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Hearing Journal:
doi: 10.1097/01.HJ.0000433588.95354.27
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Come Together to Provide First-Class, Sustainable Audiology Care in Guatemala

de Muñoz, Patricia Castellanos AuD

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Dr. Castellanos is general manager and audiologist with Centro de Audición y Adiestramiento Fonético (CEDAF), founder and president of Smiles that Listen Foundation, and founder and audiologist with Grupo Coclear cochlear implant program in Guatemala.

Like other developing countries, Guatemala has had the privilege of receiving many groups of professionals interested in the hearing health of our people, especially children.

Figure. In a 2011 hu...
Figure. In a 2011 hu...
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It is no secret that our country has very scarce audiology services that are mainly concentrated in the capital city. These circumstances prevent most of the population from having access to or even the knowledge of such services.

Figure. Patricia Cas...
Figure. Patricia Cas...
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This situation, combined with the desire to serve, motivates different groups of audiologists to visit my country and volunteer their services. They screen, diagnose, and fit hearing aids, mostly to the pediatric population.

Many of these groups travel with the support of foreign universities or hearing aid manufacturers. Therefore, the potential for support, coverage, and impact in the Guatemalan population could be greater if efforts were focused on two goals: offering first-class audiology services to the population in need and preparing the human resources necessary for a sustainable program.

Figure. During a 201...
Figure. During a 201...
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However, I have seen, through patients and my professional practice, how foreign groups bring their own agendas that oftentimes do not include local community services, losing sight of patients’ need for local follow-up and the benefits obtained from continued care. This attitude does not support the efforts and the academic level of local professionals, who are excluded from the process.

When talking about first-class audiology services, I mean establishing accurate diagnoses and offering hearing aids of the utmost quality, in good condition, and with the option of providing maintenance services. This goal seems simple but is rather complex.

In older children with no other developmental challenges, it is easy and quick to establish an accurate diagnosis. The procedure becomes more complicated when we refer to babies, young children, or those of any age who do not cooperate during pure-tone audiometry.

Such patients require more sophisticated studies that are not offered during these types of visits because of the cost and of the difficulty in transporting the required equipment. Many times we require a soundproof booth or several sessions to complete a test, but when we travel with a closed agenda, we do not have sufficient time to conduct audiology studies by stages. Thus, a team of local professionals would be more adequate for meeting this objective.

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SUSTAINABLE LOCAL SUPPORT

Here is the main recommendation: contact an audiologist or an audiology practitioner in the country to become part of the mission. This professional can help establish the necessary mechanisms for access to all needed tests, facilitating the confirmation of diagnoses in difficult-to-test children.

Hearing aid fitting comes with certain considerations. The first and most obvious is to guarantee the adequate model for the degree of loss. This consideration also implies a good diagnosis and several options of hearing aid models.

The second consideration is whether to offer refurbished or new hearing aids. All hearing aids, especially those that have been refurbished, require maintenance, parts, and batteries. Again, a local practitioner can assume the responsibility and provide follow-up services.

The training of local human resources is a must because most developing countries do not offer training programs in audiology or related fields. Audiology is still carried out, so available skills should be upgraded to ensure quality services.

Sessions must include in-service training and theory. They can be organized by stages and in different areas. There are individuals with the potential to diagnose hearing loss, those who can make molds and basic repairs, and others who can assist parents and families.

Sustainable local support offers many advantages. Such an approach:

Figure. We offer tra...
Figure. We offer tra...
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* Favors follow-up appointments and maintenance.

* Ensures that the hearing aids are used correctly and continuously.

* Extends the useful life of hearing aids through maintenance services.

* Enables the renewal of molds as required.

* Favors professional development of human resources through follow-up consultations and in-service training during humanitarian brigades.

* Supports the formation of reference centers to capture new cases.

* Gives parents someone to contact for advice.

* Consolidates databases to avoid situations where the same individuals receive hearing aids all the time.

* Allows for the assertive adaptation of safety measures according to the customs and ways of each region.

* Minimizes language and cultural barriers during the humanitarian brigades.

* Makes the economic, human, and technological efforts of international donors more efficient.

* Strengthens support networks.

I wish to thank all the groups, organizations, and institutions who contribute in one way or another to the hearing health of the people with hearing loss in my country. Special gratitude goes to those who have trusted me with whom I have formed relationships.

Their efforts for the past years have promoted the outreach of audiological services to faraway places. With them, we have served hundreds of children and their families throughout the country. Thank you because every effort, no matter how small, contributes to improving the quality of life of our people.

I also wish to invite other groups to join efforts for the continuity and sustainability of the programs that are thoughtfully and carefully planned with such anticipation and are enthusiastically awaited by the underserved people of Guatemala.

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© 2013 by Lippincott Williams & Wilkins, Inc.

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