Costly cochlear implants beyond reach of masses

About one in 1000 babies born in India is profoundly deaf. So, given the nearly 50,000 births in the country per day, the number of fully deaf children would be incredibly high.

But what’s scarier is the cost for the only solution available to bestow hearing to deaf children.

Cochlear implants — devices that electronically stimulate the hearing nerve of the cochlea (auditory portion of the inner ear) to enable people to hear — cost an exorbitant Rs 5-10 lakh. Such devices have been in India since the last 15 years.

Unlike people with partial hearing, hearing aids don’t work for babies with profound deafness in both ears.

Maya KT, consultant, ENT, Manipal Specialty Hospital, Bangalore, says profound deafness occurs due to various factors, including genetic causes, viral infections, rubella, meningitis during pregnancy, marriages amongst cousins, etc.

“Apart from the cost of the surgery, one has to add the costs of the intensive speech therapy required for 1-2 years to help the child associate various sounds and learn speech. Though the implants have existed in India for long, usage is minuscule because of the high costs,” she says.

Thus, of almost a million profoundly deaf children, only about 5,000 have cochlear implants.

Dyranda Hortle, regional director, southern Asia, Cochlear Ltd, a company manufacturing implantable hearing solutions, says penetration of cochlear implants in India is only 1-2%. “In Australia, there are about 250 babies born profoundly deaf each year. The number is a fragment compared with India. The government there provides cochlear implants for all babies.”

However, unlike the West, where costs of such surgeries are covered through insurance or by the government, such expenses are borne out of pocket by patients here, says Shalabh Sharma, cochlear implant surgeon, Sir Ganga Ram Hospital, New Delhi.

“But those who manage to source the expenses are going in for it. The aim of the implant is to bring the child into the mainstream so that he can do all those activities that other children do. Implants have to be inserted at an early age, from eight months onwards,” he adds.

Early implantation, before the age of five, aids extensively in speech development and language, says Hortle.

“A child hears sounds from day one, and hearing centres in the brain are activated and stimulated. If the child does not hear any sound for years together, these centres don’t develop. At a latter age, say 9-10 years, if implants are put, the child’s understanding of various sounds and their associations will not be good,” adds Sharma.

After the implantation surgery is done, a time gap of two to three weeks is given for healing, after which the speech processor associated with the implant is switched on, says Hortle.

“Only after the processor is switched can the child hear sounds, and instantaneously, the training starts with oratory verbal therapists and the support of the child’s parents.”

Hortle says, apart from profoundly deaf babies, cochlear implants are also meant for adults who have lost complete hearing due to diseases or accidents, and in whom hearing aids produce nil effect. “However, the main target group remains babies.