Medical days to hear better: 73 therapists, mothers and parents received training to teach how to listen

800 million people in the world live with hearing disabilities. However, the WHO indicates that 60% of childhood hearing loss can be prevented with early care.

The ear was the first sensory organ replaced by an implant and the world's first cochlear implant surgery was performed in Australia in 1978. This technology requires not only surgery but also a therapy process for sound sensation to be effective. Today, surgery for this procedure in Guatemala has an estimated cost of Q150,000.00, not including the costs of therapy, maintenance of the device, among others.

Before 2019, the Guatemalan Social Security Institute (IGSS) had only provided hearing tools to two people with deep deafness through a technology known as a cochlear implant, a device consisting of two parts: internally, a device with 16 electrodes is introduced to transmit bioelectric stimuli to the auditory nerve, and externally, a processor that picks up sound signals by means of a microphone. These devices electrically stimulate the ear to produce a sound sensation.

From 2019 to 2021, the IGSS through the AMEDIGSS project, an agreement between the Social Security and UNOPS, performed 40 implants on children affiliated to the IGSS through the Clínicas para Oír Mejor, S.A. [Clinics to hear better]. This agreement included the necessary and integral care after the implant, thanks to the 208 auditory-verbal therapies included in the contract with the Clínicas para Oír Mejor, S.A., that ensure that the listening and speaking process in children with cochlear implants is the appropriate one.

What happens when a hearing-impaired person receives a cochlear implant? The implant is a device instance that gives access to hearing, but the brain must be taught to listen, because prior to implantation, hearing deprivation causes neurons that should work for listening to be located in the closest areas of our brain: the visual and movement areas, this is known as a reorganization of the functions of the neurons of our brain, and because of this the person with deafness develops the visual and movement areas more. With the implant, the person has to begin a process of reorganizing the neurons in their brain to strengthen the listening area, the area that, so to speak, was asleep due to lack of stimulation.

After receiving the implant, learning to listen requires auditory brain development that does not happen overnight: it takes, on average, 16 months of listening for the first words to appear. This process allows the brain to begin discriminating what it hears. After that phase comes language: People with profound hearing disabilities do not develop verbal language, so listening allows them to start the process of learning to communicate verbally, the spoken language is developed one word at a time.

If the person does not receive proper rehabilitation, the implant and this wonderful technology will not be successful.

The success of the implant will be greater if the goal of keeping patients listening all the time is met, and that is why this project has a focus on the person and their families, because the social circle of each person, child plays an indispensable role in rehabilitation. In this context, on May 24-25, 21 therapists, 43 mothers and 9 parents received a teaching workshop to reinforce their knowledge of auditory-verbal therapies.

During these medical days, the following most relevant actions were identified:

1. It is important to identify the daily life of families and children, this helps meet specific verbal communication needs and also to establish clear goals for therapies, such as identifying the words needed to respond to the person's language needs. For example, for a person who works at a pharmacy it may be more important to learn to say aspirin than to know how to say the color yellow.
2. The content of therapies should be consistent with the age of the person receiving the implant.
3. The brain of a person with a cochlear implant must be stimulated throughout the day, so the people who are their support system (families and primary caregivers) contribute to improving the person's quality of life by nourishing the brain.
4. During therapy routines and strategies must be made and practiced at home.
5. It is recommended that the person with an implant listen for 10 hours a day, from the moment they wake up, they should have access to sounds.

Thanks to these medical days to hear better, mothers, fathers and therapists have new knowledge as part of the ongoing commitment of the UNOPS-IGSS agreement and the Clínicas para Oír Mejor, S.A. to provide comprehensive care focused on the needs of the people.