Hearing Loss in Developing CountriesAs of 2018, an estimated 466 million people around the globe suffer from hearing loss. Access to technology and medical care to aid those with hearing loss is rather limited in developing nations. Language barriers, stemming from a lack of sign language interpreters, prevent communication between patients and doctors. By identifying the signs of hearing loss earlier, individuals may have opportunities to receive medical help and progress in their communities. Addressing hearing loss in developing countries through public health measures and advocacy will aid the economy and overall well-being of developing countries.

Causes of Hearing Loss in Developing Countries

The two primary kinds of hearing loss in developing countries are congenital and acquired. Congenital causes can come from a family history of hearing loss, prenatal factors or complications during childbirth. Severe infection during pregnancy often passes onto the baby. Low birth weight, a lack of oxygen during birth, premature birth or preeclampsia are all contributors to hearing loss in newborns.

Acquired causes of hearing loss happen at birth, during childhood or from aging. Old age or exposure to loud noises during one’s lifetime can destroy sensory cells in the ear. Trauma from an accident or even severe, recurring ear infections can also lead to deafness in one or both ears. For example, chronic ear infections in South-East Asia, the Pacific Islands and Africa affect up to 46% of their populations. In a study in Brazil involving 70 subjects, the Zika virus caused hearing loss for 7% of the children between 0-10 months.

Effects on Children

Unlike further developed countries, mothers and families are unable to screen their newborns during and after pregnancy. Approximately 34 million children have disabling hearing loss, and the majority of these children suffer socially and emotionally. Without the ability to communicate effectively, these children end up isolated within their homes. They can not receive an education, so in their adult life, they remain illiterate. A lack of education means higher unemployment rates throughout the country.

Some forms of prevention against disease may also put newborns at risk of developing deafness. Around 660,000 out of 219 million people die each year from malaria. Chemoprophylaxis is one of several forms of medication to prevent contracting the illness. Malaria can lead to low birth rate and deafness, but so can antimalaria medication such as Chemoprophylaxis. Other medicines used for infections during pregnancy or tuberculosis can similarly result in deafness for newborn children.

Organizations and Advocacy

Children must be immunized against severe diseases to aid hearing loss in developing countries. Mothers must be encouraged to take medications needed during their pregnancies properly, and earlier screenings on newborns need to be readily available. World Wide Hearing provides affordable hearing aids to countries lacking hearing clinics. With less than 10% of hearing aid distribution worldwide, World Wide Hearing ensures the deaf’s social inclusivity.

Partners for a Greater Voice built a school for the deaf in the Dominican Republic and also provides hearing aids to those with lower incomes. The trained teachers prioritize oral education and thus communicate effectively with students. Grand Challenges Canada pairs with Hearing Access World to distribute hearing loss diagnostic kits, and provide affordable screenings coupled with hearing aids. Along with donations and massive investments, projects involving Audio Techs also refer some patients to doctors that will cater to severe needs.

By preventing disease and providing needed resources, these organizations can limit the detriment of hearing loss in developing countries. Starting with the youth will benefit the economy as more children go to school and have jobs readily available. Age-related hearing loss must be managed through implementing active communication catered towards the deaf. Young or old, the deaf community will attain a better quality of life and socioeconomic confidence with accessible programs.

Sydney Stokes
Photo: Wikimedia Commons

Mental Health in the Developing World
According to the World Health Organization, the number of people diagnosed with a mental health disease has increased by 40 percent in the last 30 years. Poverty has been well-established as a driving force behind mental illnesses in the developing world. The Mental Health Foundation reports that 23 percent of men and 26 percent of women among the lowest socioeconomic class are at high risk of mental health problems. However, Psychiatric Times reports that many psychiatrists receive little training on intervening and addressing poverty and its relationship to mental disorders. The nonprofit Grand Challenges Canada is improving mental health in the developing world by funding innovations and expanding access to mental health care.

Mental Health in the Developing World By the Numbers

According to Grand Challenges Canada, 75 percent of the global burden from mental disorders is in developing countries. In addition, a World Health Organization report reveals some cogent statistics about the relationship between poverty and mental health:

  1. Depression is 1.5 to 2 times higher among low-income individuals.
  2. Common mental disorders are more prevalent for people living in poor and overcrowded housing.
  3. People with the lowest socioeconomic status have eight times more relative risk for schizophrenia than those of a higher socioeconomic status.
  4. People experiencing hunger or facing debts are more likely to suffer from common mental disorders.
  5. Evidence indicates the relationship between poverty and poor mental health is cyclical. Grand Challenges Canada is committed to ending the poverty-mental illness feedback loop.

Grand Challenges Canada

According to its website, Grand Challenges Canada has given 159,000 individuals access to mental health treatment. The organization’s project portfolio entails 85 projects in 31 countries and estimates that by 2030, the number of individuals impacted will be between 1.1 million to 3.2 million. Global Challenges Canada has influenced 17 mental health policies in various countries.

One example of Grand Challenges Canada improving mental health in the developing world is The Friendship Bench project in Zimbabwe. In 2012, Grand Challenges Canada funded a controlled study of more than 500 individuals with depression in the country. The patients involved received six 45-minute cognitive behavioral therapy sessions with a lay health worker, one of which took place in the individual’s home. The study found the prevalence of depression throughout program participants after treatment was less than 10 percent versus the approximate 33 percent of non-participants. The program has now spread to more than 70 clinics in Zimbabwe’s three largest cities.

In Vietnam, Grand Challenges Canada partnered with the Center for Creative Initiatives in Health and Population to develop the Smart Care project. The focus of the campaign centers around early diagnosis of autism spectrum disorder (ASD) to enable the best circumstances for children with the disorder. The program is based on a mobile platform, which includes apps to support screening and home-based intervention, a model of pilot screening development and health checkups for children with ASD.

Grand Challenges Canada is improving mental health in the developing world through the funding of technologies that vastly expand access to care. In 2016 and 2017, the organization invested over CA$42 million in projects to mitigate mental disorders. By 2030, Grand Challenges Canada expects to have seen symptomatic improvement in 297,000 to 844,000 individuals involved in projects.

– Zach Brown
Photo: Flickr

MNS disorders
When discussing health in developing countries, the diseases that come to mind are often exotic, tropical diseases that–although tragic–strangely spark our curiousity. We think of tropical disease such as malaria, dengue fever or parasitic diseases from which we in the developed world are completely safe. Tackling diseases such as these is incredibly important, but we often forget about other types of diseases that may be more familiar to us.

Rather than diseases that afflict the body physically, attention to mental, neurological and substance use (MNS) disorders is usually overlooked when addressing health issues in developing countries. MNS disorders are the leading cause of Disability Adjusted Life Years globally and account for 14 percent of the global burden of disease.

Although usually forgotten, three-fourths of the people worldwide suffering from mental illnesses are in developing countries. Worse, eighty-five percent of the people afflicted by severe mental illnesses in developing countries will not receive the care they need and deserve.

Mental illnesses are surrounded by stigma in many developing countries, which results in social exclusion, discrimination and in many cases isolation by means of being tied to trees or locked in rooms.

Addressing mental health conditions in developing countries is particularly important because widespread poverty increases vulnerability for developing MNS disorders. In addition to this, chronic conditions and mental disorders mutually reinforce each other. Other chronic conditions can increase the risk of developing mental illnesses and vice versa.

MNS disorders directly affect an individual’s ability to have stable relationships with family members and other members of the community and essentially prevent them from being able to fully contribute to society.

A 2010 report by the World Economic Forum and the Harvard School of Public Health showed that indirect costs of mental health conditions in low- and middle-income countries were estimated to be $583 billion and estimated to more than double by 2030 to $1.4 trillion. Along with cardiovascular disease, mental health conditions are the main economic burden of non-communicable disease, accounting for almost 70 percent of lost output.

A study in Nigeria asked 250 people about their primary reactions to mental illness and their responses included fear, avoidance and anger. It is extremely rare that those suffering from mental diseases in Nigeria receive treatment.

In Kaduna, there is an effort to help those suffering and reduce stigma. Through hard work, counseling and prayer, this treatment center that is half prison, half hospital helps its patients treat their mental illnesses. Men learn skills such as welding, sales and learn to build an array of sellable items ranging from pots to sofas. Women learn skills such as sewing and making baby clothes. Stalls are available for patients to sell their goods and gain income.

Despite the small size of this program, it is a testament of the success that can come from helping those dealing with MNS disorders to receive treatment and learn employable skills so that they can earn income.

More programs such as these are necessary to address mental health disorders and reduce stigma in developing countries, but funding is often a main roadblock. Low- and middle-income countries spend less than one percent of their already small health budget on addressing mental health.

Some organizations have begun funding these programs, which is a great first step to addressing and drawing the necessary attention to mental health disorders. Grand Challenges Canada, funded by the Canadian government, has already invested $31.5 million to date in “funding for bold, transformational proposals to improve mental health treatment, expand access to care and reduce the stigma in developing countries.”

There is scientific evidence to prove that moderate additional cost is needed to effectively address and treat mental illnesses and can even come with economic benefits, all while helping those suffering to live productive, healthy lives.

– Kimberly Tierney 

Sources: World Economic Forum, Nature, Youtube, Global Mental Health, Voice of America, The Agenda, WHO
Photo: The Guardian

On March 5, 2014, the Bill & Melinda Gates Foundation officially joined Grand Challenges Canada’s Saving Brains initiative.

The Saving Brains initiative is focused on improving child development worldwide by helping children reach their full potential. The need to do so is demonstrate by data released in 2007 that reported over 200 million children living in developing countries to be unable of reaching their developmental potential.

The Gates Foundation, in partnership with Grand Challenges Canada, has launched the new topic, “Explore New Ways to Measure Fetal and Infant Brain Development.” This new program will be a great addition to the country’s Muskoka Initiative, which is dedicated to the health of both women and children.

With its involvement, the Gates Foundation will be the very first global partner of Grand Challenges Canada. Other extensions of Grand Challenges, such as Grand Challenges Brazil, gained regional partners in the Maria Cecilia Souto Vidigal Foundation and the Bernard van Leer Foundation in November 2013.

As of 2014, Grand Challenges Canada’s Saving Brains initiative, currently funded by Canada’s government, has used over $28 billion in about 46 different projects. Saving Brains is determined to see an increase in human capital in low-income and middle-income nations by looking to improve brain development.

In a blog post written by Jeff Murray, the Interim Deputy Director in Family Health for the Gates Foundation, and Karlee Silver, the Vice President of Targeted Challenges for Grand Challenges Canada, the pair address the importance of the new initiative. Murray and Silver note that although there has been great success in reducing deaths of children under the age of five and various causes of mortality, it is now necessary to ensure that these children are not just living, but truly thriving.

“Promoting health, providing enriching and nurturing experiences and protecting children from maltreatment in the early years can set them on a trajectory towards long-term health, productivity and participation in society,” Murray and Silver write.

The ultimate goal is to ensure that young children across the globe are able to live the best possible lives.

Murray and Silver explain that the new initiative undertaken in partnership with the Gates Foundation will explore new approaches for measuring both fetal and infant brain development. They hope that these new methods will be “simple, reliable, non-invasive, objective and universally applicable.”

Developing new approaches to measuring development will also help in measuring an infant’s gestational age at birth. The gestational age is related to brain development and growth in both the fetus and infant stages of life.

In regard to the effect such developments could have worldwide, the National Scientific Council on the Developing Child reported in 2010 that having healthy child development is the foundation of a society that will have a successful future.

In a March 5 press release, Dr. Peter Singer, Chief Executive Officer of Grand Challenges Canada, said, “Together with other partners, we will be able to unleash the power of innovation to ensure children not only survive, but also thrive. This is no less than what any parent would want for their children, anywhere in the world.”

– Julie Guacci

Sources: CNW Group, Grand Challenges Canada, Grand Challenges Canada Press Release, Yahoo Finance Canada
Photo: IDRC