Cochlear implants can cure profound deafness

About three to four children for every 1,000 are born deaf in this country. Most of them don’t have a chance at being cured. Not because curing them is scientifically impossible but because deafness is down below in the list of our government’s priorities.

A cochlear implant surgery can bring them out of the world of silence and give them the gift of hearing and speaking. But that gift, it seems, is hard to buy as the cost of a single surgery is anywhere between Rs5-10lakh, or more.

It’s not the department of health and family Welfare did not try. With help from the National Rural Health Mission, about seven children were treated. Soon, word spread and the department got 100s of applications.

“We could not afford to reach out to the thousands of children. In a year, we cover one crore children under the Suvarna Arogya Chaitanya Programme with a budget of Rs10 crore.

We were told that each surgery costs Rs6.5 lakh. Although that is a subsidised rate (about Rs10lakh otherwise) for the government, it is still too high compared to other life-saving surgeries,” said Dr BV Karur, joint director, health education training, department of health and family welfare.

Moreover, the Suvarna Arogya Chaitanya Programme only covers school-going Standard 1-10 children. “Children who require these surgeries are below five years of age and are not school-going. Therefore we have referred the matter to the department of women and child welfare a year ago,” he said.

“Time is of essence and implants are successful only if the children receive it in the first seven years of life when the brain and neural systems are still ‘raw’ enough to receive the sound stimulus (a phenomenon called ‘neural plasticity’),” says Dr Sunil Narayan Dutt, Senior Consultant in ENT and Head-Neck Surgery, Apollo Hospitals.

The hospital completed 50 such surgeries, there are plenty to be done but the cost hurdle is keeping the treatment from being accessible to the 15,000 who need it in the state.

There is no reason why a disability that can be eliminated completely should not be, says Dr Dutt.

“The Rajeev Arogyasri Programme in Andhra Pradesh covers all types of surgeries. From initiation to date, over 500 children have been given the implants,” he says. Deafness is being belittled and sidelined in the state even by corporates who do not want to loosen their purse strings for the cause.

That leaves the child out in the cold when he can become a contributing member of society like any other ‘normal’ child.

“Public health studies have shown that surgery is the second most cost-effective one after coronary angioplasty. There is all reason for why we should give it the importance it deserves,” Dr Dutt says.

Research was initiated on developing an indigenous implant by ISRO during the presidency of Dr Abdul Kalam. That seven-channel device is awaiting animal testing.

Once that becomes a practical solution, the cost of surgery could be restricted to just Rs1.5 lakh, Dr Dutt adds. For now, the statistics of children born with deafness and suffering from profound deafness remains the same as there is little awareness on what leads to the birth of children with congenital abnormalities — marrying a blood relative.

“It’s essential to screen the child - with a simple test called Otoacoustic Emission — soon after birth. Our country lacks the system for it, as the investment for equipment is high, then the maintenance and training aspects are seen as burdensome too. The disability usually goes undetected for a couple of years and that further delays the day when the child is ‘born again’. For the day you switch on the implant is the day he or she is born as it takes more time to learn to speak and hear after the surgery,” says Dr Dutt , who also founded the Cochlear Group of India.