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Deafness and ear disease in Nepal

Deafness is the commonest single disability in Nepal (and is possibly so in many developing countries).

Deafness is an invisible disability. Without good hearing we cannot develop normal speech and language. In the developing world sufferers are frequently unable to benefit from education and therefore have very poor employment and social prospects.

Deafness most commonly occurs from disorders of the middle or inner ears. Middle ear infections as well as producing deafness, can cause persistent ear discharge, and carry a risk of death through serious complications such as brain abscess. Inner ear deafness is sometimes present at birth, where it can be hereditary or associated with maternal infection, such as rubella. In later life degeneration of the inner ear is a significant problem causing deafness in older people.

In 1991 a nationwide survey of deafness and ear disease in Nepal was undertaken by BRINOS, with the guidance of the Liverpool Institute of Tropical Medicine and the Department of Community Medicine, Tribhuvan University Teaching Hospital (TUTH), Kathmandu. The main findings extrapolated from 16,000 people surveyed were:

•     2.7 million out of the population of 19 million were significantly deaf.
•    1.5 million had abnormal ear drums indicative of preventable ear disease.
•     32% of hearing impairment is associated with middle ear infection or its sequelae.
•     70% of those suffering from middle ear infection or its sequelae are of school age.
•     61% of individuals aware of ear problems had never attended their local health post.
•     of the 39% who had received treatment, 66% were unsatisfied.
•     50% of all ear disease is PREVENTABLE.

Small Child in need of help

Potentially life-threatening middle ear disease

A fistula exposing the mastoid bone: Caused by a dangerous middle ear infection