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“Waiting over 5 years for testing”: audiologist assists under-resourced communities in Nauru

Oct 30, 2023

Like so many of her fellow Australian healthcare workers, Jessica-Lee Miettinen has always known she wanted to use her expertise to help communities in need. In July, the Audiology Australia (AudA) accredited audiologist got her chance with a lifechanging humanitarian trip to Nauru.

She spoke to AudA about her lifechanging experience, and the role Australian audiologists can play in improving global hearing health.

The reality of Nauru

Jess arrived on the island as the only audiologist in a multidisciplinary team facilitated by the Royal Australasian College of Surgeons (RACS). Over the course of a week, they provided ear, nose and throat surgical care to countless patients from the under-resourced island community.

Her role was to provide essential pre-operative and post-operative audiological testing. This meant assessing both hearing and middle-ear status (to help the medical team determine candidacy for surgery) as well as checking whether hearing had improved post-operatively (if appropriate).

The task quickly saw her confronted with the significant disadvantage faced by those she was assessing. Among the 37 clients she saw, many had waited years for audiological testing and others had never been assessed at all.

“Participating in humanitarian work is an eye-opening experience,” said Jess.

“Being able to help people who do not have access to the same level of healthcare that we often take for granted in Australia is very rewarding.”

Working as the only audiologist was challenging at times. Far from her usual place of practice at Logan Hospital in the south of Brisbane, where she is part of a wonderful team of Audiologists, Jess was presented with the task of assessing patients with a variety of medical conditions and varying degrees of hearing loss without the ability to consult with another audiologist.

Some of the patients exhibited symptoms that she had never seen in Australia – a direct result of her patients being unable to access regular hearing care on the small island nation.

“I saw a 40-year-old man who received a shunt for hydrocephaly at the age of 10. He said the shunt had not been reviewed since he was 11 years old. He was experiencing some vestibular symptoms as well as hearing loss on the shunt side, which had begun only about a year ago.

“I saw a young adult who was born in Australia and reportedly passed her newborn hearing screening in both ears; however, she had become unwell with bacterial meningitis at the age of 6 months. Unfortunately, she now has bilateral profound sensorineural hearing loss, but has luckily had the opportunity to learn sign language at school.”

There were challenges working at the Republic of Nauru Hospital. Jess experienced language barriers, which she worked through with the help of local nurses and had to navigate the lack of resources for testing, including finding an appropriate space for testing (as there were no sound-treated spaces available).

Eventually, she was presented with an operating theatre as a testing environment.

“It was located in a quieter part of the hospital – not adjacent to the other operating theatre where the team were operating on patients.”

Despite the challenges, Jess is glad she was able to take the opportunity when it arose earlier this year.

A long-time dream as an audiologist and former registered nurse with a passion for health communication, she’d pushed outreach to one side as a sole parent.

With her daughter now a teenager, and the Director of ENT at her hospital asking the Audiology Department for expressions of interest to join the RACS-supported team, the time was right.

“I was very thankful for the invitation to go. It was a very rewarding experience and a fabulous opportunity to use my problem-solving skills to adapt to the different practices and to see the differences in procedures in Nauru compared with Australia.”

A rewarding experience for Australian audiologists

Humanitarian work is its own reward and for many communities such as those on Nauru, visiting healthcare workers such as Jess and the ENT team are their only chance at accessing care.

Economic challenges, a population of around 10,000, a land mass smaller than most Australian metropolitan councils and its nearest neighbour hundreds of kilometres away has meant that Nauru, like other Pacific Island nations, struggles to maintain a large, highly qualified workforce.

To support the local population, healthcare teams from Australia and around the world frequently travel to the island and provide their services

Participating in audiological humanitarian or developmental aid activities can be a powerful way for AudA members to further their skills and experience. Audiology Australia endorses and supports member participation in these activities with approved work able to contribute towards Continuing Professional Development (CPD) point requirements for the current cycle.

These experiences take us back to why audiologists do what we do and why it matters. It reminds us of the fundamental impact that audiologists can have on a person’s overall health, the wellbeing of in-need communities and the difference access to these services can make.

Jessica-Lee agrees.

“As we live in a majority hearing world, hearing well keeps us connected with the people around us. As audiologists, it is our job to raise awareness about hearing health and managing hearing loss.”

Jessica-Lee Miettinen would like to thank the Mater Hospital Audiology Department for lending her a portable audiometer, Diatec for lending her a tympanometer to take to Nauru, and Associate Professor Bernard Whitfield, Director – ENT Logan Hospital for inviting audiologists to take part in the opportunity.

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.

Notes for non-audiologists

  • Vestibular: the vestibular system includes the inner ear and brain responsible for balance. Vestibular symptoms include vertigo and nausea.
  • Shunt for hydrocephaly: a tube to help drain excess fluid from the brain.
  • Sensorineural hearing loss: damage to the tiny hair cells in the inner ear causing hearing loss. Sensorineural hearing loss is the most common type of hearing loss.

World Hearing Day 2024

Sunday 3 March 2024 is World Hearing Day. This year’s theme is “Changing mindsets: Let’s make ear and hearing care a reality for all!”

Change is the only constant and in the realm of ear and hearing care it’s an absolute must, with over 80% of the world’s ear and hearing care needs remaining unmet.

To play your part and create change, please consider sharing this story on your social media channels to promote the importance of ear and hearing care for all.

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