Cambodia still bears the scars of the brutal Khmer Rouge regime, which came to an end in 1979. According to the UN, the south-east Asian country is one of the poorest in the world. It is therefore not surprising, that the country is plagued by inadequate healthcare, particularly in rural areas, with just 0.2 physicians for every 1,000 inhabitants.
Place & Year
Project Partners
All Ears CambodiaAwards
John Bamford AwardSupport
Main Focus
Cambodia’s healthcare sector is heavily dependent on development aid, which is primarily directed toward fighting HIV, tuberculosis, and malaria. Although chronic middle ear disease is a major public health problem in Cambodia, there is no state-sponsored training program for audiologists, who according to the WHO, number fewer than one per million inhabitants. As anywhere, hearing loss among Cambodians can have any number of causes, but among the most frequent are incorrect treatment of middle ear infections, overdosed malaria drugs and acoustic trauma caused by landmines. Ototoxicity and inner ear defects causing congenital hearing loss also rank high as common causes.
Audiological care in a country without audiologists
However, there is still hope. For some twelve years now, the organization All Ears Cambodia has been working to improve the hearing health of Cambodia’s poorest inhabitants. This project began in 2003 as a one-man clinic run by Glyn Vaughan from England and has since evolved into a network of four clinics with 28 employees. In addition to working at the clinics, the team also conducts mobile missions, to provide primary care to people in remote areas. All Ears Cambodia also runs a two-year training program for clinical workers in its own training center. The program includes practical training under the guidance of a senior clinician in the mornings and classroom lectures in the afternoons.
Patients living in poverty are treated for free at the All Ears Cambodia clinics, with voluntary donations towards medical supplies being used to help other patients in difficult financial situations whom may not qualify for free treatment. The Cambodian government uses a voucher system to assess the need of patients.
Prevention work under the spotlight
The Hear the World Foundation has been financially supporting All Ears Cambodia (AEC) since 2010, by donating hearing aids, batteries and by providing professional expertise on site.
AEC is funding prevention work, as chronic middle ear infections are a widespread problem in Cambodia. These infections often go untreated for years, causing the eardrum to become inflamed until it perforates, which leads to hearing loss. However, the general population is largely unaware of the way this infection develops. Remedying the situation and spreading information through workshops, posters and easy to read leaflets are vital elements of All Ears Cambodia’s work. Next to the prevention work, they also distribute protective ear plugs for children with damaged eardrums to wear while swimming, as water can enter the middle ear through a perforated eardrum, leading to further infection and, ultimately, to hearing loss. Hear the World has funded a laboratory at the clinic in Siem Reap, since August 2015. The lab uses state-of-the-art technology to manufacture ear plugs and ear molds for hearing aids. “At our new laboratory, we manufacture around 2,800 ear molds and devices per year to protect ears against water and noise. The training program at Phonak Singapore provided me with the expertise I need to work here,” explains Lo, Senior Clinician in Siem Reap.
Currently AEC is working on an awareness campaign about the dangers of noise exposure targeted at Cambodia’s around 330,000 factory workers. Hearing protection is rarely used in the clothing industry and on construction sites in the country. Noise induced hearing loss is easily preventable and this is one of All Ears Cambodia’s major goals for next year.
Specialist care for girls and women at high risk
Another focus of the partnership between the Hear the World Foundation and All Ears Cambodia is providing primary ear healthcare and aural rehabilitation services for girls and women at high risk of ear disease and hearing loss. These are girls and women from families of minimum income, former victims of trafficking or domestic abuse including acid attack victims, those living with AIDS/HIV, and orphans, who presently do not have an opportunity to receive the specialist care required. By providing hearing health care, the girls and women will develop better speech and language and have a better chance to be integrated into mainstream schooling and to integrate socially.
Prof John Bamford was a member of the Hear the World Foundation Advisory Board and was the Head of the Audiology Department at the University of Manchester in 2007. He retains a strong interest in childhood screening, paediatric audiology, and service development and improvement. He chaired a review of audiology services for the Irish Health Service Executive, and was advising on the implementation of a new Audiology Clinical Care Programme in Ireland.
