Project Proposal: NAFA has supported a child education sponsorship program at Thimi VSN School since 2003.  They requested HearingNEPAL Program assistance in running a trial ear camp at the school, to determine the need for hearing support for the students.

Location: Thimi VSN School, Kathmandu

Date Commenced: January 2010

Date Concluded: November 2010

Partners: NAFA, Thimi VSN School, NAHOH

Beneficiaries: The children and staff of Thimi VSN School.

Trip 1 – January 2010

Partners: NAFA, Thimi VSN School

Staff:  Surendra Prajapati ( School Principal, VSN, Thimi)

Volunteers: Sue & Lew Tuck (HearingNEPAL Program)

Objectives: To provide primary ear care and audiological assessments for students of the school identified by their principal Surendra as having possible ear health or hearing problems.

  • Lew screened with the portable screening audiometer and a hand held otoscope. Where wax blockage was an issue, apply wax sol and refer to local school medical clinic for treatment.
  • Sue performed diagnostic audiology on those who failed initial screening (Lew) and the younger children. This included Video otoscopy, air and bone conduction testing (with masking if required), and middle ear impedance and reflex assessment.
    • Diagnostic evaluation would result in
      1. No further action, i.e. no medical follow up or loss meeting requirements for hearing aid / assistive listening device fitting.
      2. As above, but retest in 12 months
      3. Urgent medical referral – with recommendation to medical clinic that ENT advice would be prudent. Note that ENTs are not easily accessible, and so this advice was not given lightly!
      4. As above, with no urgency, e.g. Holes in ear drums, no infection present, clients under 15 yo, an age below which ENTs were unlikely to operate.
      5. Medical clinic referral for the removal of ear wax and organise for testing.
      6. Medical Clinic referral for primary treatment of infection
      7. Referral for hearing aid or assistive listening device fitting

      Before fitting of the hearing aids, it was established that the headmaster would accept responsibility for the aids, maintenance and battery issue. Surendra was duly trained. He was also familiarised with the whole testing and result interpretation process, so that he could act as a reliable interpreterIt was decided that a fee of Rs 500 (about $8, 2 – 4 days wages) would be charged for each aid, although if the headmaster felt that less would be appropriate, then he would make that judgment.

      Reliable power was an issue on the first visit, but remedied for the second visit.

      Equipment was transported from Kopan for the exercise.

      Only Spare batteries and hearing aid cleaning equipment were left at the school.

Outcomes:

  • Hearing assessments completed:     33
  • Medical follow up required :           11
  • Hearing aids fitted (Monaural):       3
  • Hearing aids fitted (Binaural-exceptional circumstances): nil

Trip 2 – October 2010

Partners: NAHOH, Thimi VSN School

Staff: Keshab Dangol CMA (NAHOH)

Volunteers: Sue & Lew Tuck (HearingNEPAL Program), Macha Bhai (NAHOH)

Objectives: To run an ear camp (primary ear care & rehabilitation) for all students and teachers  of Thimi VSN School and workers from a nearby carpet factory.

Outcomes:

  • Primary Ear Care Examinations  at Thimi School:      271
  • Advice given to those children who required ENT referral