Bridging Continents Through Sound

Earlier this year, Oticon Medical Marketing Manager and audiologist, Hilary McManus, had the opportunity to travel to Malawi with Hearing the Call, a nonprofit organization that focuses not on short-term relief, but on the long-term development of sustainable hearing healthcare in the communities it serves. Rather than providing one-time care and moving on, Hearing the Call collaborates with local professionals to build lasting systems through education, training, and access to resources.

This model of development over relief is backed by growing global health research. Short-term missions can sometimes unintentionally undermine local providers, disrupt continuity of care, and create dependency. Sustainable development, on the other hand, strengthens local infrastructure, empowers communities, and ensures that care continues long after international teams depart.^1.2.3.4.

In Malawi, Hilary saw firsthand the vital role local providers play in ensuring that care is both sustainable and culturally responsive. These providers bring invaluable insights into their communities, enhancing the quality and relevance of the care delivered.

During three clinical days, Hilary’s group saw 174 patients, which included 113 traditional hearing aid fittings and eight Ponto™ fittings. They were also able to provide training to local audiologists and audiology students to ensure these patients receive top-tier follow-up care.

It was a whirlwind of activity, but what stood out most was the collaboration with dedicated Malawian clinicians and students, whose commitment to their patients and profession is nothing short of inspiring. Hilary’s group tried to see as many patients as possible while still providing excellent care. Even in this fast-paced environment, every individual on the team was able to not only teach, but learn from clinicians, students, and patients.

One of the audiologists on the trip asked everyone to think of one word to describe their time in Malawi and the first word that popped into Hilary’s mind was laughter. “Of course, we all worked hard giving those who attended the outreach clinics the best possible care,” Hilary shared. “But what I remember most are the moments of shared laughter between team members, with patients, and with my Malawian colleagues. It was the kind of laughter that supersedes language barriers, eases the weight of long days, and reminds you why you chose this profession in the first place.”

Despite the high prevalence of otitis media (an infection of the middle ear) and associated hearing loss, few Malawians have ever received a hearing device. Misconceptions about hearing loss and ear infections, combined with limited access to care with widespread use of home remedies, highlight critical gaps in hearing health literacy and service delivery. Bone anchored hearing systems like Ponto are uniquely suited to these communities, where conductive hearing loss and middle ear conditions are extremely common.

A Note from Yamikani Dumbo, Local Malawi Audiologist

Malawi faces significant challenges in addressing hearing loss due to limited resources. There is only one institution offering an Audiology degree, making it difficult for aspiring audiologists to access education and training. Consequently, the country lacks sufficient audiologists to provide essential services. Those who do qualify often seek job opportunities abroad, leaving Malawi with a severe shortage of skilled professionals.

Although four government hospitals offer audiology services, access to care remains insufficient due to limited equipment and resources. Furthermore, the absence of hearing aids at these hospitals limits the effectiveness of hearing loss diagnoses. This lack of services and essential tools deepens the problem, leaving many individuals without access to the care they need.

The state of audiology in Malawi is concerning and requires attention. There is a need to raise awareness through educating the public about the importance of ear health and the consequences of untreated hearing loss. Increasing accessibility in audiology education and training opportunities to increase the number of skilled professionals is needed to minimize challenges in accessing care. It is also essential to improve local audiology services by providing appropriate equipment and resources so they can offer comprehensive care.

Resources and Special Thanks

Hearing the Call was founded in 2016 to address the needs of thousands of individuals worldwide with treatable hearing losses who lack access to hearing aids. If you or your organization would like to support their efforts to aid hard of hearing people around the world, please visit https://hearingthecall.org/. You can also learn more about their outreach trips and volunteer opportunities.

Hilary and Oticon Medical would like to personally thank all the Hearing the Call employees and volunteers she worked with on this trip, including co-development and clinical lead Dr. Heidi Hill, co-development lead Dr. Jenna Vallario, Entheos Director of Education and Research Laurel Gregory, and photographer/videographer Cristian Veaudry.

Thanks also go out to the hearing care professionals who joined HIlary on the Malawi trip, including Dr. Sarah Conrad, Dr. Nad Kattan, and audiology student Anna Rippy and Malawian audiologists Yamikani Dumbo and Alinane Malili, Head of the Audiology Department at African Bible College (ABC), ENT physician Dr. Julia Toman and infectious disease specialist Dr. Zach Porterfield.

Most of all, we’d like to share our deep appreciation of the incredible, very soon-to-be audiologists Mphatso Dube, Enittah Chikuse, Flocy Square, Angella Banda, Peace Chikuniwenda, Micah Mbewe, Mercy Msakwiza, Cuthbert Mbalame, and Jane Iradukunda.

References

1. Chaus, M. (2020). The dark side of doing good: A qualitative study to explore perceptions of local healthcare providers regarding short-term surgical missions in Port-au-Prince, Haiti. Journal of Global Health Reports, 4, e2020002. https://doi.org/10.29392/001c.11876

• •  Journal of Global Health Reports

2. Tracey, P., Rajaratnam, E., Varughese, J., Venegas, D., Gombachika, B., Pindani, M., Ashbourne, E., & Martiniuk, A. (2022). Guidelines for short-term medical missions: Perspectives from host countries. Globalization and Health, 18(1), 19. https://doi.org/10.1186/s12992-022-00815-7

• •  BioMed Central

3. Melby, M. K., Loh, L. C., Evert, J., Prater, C., Lin, H., & Khan, O. A. (2016). Beyond medical "missions" to impact-driven short-term experiences in global health (STEGHs): Ethical principles to optimize community benefit and learner experience. Academic Medicine, 91(5), 633–638. https://doi.org/10.1097/ACM.0000000000001009

• • ResearchGate

4. Prasad, S., Aldrink, M., Compton, B., Lasker, J., Donkor, P., Weakliam, D., Rowthorn, V., Mantey, E., Martin, K., Omaswa, F., Benzian, H., Calgua-Guerra, E., Maractho, E., Agyire-Tettey, K., Crisp, N., & Balasubramaniam, R. (2022). Global health partnerships and the Brocher Declaration: Principles for ethical short-term engagements in global health. Annals of Global Health, 88(1), 31. https://doi.org/10.5334/aogh.3577

• • Annals of Global Health