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Full Interview: AudA Audiologist Seray Lim on World Hearing Day

Mar 1, 2024

Joining us to talk about this World Hearing Day (WHD) 2024 and drawing on her extensive experience working in adult aural rehabilitation, including with Aboriginal and Torres Strait Islander clients, is Seray Lim. Seray is the director of Arches Audiology, an independent audiology clinic based in Melbourne’s south-eastern suburbs.

Seray Lim

Here is our full interview:

What does this year’s WHD ‘Changing Mindsets: Let’s make ear and hearing care a reality for all’ mean to you?

Changing mindsets is one of the hardest things to do. The theme of ‘Changing Mindsets: Let’s make ear and hearing care a reality for all’ implies that the current mindset is actually that it isn’t important nor a priority. Which to me as an audiologist, who has worked in rural and remote communities and in Cambodia, and as a mother of a school age child who has hearing loss, is unsettling. So, what I love about World Hearing Day is that it encourages all stakeholders around the world to raise awareness on ear and hearing care and understand the cost of unaddressed hearing loss to individuals’, communities, and societies. It is an opportunity to come together to innovate and create.

According to the WHO 80% of ear and hearing care needs remain unmet globally. In Australia this is particularly true for Aboriginal and Torres Strait Islanders and those living in regional and remote communities. What do you see as some of the barriers to access to hearing care?

Before I answer this question, I would like you to consider the statements below, taken from the Hear Us: Inquiry into Hearing Health in Australia: ‘Indigenous children in Australia experience an average of 32 weeks of middle ear infections between the ages of two and 20 years, compared to just two weeks for non-Indigenous children,’ (Chapter 8.13, page 124), and ‘As noted above, Indigenous children, especially those from remote areas, suffer very high rates of ear disease and hearing impairment. The committee heard a considerable amount of evidence which strongly suggests a link between hearing impairment among Indigenous school children and poor educational outcomes. This link has been made in the past, though the problem appears to be still widely in evidence today.  (Chapter 8.25, page 128).

In 2020, Jack DeLacy, Tinashe Dune and John Macdonald conducted a systemic content review looking at the risk factors for otitis media in Aboriginal and Torres Strait Islander children. They found there is a research bias towards biomedical approaches (vaccines and antibiotics, which are highly important) over addressing social determinants of health contributing to high rates of otitis media in Aboriginal children. The articles reviewed listed social determinants as housing-related factors, exposure to tobacco smoke, low socio-economic status, lack of access to services, low income and poverty, education of primary caregivers which contribute to high rates of otitis media in Aboriginal children.

However, despite the link there were no intervention studies and the authors note that a shift in approaches to manage otitis media is desperately needed as ‘intervention studies are crucial for policy development’.

In my opinion, current policies and research bias are the greatest barriers to improving ear and hearing health care to Aboriginal and Torres Strait Islanders people. I agree with the authors that a ‘broader public health lens is required to address the underlying social factors reported to be driving the gap in OM rates between Aboriginal and non-Aboriginal children.’ The way I see it is that until then, the status quo will remain. What we really need to see is a change in the current mindset of policy makers, research institutions, stakeholders etc towards investing in activities that fill the gaps in our current knowledge, commit more to research with a public health view lens.

I implore appropriate immediate action is taken in collaboration with Aboriginal and Torres Strait Islanders people, at all levels of ear and hearing health care and by all stakeholders, governments, and communities. Changing mindsets can take some time so let’s get moving towards creating better policies and programs to achieve WHO’s World Hearing Day 2024 ‘Let’s make ear and hearing care a reality for all!’.

What information or engagement is needed to change public perception and understanding of hearing health and hearing loss?

Storytelling is a highly effective way in engaging people and so sharing personal stories can assist in changing public perception and understanding of hearing health and hearing loss. Holding information sessions or talks which includes patient journeys, knowledge sharing, evidence, as well as the real benefits to individuals, may be a way to encourage other health professionals such as GPs, Speech Pathologists, Maternal, Child and Health Nurses to think about a referral to an audiologist.

Looking into the future what changes do you hope to see?

There are a number of great programs that currently exist in different states but what I would like to see is a nationwide commitment to making ear and hearing care a reality for all by establishing a SunSmart-like campaign. To get to this point, I believe the broadening of views to include a public health lens and health promotion understanding must exist.

My hope for the future is that the current percentage of preventable hearing loss will be significantly reduced from The World Health Organization’s estimate of 49% in children and 37% in adults, globally. Given the causes of preventable hearing loss includes meningitis, rubella, ear infection, glue ear and noise-induced hearing loss, I hope there will be great investments into systems and infrastructure that empower people to take preventative action such as immunisations, practicing good hygiene and noise protection that enable the process of seeking early intervention and access to service providers and sustainable interventions.

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