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Bringing Better Hearing to Jordan, One Refugee at a Time

Beck, Steve

doi: 10.1097/01.HJ.0000527875.13700.2f
Audiology Without Borders

Mr. Beck is the operations manager of Pacific Hearing Service, a private audiology practice with offices in Menlo Park and Los Altos, CA, where he does “anything that doesn't require a license.” He assumed this role after retiring from his first career in the Silicon Valley tech industry.

Last April 2017, I had the privilege of visiting Jordan with the Entheos Audiology Cooperative to help establish hearing clinics at three Palestinian refugee camps and Souriyat Across Borders, an organization that serves Syrian refugees. This was my fourth trip to Jordan and Entheos’ fifth. Over four days, my team and I saw over 150 patients for hearing tests and hearing aid fitting. It was amazing to experience the impact we could have on people's lives.

audiology, hearing health care, refugees

audiology, hearing health care, refugees



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Mary Thorpe, AuD, of Sarasota, FL, told of fitting Anan, a four-year-old girl. Our testing audiologists had found that Anan had a moderate-to-severe, bilateral sensorineural hearing loss. Her father reported that she had some limited speech and daily hearing difficulties.

When Thorpe fit Anan with hearing aids, it seemed that the sound overwhelmed the child at first, but as the aids were adjusted, Anan started smiling with delight. She immediately began to engage with the audiologists and with her father. She laughed with excitement at her ability to hear. By providing her with hearing aids at this young age, we are confident that we have greatly improved her chances of succeeding in school and in life.

Last year, we fit Anan's brother with hearing aids too. Congenital hearing loss is a common problem among Palestinian refugees, and we often saw families with two or more children who had similar or identical hearing losses.

Jane Baxter, AuD, of Menlo Park, CA (full disclosure: Jane is my wife), recalled treating a young boy with no speech ability during her visit in the refugee camp in September 2015. But when she turned on his new hearing aids, he was so excited at discovering his own voice that he started singing and wouldn't stop. When he came back to our clinic this year, we were delighted to see that his hearing aids have helped him develop speech. Unfortunately, his hearing loss was progressive, so we fit him with more powerful hearing aids this time.

Baxter also noted the inspiring attitude of several 13-year-olds who were getting hearing aids. In contrast to many American teens (and people of other ages) who are resistant to any kind of hearing device, these young people were genuinely excited to be getting help with their hearing.

Nora Stewart, founder and chief vision officer of Entheos, has fond memories of a girl named Khadeja, who received hearing aids on Entheos’ first Jordan trip. She was about to start third grade then, and was beginning to fall behind in school because of her hearing loss. She has seen us on subsequent visits and got a new set of hearing aids last fall. She proudly reported that she is getting straight A's in school, thanks to being able to hear in class. She also brought along her favorite doll, which she named Nora.

We saw other children who had simply stopped going to school because their hearing loss made it too difficult. With hearing aids, they were hopeful of being able to attend school again.

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The success of every service trip depends on the solid organization of the host country. On this trip, we worked with two organizations: Life for Relief and Development, a Michigan-based NGO (non-government organization), and the Alalusi Foundation, which is especially involved in funding Souriyat Across Borders. In the clinics at Souriyat's house in Amman, we saw children from Syria whose hearing had been severely damaged by explosions and gunfire. Many of these children also lost parts of their limbs, and some wore prosthetics. Hearing loss was only one of their problems, but they were very grateful to be receiving help for it.

Even though our clinics are of the pop-up variety—setting up in the morning and tearing down at the end of the day—our testing and fittings are nearly as complete as they would be done at home. The audiologists perform audiometry, tympanometry, and otoacoustic emissions testing to get a complete picture of each patient's hearing loss. In the fitting process, they use real-ear measurement to ensure the optimal programming of each patient's hearing aids. We remove cerumen when necessary, make custom earmolds onsite, and counsel every patient on the use and maintenance of their hearing aids.

Because we return to sites we've previously visited, it's been gratifying to see how our returning patients are doing. Sometimes they need maintenance on their hearing aids, and sometimes they just want to tell us how much they appreciate what we've done for them. Parents have made long trips just to come back and thank us for having given their children a future.

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On our last evening in Amman in April, we gathered in a hotel conference room to share the moments that made the trip special for us. The stories often brought us to tears.

Some of the stories were unbearably sad, such as the parents who had such high hopes for hearing aids for their children only to be crushed when they learned that their children's hearing losses were too profound. They needed cochlear implants, which they probably would never obtain.

More often, the stories were poignant and happy, as in the case of the young mother who had never been able to hear her baby's cry before. And there was the teenage girl who lacked spoken language skills and used sign language. She squealed in delight at being able to hear any sound at all with her new hearing aid and dashed around the clinic, hugging everyone in sight.

Joining us that last evening was Esraa Aldabass, a fourth-year medical student from Syria who spoke English well enough to translate for us. Four days earlier, we didn't know her, but now we considered her a close friend. Esraa was in medical school, but like so many others, she fled Syria to escape the violence. As another team member shared a story of a patient at Souriyat whose entire family had been killed in Syria, Esraa laid her head down and sobbed. It struck me that the Syrian tragedy may still be an abstraction for us, but for people like Esraa, it's all too real. But these stories also serve to inspire us to bring hope and hearing health care to more hearing-impaired refugees.



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