By Professor Dr Sayed Nusrat Raza
Sound is all around us. Humans listen and respond. Expression of views is a fundamental right of all human beings. Noise attracts and alerts all living beings, including humans, about potential dangers, music uplifts the spirit, laughter helps people bond, and a crying infant alerts her mother about her needs. Above all of this is language; the primary distinction between Man and Beast. Human language is capable of conveying complex ideas, intricate feelings, technical instructions, and the primary medium for the transfer of knowledge beyond boundaries and time. Estimates suggest that there are more than 7 thousand spoken languages in the world today, not to mention all the languages that have gone extinct throughout history. It would be an understatement to say that “sound is important”. Yet if a blessing is ubiquitous in nature, it does become taken for granted.
Enter the world of the deaf; a world of silence. In one sense, a unique world of its own, but practically cut off from society. Hearing loss can come in different varieties and intensities. From the mild hearing loss that essentially all of us may experience during a cold or with wax build up in our ears, to the severe birth-related deafness that precludes any language acquisition by the child. At one time, especially in a developing country like ours, it was considered “Divine Will” and a “Trial of patience” if a family member was born completely deaf. But with “Divine Will” there is an element of “Grace” as well, and there are now options to treat hearing loss of practically all severities.
It is in this regard that 3rd March is designated by WHO as “World Hearing Day”; to raise awareness about hearing health, screening and testing of hearing disorders, prevention of deafness, and to implement hearing restoration strategies throughout the world. This is especially poignant for a country like Pakistan, where, according to some studies (which may be underestimating due to scarcity of high-quality data), 1 out of every 1000 children born has some significant deafness. This would come down to more than a million deaf people in our entire population. Cousin marriages probably have a huge role to play in the prevalence of hearing loss in our society.
A few common myths should be dispelled at this point; (1) normal hearing parents may give birth to a deaf child, (2) deafness may not be immediately apparent to the parents, (3) deafness does not necessarily mean a lack of intelligence; (4) if deafness is suspected then urgent testing should be done, (5) a child who cannot hear speech would be unable to develop speech (they become deaf and mute) (6) and most importantly birth related deafness CAN BE TREATED. The treatment options, however, are time bound: if a deaf child is treated within the first 2 years of life, he may be able to develop listening and speaking skills at par with his peers, but beyond 5 years of age the hearing abilities are permanently stifled. Options for hearing restoration (depending on the cause) range from medication and hearing aids to Middle Ear surgery and Cochlear Implants.
For deaf children and those working in the field of hearing restoration, cochlear implants are nothing short of a miracle. In cases where the inner ear has been damaged, and sound is unable to travel to the hearing nerve, the cochlear implant is a definitive treatment. It consists of two parts: an internal unit that is surgically inserted into the inner ear, and an external unit that the patient wears on their head. The external unit captures sound, converts it into signals that are transmitted to the internal unit, which directly stimulates the auditory nerve, mimicking sound and speech.
Foundation University, and its constituent hospital (Fauji Foundation Hospital) have taken up a key role and a firm commitment to treat birth-related deafness.
This is a multidisciplinary project that requires input from ENT, Radiology, Pediatric, Anesthesia, and Speech Rehabilitation department, along with a strong administrative team. Prof. Dr. Sayed Nusrat Raza (writer of the article) and his team of expert doctors in the field, including Dr. Uzair Mushahid, Dr. Nudrat Khalil, Dr. Sana Arif, have carried out cochlear implants over nearly 50 deaf children and changed their lives forever. These children have transcended from a silent world to a universe of sound, music, laughter and speech. These 50 children were fitted with cochlear implants in less than 6 months. As is expected, advanced technology is bound to be expensive (cost per patient is around Rs. 2.2 million) and as such beyond the capacity of an average Pakistani citizen. Ever ready to help the needy; Pakistan Bait ul Maal (PBM) has ensured that all 50 patients undergoing cochlear implant surgery were fully funded by the state. Furthermore, Foundation University, in collaboration with its Rehabilitation Medicine department, has ensured that post implantation, these newly hearing children have access to highly quality speech therapy services, which ensures normal listening and speech skills are developed.
On 27th February 2025, a ceremony was conducted in Foundation University Medical College marking “A half century of Cochlear Implants”. The attendees were apprised about the condition of deaf children in Pakistan and the role Cochlear Implantation plays in restoration of hearing. Previously implanted children were brought on stage to showcase their respective stages of progress with the implant (ranging from detection of sound, single word formation to recitation of Holy Quran and conversation with the chief guest). A small documentary about the SAMAAT/ Cochlear Implant program at Fauji Foundation Hospital was screened. As some audience members later recounted, not only did they learn for the first time that childhood deafness could be treated, but the heart touching performance of newly hearing children almost brought tears to their eyes.
After the ceremony, the commitment for continuing the fight against deafness was re-emphasized; “We cannot allow them to stay deaf, just because they cannot afford to hear!” was emphatically stated by Prof. Dr. Sayed Nusrat Raza and his team. The SAMAAT program (which coordinates between Foundation University, various departments of Fauji Foundation Hospital and Pakistan Bait Ul Maal for hearing screening, hearing restoration and cochlear implantation program) will be a “Beacon Of Sound” for all hearing impaired patients and their families in the country.
Writer is ENT specialist and Professor at Foundation University Medical College and can be contacted at Sayed.nusrat@fui.edu.pk
