Publications

Newsletter 1a

The front page is dominated by a logo of the Society for Sound Hearing logo alongwith its tagline: Action for Ear and Hearing Care for all. It also states the overarching aim of the society which is to 'Develop Comprehensive, inclusive and sustainable ear & hearing care programs in Asian countries'.

The page carries the logo of CBM and indicates the Society is supported by CBM.

The newsletter also gives the address and contact details:

Society for Sound Hearing
Room No 306 A, Office of the Dean
Maulana Azad Medical College, Bahadur Shah Zafar Marg
New Delhi, India 110002
Phones: +91-9212666995 Fax: +91-11-23235574
E-mail: shellychadha@gmail.com, bulancoosh@gmail.com
Website: www.soundhearing2030.org/

Newsletter 2a

The inner page carries a picture of a girl with the logo of the Society for Sound Hearing logo alongwith its tagline: Action for Ear and Hearing Care for all. The newsletter is an account of all activities of the society from 2005-2011.

Newsletter 3a

The page outlines the Vision, Mission, goal and objectives of the society. It also outlines the countries included in the organisation.

ABOUT SOUND HEARING 2030

SOUND HEARING 2030 is an initiative for the prevention and elimination of hearing impairment. Its key function is improving the quality of life of persons with hearing impairment through development of comprehensive, inclusive, and sustainable ear and hearing care programs at national and sub national levels. This would be by facilitation, guidance, technical support, sharing of information, monitoring and evaluation, all in collaboration with National Committees and all stake holders of target countries in the South East Asia and other regions.
In 2002, the Recommendations of the WHO Inter-Country Consultative Meeting in Colombo stated that an institutional structure needs to be put in place for all the stakeholders to move on and provide a mechanism for regional cooperation among SEA countries in relation to all aspects of deafness prevention and ear and hearing care. This led to the launch of the Sound Hearing 2030 program.

The Society for Sound Hearing (SSH) has been ratified at the first General Body meeting in Bangkok on the 4th of October 2005, with the initial support of WHO SEARO and CBM. It is a permanent New Delhi based international organization with representations from professional societies, governmental focal persons, international NGOs, agencies, and active individuals.

• VISION: To improve the quality of life in the Asian Region by including in developmental programs the RIGHT TO BETTER HEARING.
• MISSION: To eliminate avoidable hearing impairment by the year 2030 through development of sustainable and inclusive ear and hearing care systems.
• GOAL: The Goal of the SOUND HEARING 2030 program is to reduce avoidable hearing impairment to 50% by 2015 and 90% by the year 2030.

OBJECTIVES:

1. To raise awareness at all levels within the community.
2. To promote sustainable and comprehensive ear and hearing health care.
3. To facilitate the increase of appropriately trained community oriented ear and hearing health care professionals and personnel.
4. To enhance access to appropriate ear and hearing health care.
5. To advocate and promote sustainable and comprehensive ear and hearing care, as national health systems development.

COUNTRIES INCLUDED: The countries included at the start of the regional organization are eleven countries, in accordance with the WHO regional division. At present the Society for Sound Hearing is focussed on the South East Asia Region of the World Health Organization. The target countries shall be expanded to include all countries of Asia and finally be extended all over the globe.

The countries include: Bangladesh, Bhutan, DPR Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste.

Newsletter 4a

The page outlines the Functions, Priorities, Supporting Agencies of the society.

FUNCTIONS of SSH:

1. Promote the principle and practice of primary ear and hearing health care, as a fundamental aspect of public health intervention.
2. To facilitate the resource mobilization in the countries for enhancing access to simple and appropriate ear and hearing health carel.
3. To identify good practices, and to exchange such experience and information on all aspects related to hearing loss and impairment.
4. To collaborate with national programmes on deafness hearing impairment.
5. To work closely in partnership with national expertise, institutions, committees, national and international Civil Society, WHO and other development partners in promoting better hearing for all.

PRIORITIES (may vary with each country):

1. Care for the underprivileged communities.
2. Focus on early detection, intervention and rehabilitation of the most commonly occurring and preventable causes of deafness and hearing impairment, such as:
   1. middle ear infection
   2. congenital
   3. ototoxicity
   4. impacted cerumen
   5. aging (presbycusis)
3. Prevention programs at all levels of services.
4. Human resource development.

Infrastructure development specially focused on the primary and secondary level.

SUPPORTING AGENCIES:

It carries the logos of WHO and CBM.

WHO Headquarters and WHO SEARO has been actively involved since the development of the organization in its early phase, with great support from the Prevention for Hearing Impairment(PHI-PBD) official Dr Andrew Smith (founding member) and Regional Advisors for Disability, Prevention of Injury and rehabilitation (RA-DPR) officials: Dr Madan Upadhyay (founding member), Dr Santikarn Chamaiparn and Dr. Sara Varughese.
Technical support as well as financial support for meetings, symposiums and epidemiological data update has been provided by the W.H.O. SEARO alongwith great inputs and advice of Dr Sawat Ramaboot (founding member) and Dr U Than Sein.

CBM, under the leadership of Dr Allen Foster has been the main financial sponsor, for organizational activities as well as programs and meetings. Ms Silvana Mehra (founding member) as well as other Regional Directors and the staff of CBM has given ongoing technical support for set up, capacity building and program planning of the organization, as well as distribution of recommendations through all CBM channels. This in turn has initiated implementation activities in the form of community ear and hearing / prevention of hearing impairment projects in several locations in the region.

IMPACT through involvement of Dr Padman Ratnesar (founding member), HEARING INTERNATIONAL through involvement of Dr Suchitra Prasansuk (founding member), IFOS through Dr Arun Agarwal (founding member)and Dr M Alauddin (founding member) have given invaluable inputs in the development of terms of reference and the rules of procedures of the organization.

OTHER LINKAGES:

International Society of Audiologists (ISA) - ASEAN ORL HNS - SAARC ENT - WHO CC BANGKOK - WHO CC JAKARTA - WWHEARING - NATIONAL COMMITTEES - ACTIVE INDIVIDUALS - HEARING AIDS MANUFACTURERS AND COMPANIES

Newsletter 5a

This page refers to Current Scenario on Disability.

CURRENT SCENARIO

On 9 June 2011, WHO and the World Bank officially launched the first-ever World report on disability. This landmark report reveals that more than 1 Billion people in the world experience some form of disability.

PREVALENCE

According to the World Health Organisation, 15% of the population of the world suffers with a disability. 80% live in middle & low income countires. 1/3^rd of people of disabilities are children. 2/3^rd of people of disabilities in these children could have been prevented.

STRATEGY: The World report on disability recommends that governments and their development partners provide people with disabilities access to all mainstream services, invest in specific programmes and services for those people with disabilities who are in need, and adopt a national disability strategy and plan of action.

In addition, governments should work to increase public awareness and understanding of disability, and support further research and training in the area. Importantly, people with disabilities should be consulted and involved in the design and implementation of these efforts.

World report: Prevalence of moderate and severe disability (in millions), by leading health condition associated with disability, and by age and income status of countries.

HEARING DISABILITY: THE PROBLEM

All age groups are prone to ear and hearing disorders but, it is essentially the younger age group which faces the maximum morbidity in this regard. The common ear diseases that are prevalent in our country include Chronic Suppurative Otitis Media, Secretory otitis Media and Wax impaction. A large number of these diseases are preventable. Others can be treated medically or surgically. Effective and early treatment of these ear diseases can lead to improvement in the outcome of the affected persons.

However, it is estimated that over 166 million people in the developing world face a severe lack of intervention services for hearing loss. According to the World Health Organization (WHO), this crisis results from a substantial increase in "disabling hearing impairment" over the last 15 years. This is compounded by a severe shortage of skilled health care workers, especially so in the developing countries.

NOISE as a cause of hearing loss:

Recent reports WHO[2002] and Nelson[2005] state that worldwide, 16% of the disabling hearing loss in adults is attributed to occupational noise ranging from 7% to 21% in various sub regions. However, Noise is no longer an occupational problem alone, as it is has now permeated all aspects of our social life. Smith et al. (2000) found that the number of young people with social noise exposure has tripled (19%) since early 1980s while occupational noise has decreased. Serra et al. (2005) studied that sound levels of Personal Music Devices (PMDs) range between 75-105 dB and of discos between 104.3-112.4 dB so their chronic use leads to Noise Induced Hearing Loss [NIHL]. NIHL can be prevented to a large extent by reducing exposure time and levels. For this attention has to be drawn to the need for ensuring that sufficient preventive measures are in place.

Newletter 6a

This page refers Founder members, Executive Committee, Advisory Board and Secretariat.

FOUNDER MEMBERS: The founder members who worked to establish the organisation were the representatives of nine lead organisations. They are, as given below

1. Dr. Madan P. Upadhyay (WHOSEARO)
2. Dr. Andrew Smith (WHO)
3. Prof A. K. Agarwal (IFOS)
4. Prof. M. Alauddin (SAARC-ENT)
5. Dr. Bulantrisna Djelantik (STP WHOSEARO)
6. Ms. Silvana Inselmann (CBM)
7. Prof. Suchitra Prasansuk (HI)
8. Dr. Sawat Ramaboot (WHO SEARO)
9. Dr. Padman Ratnesar (IMPACT)

An image of the Founder Members - Top Right to Left: Dr. A.K. Agarwal, Dr. Madan Upadhyay, Dr. Padman Ratnesar;Bottom Right to Left: Ms Silvana Mehra, Dr. Bulantrisna Djelantik, Dr. Andrew Smith

EXECUTIVE COMMITTEE: The first Executive Committee completed its tenure from 2005 to 2009.

The second executive committee was elected in December 2009 during the 3rd General Body meeting of the organisation, held in Kathmandu, Nepal. The executive members include:

1. Prof. Arun K. Agarwal, India, President
2. Dr. Bulantrisna Djelantik, Indonesia, Past President & COO
3. Dr. Madan Upadhyay, Nepal, Senior Vice President
4. Ms Silvana Mehra, CBM, Vice President
5. Prof. Suneela Garg, India, Treasurer
6. Prof. Shelly Khanna Chadha, India, Secretay General
7. Prof. Rakesh Shrivatava, Nepal, Joint Secretary
8. Professor Suchitra Prasansuk, Thailand, Member
9. Dr. U. Than Sein, Myanmar, Member
10. Dr. Ronny Suwento, Indonesia, Member
11. Dr. A.H. Joarder, Bangladesh, Member
12. Dr. M.N.G. Mani, India, Member

An image of the EXECUTIVE COMMITTEE 2009-2013. Starting from Top Right to Left: Prof. Suneela Garg, prof. Shelly Chadha, Dr. MNG Mani, Dr. U. Than Sein, Prof. Rakesh Shrivastava, Mr. Vikas Katoch (CBM SARON), Dr. Ronny Suwento, Dr. A.H. Joarder; Bottom left to right: Ms. Silvana Mehra, Dr. M. Upadhyay, Prof. A.K. Agarwal, Dr. Bulantrisna Djelantik, Prof. Suchitra Prasansuk

ADVISORY BOARD: An advisory board constituted in 2009 consists of the following members:

1. Dr. J.J. Grote, IFOS
2. Dr. Andrew Smith, LSHTM
3. Dr. Prangopal Dutta, Bangladesh
4. Dr. Bradley McPherson, ISA

Images of the members of Advisory Board. Starting from Top Left: Dr. J.J. Grote, Top right: Dr. Andrew Smith;Bottom left: Dr. Prangopal Dutta, Bottom right: Dr. B. Mc Pherson

SECRETARIAT: The Office of the secretariat is located at the Maulana Azad Medical College, New Delhi. Ms. Janki Mehta is the Office Administrator. Part time employees of the office consist of Ms. Indubala and Mr. Mayank Kamboj.

An image of the secretariat members.

Newsletter 7a

This page outlines the Activities of the society:

ACTIVITIES

1. Preparation of a report on: Situation Review And Update On Deafness, Hearing Loss And Intervention Programmes in collaboration with WHO SEARO.The report has been published as a booklet by WHO SEARO in December 2007 and can be downloaded from
   http://www.searo.who.int/LinkFiles/Publications_SRUDHLIP.pdf
2. Technical guidance for Development of the National Programme for Prevention & Control of Deafness based on the concept of "Healthy Ear District": The Secretariat of the Sound Hearing in Delhi has been providing complete technical support and guidance to the Indian government in it's implementation of the Healthy Ear District Project in various states of the country.
3. Launching of the Indonesian National Committee for the Management of Hearing Impairment and Deafness: December 2007, the Indonesian National Committee was launched as a collaborative effort of Indonesian government, Sound Hearing 2030 and WHO Indonesia. Subsequently, 8 provincial committees have been formed in Indonesia.
4. International Symposium on Deafness in Childhood was organized in Jakarta, Indonesia in December 2007. It was attended by over 150 medical doctors, ENT doctors and audiologists..
5. School Screening Programme in New Delhi, India: The Secretariat has been involved in carrying out an extensive project to screen all the school going children of Delhi for the presence of ear and hearing diseases. This is being done in collaboration with a local NGO.
6. Launching of the National Committee for the Management of Hearing Impairment and Deafness in Bangladesh: In May 2008, a Joint meeting between members of the Society for Sound Hearing and the Bangladesh government officials was organized in Dhaka. The Bangladesh National Committee was the outcome of this meeting.
7. Developing prototype and field tested country publicity materials: 15 posters, 6 pamphlets and 2 flip charts have been developed through the collaborative efforts of the members about the Sound Hearing 2030 concepts. These have been field tested and validated. The material is readily available for download at: http://www.soundhearing2030.org/awareness.php
8. Developing & maintaining accessible website: A fully accessible website: www.soundhearing2030.org has been developed professionally and is fully functional.
9. Developing partnerships with other like minded organizations, Disabled people's organizations, audiologists and teachers for hearing impaired through participation in various activities such as the '2nd Deaf Expo' held in India in December 2010. Efforts for developing partnership with international organizations such as WHO SEARO, WHO HQ, UNESCO are underway.
10. An Expert Committee meeting for 'Developing guidelines regarding Infant Hearing Screening in India' was held in January 2009 at New Delhi, India The meeting was held in collaboration with the WHO India country office. Guidelines for India were developed as a consequence of this meeting.
11. The WHO SEA-SSH Inter-Country Consultative Meeting to Develop Guidelines of Infant Hearing Screening in the region was held at Kathmandu, Nepal in December 2009. The meeting was attended by experts from the different countries of the region as well as representatives of WHO SEARO. The meeting discussed the existing concepts of Neonatal/Infant hearing screening in the world. A report on the meeting containing some "guiding principles" was the outcome.
    An image of an infant hearing screening in Indonesia
12. Joint Expert Meeting on Guiding Principles for Infant Hearing Screening was held in Kathmandu, Nepal in March 2011. This meeting discussed the various issues related to the practical implementation of the Infant Hearing Screening in developing countries of Asia. The report and guidelines are under development.
13. Development of Guidelines regarding Inclusion of Hearing Impaired in India: These guidelines have been developed through a consultative effort of experts in the field of Inclusion, Education as well as subject experts. They have been validated and are available for download on the website.

Newsletter 8a

This page continues with the Activities of the society. This page also displays awareness material that has been created by the society for Sound Hearing including posters and flyers.

14. Pilot project for operational research in HI and Blindness program: A pilot project to develop a replicable model of integration of ear & hearing care services with existing eye care services has been carried out in India and a second project has been initiated in Nepal.
15. Needs assesment for National Committee strategy paper was developed and used as framework for organizing the India National Worshop for Strategic Planning in December 2010.
16. Seminar on Prevention of Deafness & Hearing Impairment in India: A strategy plan meeting was held in New Delhi on the in December 2010 and was attended by national experts representing all stakeholders in the community ear and hearing health care in India. It was organized as a joint venture of Sound Hearing with Govt. of India. This has to the development of the future strategy in this regard for India.
17. Completing the development of multi-level training modules: The WHO Training Manuals for Community Ear and Hearing Care are being adapted for 4 levels of trainings. The modules include a series of power-point lectures for each of the levels of training. They are presently being field tested and validated by other experts and will be uploaded on the website.

Newsletter 9a

This page outlines the Programme Concepts of the society and describes various Program such as HEALTHY EAR DISTRICT PROGRAMME, SCHOOL HEARING SCREENING PROGRAMME.

PROGRAMME CONCEPTS

HEALTHY EAR DISTRICT PROGRAMME

In most countries of the region, a district level hospital is defined as one that serves at least one million population. In some highly populated areas, the population could reach 2 million people or more. Ear and hearing care services have been found to be the weakest at this level, while on the other hand, this level plays an important role in the referral chain of the patients in the community.

A District Hospital is the first referral center for patients from the Primary Health Centers at the remote or rural areas. In order to establish a proper 'Ear & Hearing care service' at this level, the minimal requirement that ideally has to be in place at the District Hospital has been discussed at a working group during the WHO Inter-Country Consultation Meeting in Colombo in December 2002. Table 1 shows the compilation of the group recommendation.

Description	Requirements
SERVICES (minimum requirement)	Pure tone audiometry and tympanometry Simple ear surgery, eg. simple mastoidectomy; Pure tone audiometry and tympanometry Simple ear surgery, eg. mastoidectomy; Grommet / Myringotomy; Myringoplasty / Impacted ear wax / FB removal Determine types and degree of hearing loss Hearing aid fitting in adults Speech therapy if possible Outreach services Awareness raising Motivation Screening for ear disease and hearing impairment Referrals
HUMAN RESOURCES	ENT Doctor (1), Audiometrist (1) ENT Nurse / Technician (1), ENT Nurse ( O.T.) (1) Hearing Aid Technician (including Ear Mould Making) Speech Therapist / Audiologist - if possible Outreach Services coordinator
DEVELOPMENT OF HUMAN RESOURCES	The ENT doctor should have community-oriented training Have training for Audiometrists Training facilities for Para-medics Training of Primary Level Workers
DEVELOPMENT OF OTHER RESOURCES	Clinical Audiometer (1), Tympanometer (1) Operating Microscope (1) All necessary surgical instruments

This concept is already under implementation in India as a National Programme.

LESS NOISE CITIES:

As the world moves forward in the 21st century, there is increasing urbanisation with its consequent explosion of urban population leading to the development of megacities. 'Megacities' is a term coined by the United Nations, to describe cities with at least 10 million inhabitants. It is expected that by the year 2015, there will be 33 such megacities in the world. Twenty seven of these will be in developing countries. With greater development come greater problems and environmental ills. Due to increasing industrialization and mechanization, the problem of Noise has become a serious issue in such cities and the menace is likely to grow, if not checked. With this in mind, the Society for Sound Hearing has developed the concept of 'Less Noisy Cities'. This is a comprehensive programme, looking at various aspects of noise, its control and mitigation in the urban context.

The Aim of such a programme is:

To reduce noise exposure of the population living in megacities and to control its possible adverse effects.

The strategies for this include:

• Taking all stakeholders on board including the legislators, administrators, perpetrators and residents.
• Focus on Awareness building as the main component of the programme.
• Promote community empowerment through proper strategies.
• Develop stricter laws, if possible.
• Ensure better implementation of existing laws.
• Develop innovative strategies for the above.

The activities that are advocated in this regard include:

1. Creation of an Anti-Noise Cell. An effective and efficient Cell is the keystone to the success of this venture. The Cell must have representation from environmental & medical experts as well as law makers, industrial representatives and administrators.
2. Awareness campaigns
3. Make the implementation ofNOISE CONSERVATION PROGRAMME mandatory for all high risk groups.
4. Strict implementation of existing Legislation with respect to Noise.
5. Recommendations regarding development of new legislation.

These are some of the activities envisaged under the programme. For a more detailed concept note visit: www.soundhearing2030.org.

Newsletter 10a

This page describes the SCHOOL HEARING SCREENING PROGRAMME.

SCHOOL HEARING SCREENING PROGRAMME:

An image showing the School Screening in Progress in India and another image in Indonesia.

The children of Primary school going age group are the ones who are most predisposed to developing various ear diseases such as Otitis Media and Cerumen impaction, that can lead to mild to moderate and sometimes severe hearing loss. Most of these ear diseases are preventable to a great extent. As and when they occur, they can be treated, either medically or surgically. What is required is a method by which these children can be detected at an early stage and treated suitably.

The Recommendations for School Screening chalk out the principle requirements for conduct of a successful programme. These include:

1. Screening of every child in the primary section (4-10 years of age)
2. Ear examination through otoscopy
3. Hearing test through screening audiometry/hand held audio-screener/any other validated screening device
4. Impedance Audiometry with a hand held screener
5. Provision of simple services such as ear drops, wax removal etc
6. Referral of identified students to identified centres where linkages have been established.
7. Awareness creation as part of the programme, through posters, handouts, flipcharts, talks etc

For more details, please log onto www.soundhearing2030.org

COMBINED EYE-EAR & HEARING CARE SERVICES:

WHO SEA report on status of ear & hearing care states that 'the fact that deafness is increasing rapidly indicates that perhaps actions so far have been inadequate to reduce the pace at which it is increasing.' On the other hand, initiatives such as Vision 2020 have led to the development of eye care programmes in most parts of the world. Even in developing countries such as India, eye care programmes have been well established for over the last couple of decades.

Principle:

It is proposed that wherever the eye care infrastructure is well developed, primary ear & hearing care services can be initiated within the same infrastructure. This will help to minimise potential expenses and prevent duplication of effort.

An image showing Vision centre serving as Eye-Ear & Hearing Care centre in a slum area of New Delhi, India

Strategies:

1. To identify suitable centres for integration of eye care services with ear care services.
2. To train the Vision worker/CBR worker in carrying out ear and hearing care work.
3. Develop suitable formats for recording of cases, referral and follow up
4. Provide Otoscope and tuning forks (Audiometer and Tympanometer, if possible) as well as suitable questionnaires at the centre.
5. Establish linkages with the referral centre.
6. To use suitable awareness materials: posters, handouts etc for awareness creation within the community served.
7. Publicise the ear & hearing care services at the centre.
8. Carry out community based camps with awareness creation and motivate persons to avail ear & hearing care services.
9. Carry out OPD activities at the centre

This concept has already been field tested in India and is currently also being field tested in Nepal.