EAN’s latest Newsletter
February 23, 2021
Ear Aid Nepal Newsletter Feb 2021
COVID in Nepal
Since the last Ear Aid Nepal Newsletter the world has been turned upside down as we are all too well aware. COVID-19 has significantly affected everyone’s lives and has impacted upon our work at the Ear Hospital. COVID has affected life in Nepal as it has everywhere with the country shutting down for lockdown in March of last year. Working closely with the local medical authorities, the Green Pastures Hospital played an active part in the local COVID response with the Ear Centre becoming an isolation unit and routine work was suspended for a short period.
Mike had to return to the UK and has been unable to return to Pokhara over the past year. Nevertheless, work has resumed in the past few months and the Centre has been productive even in Mike’s absence. This last can be seen as a very hopeful indication for the Centre’s sustainability as inevitably Mike scales back his active involvement in the surgical work of the Centre. The three Nepali surgeons are increasing in confidence and ability and have been supported remotely by Mike, Derek Skinner and myself offering advice by WhatsApp for difficult cases.
Despite COVID-19, work has continued with only a brief interruption and with appropriate social distancing measures in place. In the final quarter of 2020, the Centre saw some 2862 patients in outpatients, there were 725 hearing tests and 67 operations took place.
The Ear Hospital and Treatment Centre has been renamed as the Green Pastures Ear Centre (GPEC) reinforcing the corporate identity of the INF site in Pokhara.
BACO (British Academic Conference of Otolaryngology) is the most important UK ENT Conference and was originally due to take place ‘face-to-face’ in summer 2020 but was postponed and took place as a virtual event in January 2021. Mike Smith and I presented a talk at the Global ENT section of the conference giving an overview of the development of Mike and INF’s work in Nepal – the talk is available on the EAN website under the ‘News’ tab. Mike also wrote an article for the journal “ENT Global Health” which describes the development, funding and administration of the Green Pastures Ear Centre, this is a fascinating read and is also available to read under the ‘News’ tab on the website.
Ear Aid Nepal has been a little backward in embracing social media, which is perhaps a reflection of the average age of our Trustees(!) but we have recently resurrected our Facebook and Twitter accounts and are resolved to make the most of these media to communicate with colleagues and supporters around the world. Please follow us on Twitter (@EarAidNepal) and on Facebook (@earaidnepal). In addition, if anyone has any relevant news or information they would like to be promoted on Twitter or Facebook then please let me and /or Derek Skinner know (email@example.com, firstname.lastname@example.org), particularly if there are photos included (with signed consent where appropriate) to enhance the impact.
Hearing Aid Research
Ear Aid Nepal and the Green Pastures Ear Centre have been collaborating with Warwick University to develop a low-cost hearing aid over the past 2-3 years and have been successful in applying for a substantial grant to take forward their work. Research has been affected by COVID-19, particularly with respect to travel to Nepal by UK researchers but we have been able to recruit local staff to carry out research activity and invest in equipment for field research. Work on the electronics for the low-cost aid has progressed well in Warwick and focus will now be able to shift towards the logistics of hearing aid supply and maintenance and environmental challenges (heat, humidity and power supply) in the field.
Ear Aid Nepal continues to donate generously on behalf of our donors to the Poor (‘Medical charity’) Fund that supports those unable to pay in full for their treatment in the GPHEC. The funding model of the hospital aims to recoup costs beyond the initial capital investment by charging patients in line with local pricing structures but these prices though low by UK or Western standards often exclude poorer Nepalis. In order to allow these individuals to receive treatment, the Green Pastures Administration run a charity Fund to which Ear Aid Nepal contributes, hypothecating funds to otology patients. Patients submit claims to a committee who assesses their need and are supported to a greater or lesser degree.
It is felt important that recipients feel committed to their treatment and in almost all cases, even the poorest patients pay a proportion of their costs. Over the past 2-3 years Ear Aid Nepal has spent on average £10,000 annually, with regular reports form Nepal outlining the patients supported and the proportion of their costs funded by the charity. In the last quarter of 2020, 38 individuals were supported to acquire hearing aids or undergo surgery with variable amounts of support averaging at approximately half of the cost of procedure or device being bourne by the patient.
Ear Aid Nepal receives quarterly reports detailing the expenditure of the Poor Fund and in addition to data, provides case reports, one of which is included below:
Bijay is 19 years old from Pokhara, Nepal. It takes about 20 minutes by walking to reach his home from Green Pastures Hospital. Currently, he studies at Grade 11. He lives with his mother, father, one elder sister and two younger sisters. As a breadwinner of the family, his father works as a labourer, and his mother is a housewife. They are poor, and it isn’t easy to afford their family expenses. Besides, his elder sister also possesses an ear problem, so she is limited to the home. She is planning to examine her ear after his brother’s treatment. His two younger sisters are relatively small.
He has a discharge from his ear since the age of nine. Due to the poor financial situation, he couldn’t go for the treatment in the hospital. One day he heard about Green Pastures Hospital from his neighbour. So he came to the ear centre in this hospital for the treatment.
When he arrived here, he went through the examination procedure. Subsequently, he was diagnosed with Left Chronic Suppurative Otitis Media. Therefore, he was advised for the intermediate surgery (Simple myringoplasty with local anaesthesia). Unfortunately, he couldn’t manage the total cost of NPR 21,520 required for surgery. So he went through the socio-economic assessment, and after the assessment, he received NPR 11,520 charity support from the ear charity fund.
Now, he is in the process of healing after the surgery. He felt very grateful for the support he received from the ear centre.
His family members are delighted to see him got treatment after a long time. They are also impressed by the love and care from the hospital.
Reports like this are inspiring and a testimony to the great things the hospital is able to achieve with a relatively small amount of money (NPR 21,520 is equivalent to about £135) and how a small contribution to these costs can be transformative to lives.
Thanks for taking the time to read the newsletter. Let’s hope for better things for 2021!