involved in the So the World May Hear program? How would you describe your experience?
Steven Sawalich: This is my family’s foundation, so I’ve been involved in the work for most of my life. My step-father, Bill Austin, started Starkey Hearing Technologies, the for-profit hearing aid manufacturer, so he could fund the work of Starkey Hearing Foundation and use hearing as a vehicle to care for people in need around the world, give them hope and empower them toward a better life. I was raised with the belief that we have a responsibility to leave this world better off than when we entered it, and that’s what I try to do each day. Working with the Starkey Hearing Foundation has been the most rewarding experience of my life and has shaped me into the man I am today. I look forward to continuing to build on its message.
CGI: What immediate responses have you seen in children after they get fitted for hearing aids?
Steven Sawalich: Watching someone hear for the first time is watching biology happen. You see the sound waves hit the brain for the first time — it is miraculous. But the thing that gets to everyone is the instant ability to connect with people and the world that is intrinsic to the human condition. You see it in people’s eyes as they suddenly realize that they can hear the world around them, and they know that they are a part of something bigger. There is nothing more powerful than watching a mother and child say "I love you" for the first time.
We have provided more than 165,000 hearing aids in the last year, but each one of those has a story. Each represents a life changed forever. There are so many people I will never forget, but Endrias really stands out for me. I met him in Ethiopia in 2012. A 16-year-old orphan, he was struggling with hearing loss and suffering from a horrible case of mossy foot (a debilitating disease caused by walking barefoot on soil containing volcanic glass).
He was shunned by his community and had no one to care for him. Once my step-father Bill Austin fit him with hearing aids, he completely opened up—that smile, I’ll never forget it. He invited Bill into his home to show him the life-threatening tumor he was struggling with, because he knew Bill cared. Here was a young man suffering with so much, but when he saw someone cared about him he was filled with hope and joy. Fortunately, Bill worked with our friends at Sheba Medical Center in Israel and got Endrias the treatment he needed for both his mossy foot and the tumor, saving his life.
Last week at our annual gala, we shared Endrias’ story with all in attendance, including President Clinton. As a surprise for my step-father, my mother, Tani, and I arranged for Endrias to come in from Ethiopia. It was the most powerful moment of the night, and I don’t know if there was a dry eye in the house.
That’s what I enjoy so much. We are able to provide care to larger and larger numbers of people, but we are also building bonds with those we help that last a lifetime.
CGI: What needs do the children still have after the fitting is complete? How do you address this through the program?
Steven Sawalich: Our efforts must be sustainable. We want to make sure that the people we help have access to the long-term care they need. That’s why having strong partners in each location we visit is so critical. Our work with CGI has been extremely helpful in this regard and has helped us develop new partnerships around the world. After hearing missions, we conduct smaller follow up missions to check in on patients, and we make sure know who they can reach out to locally when they need support.
For children who struggle with speech, aural and oral rehabilitation is needed. However, in sub-Saharan Africa, qualified speech therapists are not always available. In order to overcome this issue, we work with our local partners and provide teacher training in speech therapy techniques and hearing aid care.
We work with families and teachers so that they understand how to use and care for the hearing aids. We also identify and train older school children to act as hearing ambassadors to help younger children when they have problems with their hearing aids.
Hearing aids require batteries as well, and through our generous partner, Rayovac, we provide hearing aid batteries free of charge to all patients.
CGI: How does life change for patients after their hearing has improved?
Steven Sawalich: The difference in the quality of life for a patient after he or she has the gift of hearing is astonishing. They are now able to do basic daily tasks that we all take for granted. For many of them, the gift of hearing means that they will have the chance to be economically independent.
In the Philippines we fit a young man named Euner. Once he was fit with hearing aids, he was able to get a job as a security guard. When we returned to the Philippines, he took time off from work to be a volunteer on the mission. We see this all the time. So many people we help are then inspired to give back and help others. The gift of hearing is creating a ripple effect that we believe is changing the world for the better.
About Steven Sawalich, executive director of the Starkey Hearing Foundation
Steven Sawalich is a philanthropist whose career merges a devotion to creating a new systemic of international humanitarian aid and capturing key elements of the human experience on film. The core of his work, both as Foundation leader and filmmaker, is about opening avenues of understanding among people around the world. As executive director of the Foundation, which made a CGI commitment to give one million hearing aids to people in need worldwide during this decade, Sawalich has traveled the globe on hearing missions countless times. In countries as far flung as Madagascar and Rwanda, Haiti and India, he and his teams conduct on-the-ground work fitting those in need with hearing aids. The maxim of the Foundation is to turn no one away. Towards this end, and under Sawalich’s leadership, the Foundation fits upwards of 100,000 children and adults a year with free hearing devices and provides much needed one-to-one hearing education.