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As deafness control plan stalls in Maharashtra, children with late diagnosis suffer

Only 20 per cent of a national scheme’s programme budget utilised so far this financial year in Maharashtra.

Written by Tabassum Barnagarwala | Mumbai | Published: January 16, 2017 2:08:49 am

When Nishka Naik was a year old, her mother started panicking — the baby wouldn’t respond when called by her name, or when toys whirred and rattled. Six months ago, at Nair Hospital, Nishka was diagnosed with ‘severe’ hearing loss.

Now two years old, she faces a delay in speech therapy. Ther mother Asmita, a housewife, travels everyday from Kanjurmarg to Mumbai Central to help the baby attend special speech therapy school, but the child’s growth, she knows, is delayed.

“I wish it was diagnosed earlier. But when a baby is so young, we tend to think that maybe a sound is not attracting her attention,” Naik says.

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At Nair Hospital, like Nishka, 1,461 children visited in 2016 for hearing impairment diagnosis and therapy.

The hospital is the only government institution across the state to screen 4,500-6,000 newborns delivered every year for hearing impairment. On the first floor ward, parents throng the audiology corridor with their kids, waiting for their turn to enter the small cubicles where trained staff members conduct speech therapy.

“The more the delay in diagnosis, the more difficult it gets to teach them to speak and understand language,” Dr Jyoti Mohite, professor in the hospital’s audiology department, says.

World Health Organisation data pegs Indians suffering hearing loss at 63 million, of which children aged less than 14 form a huge chunk.
Despite a National Programme for Prevention and Control of Deafness (NPPCD) running in Maharashtra since 2010, expected expansion to all districts has not taken place. Currently, only 16 of 36 Maharashtra districts run the program.

The state government has supplied 16 district hospitals with audiometers to evaluate hearing acuity and otacaustic emission analyzers (OEA) to screen newborns for hearing loss, but high vacancies have slowed the program.

Of 16 posts for ENT surgeons, 15 are vacant. Of 16 posts for audiologists, 8 are vacant, data accessed by The Indian Express from the Directorate of Health Services (DHS) shows. Of the Rs 206.4 lakh approved for 2016-17 for the programme, only Rs 41.9 lakh had been spent until October last year.

When new-borns are suspected to be non-responsive to sound, a confirmatory test checks whether hearing loss is mild, moderate, severe or profound. A cochlear implant, surgery or hearing aid is advised which helps the parent begin speech therapy classes immediately.

At age nine, Ranjan Upadhyay’s sentences are still broken words. The Nallasopara boy was diagnosed when he was one and half years old, a year too late. “He has a hearing aid but cannot speak easily. No doctor told us to screen him after birth,” says Rajkumar Upadhyay, a businessman.

The lack of therapy and audio screening has forced rural and suburban people to seek treatment in cities. Audiologist and speech therapist Devangi Dalal receives 40 patients every month in Santacruz for hearing loss, of which a rising number she says is now from rural pockets. “As awareness is increasing, rural population is coming to Mumbai for screening. In villages, there is a lack of therapy and special schools for disabled children,” she said.

The other reason for delayed diagnosis is that the focus is on school camps and routine camps where older children can be screened. DHS data shows diagnosis is five times higher in children aged between 5-15 years (2,205 kids) than those aged less than 5 years (384 kids) which shows most are detected in schools. Data from April to October 2016 said 298 screening camps were held in schools in Maharashtra. In the same duration, 94 kids were fitted with hearing aids.

With the government scheme faltering, several patients are forced to shell out money due to lack of government facilities such as free hearing aids or proper rehabilitation under the NPCCD programme.

Bhavika Chaudhary (4) was born in super specialty Sion Hospital in Mumbai weighing just one kilo. The pediatrician adviced her parents to conduct an OAE test, but the facility was not provided in the government hospital.

“I spent Rs 25,000 on a hearing aid, Rs 500 for every session of speech therapy and fees for screening to get her correct diagnosis. We were never told such a programme exists by doctors,” said Bharat Chaudhary, a small-scale sari businessman.

The DHS has now moved a proposal to start a facility for neonatal screening in Pune to detect early hearing impairment. It is yet to start. “We have audiometer services in 16 district hospitals. The program will expand in phases,” said Dr Satish Pawar, director at DHS.

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