Great Equalization: Is MBBS From India Equal To M.D. In U.S.A?

AAPI Journal • March 2009
FEATURE
Prevention Of Deafness:
A Vision For India
by Raj Desai, M.D.
Raj Desai, M.D.
President, Project Deaf India
As One Person, I Cannot Change The World, But I Can Change The World Of One Person
Paul Shane Spear
Deafness is one of the commonest
congenital disabilities in the world. It is
estimated to be 30 times more common
than other newborn birth defects such as
sickle cell anemia, cystic fibrosis, or
hypothyroidism.
As reported by the WHO, there are
about 250 - 300 million deaf people in
the world, 2/3 of them live in the
underdeveloped nations and of these
India has the largest share. With such a
large number of hearing impaired young
Indians, it amounts to a severe loss of
productivity, both economic and
physical. The present estimate records
even a larger number of people with
milder degrees of hearing loss or
unilateral hearing loss in age group
overs 45 years of age in India.
Dr. Desai met the Ex-President Dr.
Abdul Kalam for 30 minutes and
requested that INDIA must start “EARLY
detection of newborn hearing loss and
intervention.” Dr. Kalam appreciated the
idea and within a few days following
their meeting a report occurred in the
leading daily newspaper THE TIMES OF
INDIA JAN. 27 2007: “That one out of
twelve (1/12) persons in India has
hearing loss. The problem is receiving
political attention. The Health Ministry
has launched a project called NPPCD
(NATIONAL PROGRAM FOR THE
PREVENTION AND CONTROL OF
DEAFNESS,) in addition, the program
will treat ear infections and other
diseases causing hearing loss...”
This Campaign was introduced at the
end of Jan. 2007 in 10 states and 25
districts and one Union territory of India.
These are Andhra Pradesh, Assam,
Gujarat, Karnataka, Manipur, Sikkim,
Tamil Nadu, Uttarkhand, UttarPradesh,
Delhi, and Chandigargh.
This project will be expanded to
include 203 districts covering all states
and union territories of INDIA by 2012.
The expansion will be done in a phased
manner with inclusion of 45 new
districts each year.
All the training for the program will be
provided by the medical colleges, ENT
doctors and Audiologists of the state and
districts.
Expected Benefits from the Program are:
1) Decrease in the magnitude of
hearing impaired persons.
2) Decrease in the severity/extent of
ear morbidity and hearing
impairment.
I have introduced a model for
screening newborns at hospitals, and
home birthing centers in several states of
India. This involves carrying a screening
machine, the size of a laptop computer
on the back of a scooter by a health care
worker, or audiologist. The fact is that
Newborn Baby and Mom are kept at the
hospital post delivery for 5-7 days
throughout India. Thus an audiologist
can go from one birthing center to
another and screen several infants for
hearing loss daily. For home/village
deliveries also it is practical to go to a
central location in the village, i e., a
church or a temple and screen the
newborns.
The computerized screening machines
are fairly accurate, and provide a taped
record of the child’s hearing loss. It is
necessary to data base all screenings
and further establish a followup of all
babies detected for hearing loss and
provide immediate treatment or Hearing
Aids or Cochlear Implants (CI). Although
CI are expensive at present Dr. Abdul
Kalam and his research team are
working on an economical model. IF
THE ABOVE IS REALIZED IN NEXT FEW
YEARS, THE PEOPLE OF INDIA WITH
DEAFNESS WILL ENJOY THE SAME
STATUS AS IN THE USA.
Prevention Of Deafnes In India
As we discussed earlier, India has one
of the highest incidences of deafness on
the globe. There are many causes such
as: chronic ear infections, poor ear care,
malnutrition, poor or absent prenatal
care contaminated water supply, abuse
of common drugs used for malaria,
tuberculosis, and the misuse of
antibiotics available over the counter.
Genetics also plays a significant role.
It is estimated that 40% of cases of
deafness are due to lack of a
MANDATORY vaccination for Measles
and Rubella (MR) in the NATIONAL
VACCINATION PLAN.
In south India and amongst Muslims it
is said to have more deafness (30%) due
to the custom of consanguinity.
As in the developed nations, if India
introduces mandatory MR vaccination
one can decrease the incidence of
deafness by about 40%. The rest of the
causes of deafness will only be solved as
India’s daily hygienic conditions and the
education on deafness, by its doctors
along with socio-economical conditions
get better in the future.
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