By Mara Brugés Polo – Editor-in-Chief of Audio Infos Latin America
Recent years have seen the country of Peru taking steps towards increasingly better care of its hearing loss patients, with not only the government making an effort, but private firms also launching their ideas to treat hypoacusic cases.
Although Peru passed its universal neonatal screening programme law in 2012, it was not until this year that the country’s Health Ministry (Minsa) opened its first Audiology and Neonatal Hearing Screening centre, which uses three basic procedures to detect deafness in the newborn: hearing screening, evoked potentials, and paediatric audiometry.
The health minister himself, Aníbal Velásquez, made the announcement four months ago urging other institutions to follow the example of the Health Ministry’s Madre Niño San Bartolomé national teaching hospital, and get on board and contribute so that children can be rehabilitated, achieve speech, and have better futures. According to the Ministry, more than 7,000 babies can be screened each year by this centre.
There is certainly a need for the government to call for active involvement in the initiative. Peru has 532,000 people with hearing loss, according to statistics from the national data body, INEI. Furthermore, some 300 children with congential or acquired deafness will normally end up being hearing disabled (deaf and mute) due to not being able to access treatment in time and, therefore, not developing their language abilities.
Official data suggests that this situation is compounded by the shortage of sign language interpreters in Peru. Stats show that there only 20 such specialists recognised by the Peruvian association of interpreters (Asisep), and that this may be heightening the country’s current need to boost hearing rehabilitation through the use of hearing aids and cochlear implants.
According to the news portal, Terra.com, Peru’s social security system (EsSalud) fitted 130 implants between 2007 and 2012, around 20 per year, less than 10 percent of those affected. The same website records that in 2014 the institution invested in a further 250 new implants for child patients. Today, EsSalud carries out approximately 600 newborn screenings per day at a cost of 120 new soles (approx. US$35.50) for each test.
The recent news of the inauguration of a new audiology centre estimated the investment at “350,000 soles (around US$103,550), and it will benefit not just children at this hospital but also around 300 babies per month who will be referred to other centres,” points out the Minsa press release. This all shows that Peru has for some time been preparing for new deafness cases amongst the newborn, and efforts have not merely come from the state, since private enterprises have joined in keenly in order to improve quality of life for those with hearing disabilities.
Training + Treatment: two elements of the same initiative
This is the formula behind the opening of the Hearing and Vestibular Diagnosis and Rehabilitation Centre (CDRAV) in Lima, and its aim is to meet several different purposes for different patient groups. “Our administration side is up and running, and we are providing services and schemes for hearing professionals; before the end of the year, we will be attending deaf persons and their families directly,” explains Ariel Panduro, manager of the centre, who outlines that a team of experts was trained up initially while the focus was fixed on five areas: vestibular problems, prosthetic audiology, electrophysiological tests, paediatric audiology, and rehabilitation.
“Although we are just getting started, we want to become a leading centre in Peru, and for this reason we are looking for promotion in scientific publications in audiology, incorporating new hearing care professionals, otorhinolaryngologists, and psychologists to carry out research studies, and we are going to work hard to be specialists in tinnitus,” assures Oxana Panduro, audiologist at CDRAV.
The cochlear implant (CI) waiting time in Peru can be as long as three years, while requests for hearing aids do not top 3,000 annually, within a population of 532,000 persons, as previously mentioned. Despite this situation, “cochlear implant imports to Peru are growing. In 2015, 132 devices were imported, while the request process saw 70 implants ordered. This year, CI imports went up by 200, with 246 on order, so 46 are still to arrive,” says Ariel Panduro, who also revealed that in the last 6 months, 81,838 hearing aids have been been acquired for hearing loss patients in Peru, a stat that shows a great gap in the hearing aid market.
This fact means that “our plans now include the creation of a cochlear implant protocol with an aspect especially aimed at the family. In Peru, parents are badly informed,” says Panduro. He explains that the CDRAV will promote the training of parents of children with implants.
“There are many late detections of children with hearing loss in Peru, and some of them have received implants late, at advanced ages. We want to support them, bringing them another type of rehabilitation that will help them acheive orality, and in this respect the parents’ role is fundamental since they will also learn how to treat their children,” the audiologist explains.
This year, the DCRAV has successfully imparted training courses to professionals and technicians, whose updating brought experts from Denmark, Chile, Uruguay, Colombia, and Argentina, covering subjects related to vertigo, posturography, and advanced audiometry testing. These courses have had support from well-known multinational companies in the hearing field such as Phonak, Widex, Interacoustic, and Sivantos. The CDRAV, therefore, is aware that statistics in Peru show, primarily, the need for fast intervention, rehab programmes, priority treatment for elderly adults, and early detection among children.
Despite the huge challenge facing the country in audiological matters, the CDRAV manager is facing the initiative bolstered by optimism, and he assures: “the steps we are taking have got us on the right road.”
Peru – Hearing is Still Short of the Mark
Hearing-related data from Peru reveals that there is still a long way to go before hearing-disabled persons experience improved quality of life. For example, 33.8% of those with hearing difficulties—even hearing aid users— face limitations in carrying out their daily activities.
According to data from the First Specific National Survey on Disability 2012 and the National Institute of Statistics and Computer data (Lima, March 2014), the following information reveals key indicators:
- 27,412,157 – Official population (2007 census)
- 260,873 – People with permanent communication limitations
- 260,873 – 6.2% – Households with at least one hearing-impaired person
- 1.8% – People who cannot hear, not even with hearing aids
- 0.9% – Peruvians with speech difficulties
- 89.8% – Persons with problems in maintaining fluid conversation
- 84.1% – Cannot pronounce and sound words correctly
- 82.9% – Difficulties in conversing at length in a loud voice
- 63.1% – Cannot speak or use an alternative language
- 95.9% – Difficulty in hearing sounds at low volume
- 46.6% – Cannot hear or understand conversations
- 14.4% – Difficulty in hearing sounds at high volume
Source: Audio Infos Latin America; images courtesy Panadex and ptperu
Editor’s Note: By mutual agreement, this article is republished with permission from Audiology World News, where it originally appeared on September 13, 2016. This article can be read in Spanish on Audioenportada, the website for hearing care professionals in Spain and Latin America