The impact of the COVID-19 pandemic has gone beyond educational, recreational, and occupational settings, and trickled into the humanitarian outreach domains. Programming for humanitarian outreach requires a great deal of advanced strategic planning and execution. Often, humanitarians from the Northern Hemisphere begin planning outreach projects by late fall to early winter for spring and summertime trips. With the unpredictable projection of COVID-19 cases globally, many humanitarian projects for 2020 have either been shelved with hopes that 2021 will be a healthier option or significantly postponed.
Perhaps the most difficult reality for many who serve in an outreach capacity is the knowledge that the few humanitarian services offered in low- and middle-income countries (LMICs) are likely the only available services for many communities. In these regions, travel risks are heightened, cases and fatality rates are underreported, and other issues are amplified at a foundational level, such as unstable governments, inadequate sanitation, comorbid diseases associated with a less healthy population, and limited infrastructure to roll out broad-based testing with accurate reporting measures. These concerns put humanitarians, as well as those who would be served by outreach programs—recipients who will unavoidably congregate in hopes of long-awaited services—at grave risk.
Humanitarians need to know that they can still provide outreach from a distance through virtual platforms. The World Health Organization (WHO) has recently released the WHO Ear and Hearing Survey Handbook to guide countries in gathering much-needed population-based data about the causes and prevalence of hearing loss (WHO, 2020). Ultimately, the gathered data will be used to guide public health and legislative leaders in strategic decision-making. The survey handbook outlines an easy-to-follow approach from planning and conducting the survey to managing and ensuring the quality of collected data. It also includes household roster and data collection forms and a protocol for rapid assessment of hearing loss. Though audiologists rarely pursue public health degrees, most of the handbook section titles are easily within the grasp of clinically trained audiologists as an alternative mode of humanitarian outreach in the virtual world.
An important first step of any outreach program is to raise awareness by sharing this downloadable WHO Ear and Hearing Survey Handbook with public health leaders in LMICs. Besides public health experts, the planning team detailed in the handbook includes audiologists in addition to the principal investigator, biostatistician, and survey coordinator. The planning team will be instrumental in reviewing the design, budget, timeline, and protocol; attaining ethical approvals; training field teams in the use of audiometric equipment, etc., collecting data, analysis, and writing the survey report; and eventually publishing articles in peer-reviewed scientific journals. Easy, right? But this is only step one. Humanitarian audiologists have the opportunity to offer their support and expertise from afar—an exceptional contribution to the leaders in LMICs intending to conduct the survey.
Humanitarian contributions are achievable from a distance. Since the enforcement of physical distancing (and for some, self-quarantine) measures due to COVID-19, many individuals have gained proficiency in the use of virtual platforms, which are foundational to telehealth and more specifically to teleaudiology assessment, training, and counseling necessary for the survey. Section 2 of the handbook suggests training field and health teams in LMICs in interacting with participating household members and providing information and education on the principles of ear and hearing care, otoscopy, foreign body removal, hearing and middle ear assessments, and identification of cases that need a referral for urgent medical attention.
The in-person home visits detailed in Section 3 may not be possible, but providing telehealth support to the home visit survey team is invaluable. For that matter, Section 4 discusses data management and provides additional opportunities for virtual consistency checks as needed by experienced eyes during the data submission process.
While so many humanitarians have wisely decided to sit out 2020 (and possibly 2021) outreach programs, there are opportunities to become a larger fulcrum in improved ear and hearing care in LMICs. It may feel as though humanitarian outreach projects are sitting fallow, but there is a larger picture of moving an entire province, country, or region toward the ultimate goal of local leadership and sustainability. It simply begins with step one: Bringing awareness to public health and legislative leaders of the region or country being served. Volunteer your invaluable professional assistance and expertise via telehealth to participate in the much-needed process of conducting a province-, country-, or region-wide survey.
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