Dar es Salaam. It’s noon at Muhimbili National Hospital (MNH). Relatives, friends and therapists stand beside Matilda Cosmas, 3, as they wait patiently to witness her first ever behavioral response since she was born— reaction to sound.
Remotely, doctors prepare to switch on a device without which, Matilda cannot hear.
It’s a cochlear implant, an electronic medical device that does the work of damaged parts of the inner ear (cochlea) to provide sound signals to the brain.
Normally, at the age of 3 months, Matilda should have been able to react to loud noise and recognize voices just like other children do but, she couldn’t do so at that early age.
She had a problem that required medical interventions but her parents didn’t realize it at first.
Hearing loss in infancy may be difficult to detect. Medical sources show that in almost two thirds of cases, parents are the first to suspect hearing loss.
According to hear-it.org, other health care providers can suspect it first in approximately 15 per cent of cases, and pediatricians in roughly 10 percent.
Three year old Mulhat Humud was among the surgery beneficiaries whose mother, Ms Zahra Salim, says she detected her child’s problem at an early age.
“When she was three months old, that’s when I detected her problem but I was assisted by a health worker who constantly gave me advice about my child’s hearing problem ,’’ she says.
Cost of treatment
At MNH, where Matilda and other children with the same problem are being treated, there are high hopes among the authorities, parents/guardians.
They believe that referring such ailing children to foreign countries for the implant surgery could now become a thing of the past.
Taking a child abroad for the cochlea implant costs between Sh 85million and Sh100million while at MNH the service costs only Sh33million.
This means that by having the technology here at MNH, up to Sh67million is saved, the hospital management says.
Great moment arrives
Matilda’s mother, Angelina Cosmas, smiles with anticipation as she waits to celebrate her daughter’s new milestone. She is among the parents whose children underwent surgery at the hospital.
Angelina is perhaps the most eager to witness the reaction. “I have been longing to see my daughter hear me out when I call her,” says the mother of three.
Then, all of a sudden, Matilda’s eyes pop up. She so widely opens her mouth; expressing surprise at the sound she heard, as the device was being switched on.
That was the moment of her life, last week, when six children who underwent cochlea implant surgery were now having their devices switched on.
This also included clinic follow up for the children who had undergone the procedure in foreign countries such as India.
How Matilda’s story began
Matilda will now begin her new life, going through another series of learning as she adapts to the sound and instructions, thanks to a team of experts, led by Dr Edwin Liyombo, a specialist in Ear, Nose and Throat (ENT) at MNH.
After undergoing the cochlea implant, the children are now put in the hands of speech therapists who train them on the meaning of what they would start hearing.
MNH’s speech therapist, Ms Christina Semwanga, says that there are about five steps which the children have to go through.
“We actually have to take them through sound identification, train them to understand the meanings attached to each of them,’’ she says.
“We also advise parents on how they should handle the children, such as always trying to make hearing and listening as interesting and fun as possible to them.”
“It’s usually important to show the child that he or she can consciously use and evaluate the sounds he or she receives from his or her cochlear implant,’’ advises Ms Semwanga.
“It is important to let the child’s teachers be involved. With the help of health professionals, the success of the child in coping with the sounds and the implant depends on the collaboration of all the people surrounding him/her.”
What actually causes the hearing loss?
Matilda’s hearing impairment dates as far as when she was two months old, according to doctors’ revelations tales of her mother.
“When she was two months old, she suffered a terrible fever. She was admitted in hospital for so long,” says the mother, Angelina Cosmas, who is professionally a nurse.
“Doctors have now told me that her hearing problem could have something to do with the illnesses she suffered,’’ she continues.
According to Dr Liyombo, hearing loss in children can also be caused by genetic factors.
However, he says, “If the problem is inherited, it does necessarily mean that one or both parents also have the problem.”
He says, the pre-natal causes of hearing loss include infections during pregnancy, such as rubella, syphilis, toxins consumed by the mother during pregnancy or other conditions occurring at the time of birth or shortly thereafter.
He goes on to explain other causes that occur after the child is born (post-natal causes).
That after birth, he says, trauma to the head or childhood infections, such as meningitis and measles could lead to permanent hearing loss.
“There are no studies done yet here in Tanzania to show the extent of hearing problems in children but many cases can be attributed to birth defects and childhood illnesses such as Meningitis, ’he emphasizes.Global statistics show that five out of 1,000 new born have hearing problems, which could either be profound or moderate.
Local specialists have so far been able to perform 90 per cent of the surgeries, with the visiting Indian experts handling the remaining 10 per cent.
It was the fourth time MNH specialists were carrying out the procedure after the first one that was done in June, 2017.
“After switching on the hearing device, these children will be attend clinics every week for follow ups on their progress,’’ says Dr Liyombo.
“It will take almost a year for these children to hear and speak well as normal persons,’’ he noted.
“However, full recovery depends on the victims’ seriousness to attend speech therapy sessions,’’ he says.
According to experts, while the most obvious effect of childhood hearing loss is on language development, it also has an impact on literacy, self-esteem and social skills.
Untreated hearing loss is often associated with academic underachievement, which can lead to reduced employment opportunities later in life.
Communication difficulties can have lasting emotional and psychological consequences that can lead to feelings of isolation, loneliness and depression. The impact on the family is equally profound.