Most Australians are familiar with Fiji as a dream getaway destination. But beneath the picture of an island paradise lies the reality that the Pacific nation is still developing, with the population’s rate of ear and hearing loss estimated to be 3-5 times greater than elsewhere in Australasia*. When she heard about this need for hearing care in Fiji, Audiology Australia (AudA) Accredited Audiologist Rainbow Apostol decided to act.
AudA Accredited Audiologist Rainbow Apostol (in focus, right) at the Frank Hilton Organization audiology department.
“I had been working for several years and taken part in a lot of community outreach programs, but I had always wanted to contribute more. When I heard about how I could help in Fiji, volunteering there seemed like a natural fit,” Rainbow says.
Through connections Rainbow made at university, she discovered that the Frank Hilton Organization’s audiology department, founded by AudA member Dr Donna Carkeet through Ears Inc. on Fiji’s largest and most populated island, Viti Levu, were looking for additional audiological assistance.
The clinic’s services are sorely needed as the only paediatric audiological centre in the island nation that provides services exclusively for children. After successfully applying for an Australian Volunteers Program assignment, Rainbow began her six-month stay in Fiji with her husband in October 2023.
“It is a developing country and that was reflected in my caseload as many of the kids that I saw were brought in for screening quite late in their lives,” Rainbow says.
“We were diagnosing kids with permanent hearing loss at age 5, or sometimes even up to age 10, which is unheard of in Australia.”
From the get-go, Rainbow found the experience enriching in being able to see the immediate positive impact of her mentorship with the local staff.
“It was incredibly rewarding to see the impact of our work. I remember there was one child with bilateral microtia who showed a severe hearing loss in our VROA hearing test, then once we put a bone conduction hearing aid on him, he began to respond at softer levels,” Rainbow says. “All of us in the clinic were really excited for him.”
“Then there was another child who was uncertain about wearing his hearing aids until he saw another man wearing hearing aids while on the bus with his father. The child was inspired by seeing that man and he came back to his next appointment really excited about being fit. Now he really loves his hearing aids.”
Rainbow assessing a child in Fiji.
Training Fiji’s hearing care specialists
Rainbow wasn’t alone at the Frank Hilton Organization. During her assignment, she mentored and trained two local Fijians, an audiometrist and the audiology assistant who have now gone on to take onboard a large amount of the responsibility at the clinic.
“The training was really impactful for me because I got to see their confidence and their knowledge of audiological tests grow over those six months,” Rainbow says.
“They’re an excellent team and I still have quite a good relationship with both of them.”
Rainbow admits that the training worked both ways, as her mentees showed her how to perform tasks not traditionally taught in Australia.
“In Australia, no audiologist learns how to make ear moulds. We normally take an impression, send it to a manufacturer, and they scan the impression, print the mould and send it back. In Fiji, they construct the ear moulds by hand. It was really fascinating to watch and learn how to do,” Rainbow says.
Returning home to Australia
As of the time of this article, Rainbow and her husband have now settled in back to life in Melbourne, having returned four months ago.
And while she loves her new clinic and reconnecting with her friends, family and communities – like her local church and sports clubs – sometimes, Rainbow’s longing for Fiji returns. Not just in the memories of the different clinical cases, but also in the Fijian communities that she and her husband had become a part of, like the local canoe club, which allowed them to experience the nation’s breathtaking scenery with other locals and foreign workers.
“We would start canoeing at 5am in the morning twice a week. It was really beautiful. We’d paddle out to a sandbank, see the sunrise, have a swim and then paddle back and start the day,” she reminisces.
Fiji – an island paradise.
Rainbow also keeps in touch with the team back at Frank Hilton as she nears the end of the remote phase of her assignment. Each week, her former team calls her to discuss their cases and run anything by her that they feel uncertain about.
But as a reflection of their growing abilities and Rainbow’s training, the length of their work conversations has become shorter and shorter.
“We now just chat for a couple of hours each week. It’s funny because when I left, I couldn’t help but feel a bit nervous and wonder if they were going to be okay without me, and now it’s been humbling for me to realise they don’t need me anymore,” Rainbow says.
When asked if she would recommend that other audiologists pursue humanitarian work or shorter outreach initiatives, Rainbow’s response is an emphatic “yes”.
“I think most of us really love to help others and give back to communities,” she says.
“That’s what I love about audiology. I love how audiology can help to bring people together, to ensure they’re able to communicate and connect with their friends, family and their local communities.
“We as humans are not made to be alone.”
If you are an audiologist and would like to take part in humanitarian work or have questions about how it could be counted towards your CPD, please contact Audiology Australia. You can also access our humanitarian application form here.
Rainbow’s assignment was part of the Australian Volunteers Program, an initiative of the Australian Government. To learn more visit www.australianvolunteers.com
References
*Fiji Ministry of Health & Medical Services. Clinical Guidelines: Primary Ear Disease and Hearing Care in Fiji. January 2021. Accessible here: https://www.health.gov.fj/wp-content/uploads/2021/01/Clinical-Guidelines-Primary-Ear-Disease-and-Hearing-Care-in-Fiji.pdf
Audiological terms
Bilateral microtia: A physical deformity where someone is born with two small ears and/or partially constructed ear canals in both ears.
Bone conduction hearing aids: A hearing aid alternative, where sound and vibrations are amplified through a person’s skull to ‘replicate’ hearing.
VROA (Visual Reinforcement Orientation): A hearing test where a child is prompted to turn towards a visual reward, like a puppet, when sound is played at different levels, to test their ability to hear sounds at different frequencies.