Research has shown that chronic ear disease (CED) significantly impacts social interactions, emotional well-being and functionality. Previous studies in rural communities in West Nepal and India have identified significant barriers to CED treatment and surgery. These include:
- Cost
- Accessibility
- Reputation
- Gender
- Fear of complications
These studies also revealed a significant gender imbalance, with women being less likely to seek medical attention, more likely to conceal their ear problems and experiencing higher stigma associated with the symptoms of CED compared to their male counterparts. It is important to investigate the effects of CED further to understand their impact on the population and culture. This will help find ways of tackling the stigma associated with symptoms and gender imbalance when accessing medical care and encourage people to look after their hearing and avoid self-treatments that could damage it. There needs to be an effort to improve education and awareness across communities to encourage people to access medical care, which will improve early diagnosis and reduce stigma. Better information sharing about hearing loss, its causes, effects, prevention and treatment are key to sustainable improvements in people’s quality of life.
There are already outreach programmes in Nepal, for example, with the charity BRINOS and the B.N. community Ear Care Service, and this project aims to support and extend their work with research to understand and educate rural communities about ear care health. However, to do this, it is important to understand these communities. This may involve utilising community resources to promote sustainable ear health improvement.
Funding from the ENT UK Foundation has enabled Catherine de Cates to visit the Ear Centre in Pokhara, Nepal, to find a local ENT doctor to lead this project on the ground, making new connections with the Ear Centre hospital in Pokhara via the charity Ear Aid Nepal. Catherine visited in November 2023 to set up the groundwork, allowing a local ENT doctor to lead this project along with a medical student from Bristol University. She also visited a rural Ear Camp to undertake some of the research to reach people living in more rural areas.
The project aims to explore further how chronic ear disease affects the quality of life in local communities in Nepal, as well as their understanding of ear disease and their health-seeking behaviour, focusing on stigma and gender imbalance. This will help improve education and information on ear care and ear disease to tackle the burden of quality of life in these populations.
Much has changed in the last 10 years with regard to modes of communication, education, and dissemination. For example, mobile phones are far more common and an effective alternative way to share information other than by word of mouth and radio as historically. By attending rural Ear and Dental awareness camps in Nepal, we have seen some of the ways The National Health Education Information and Communication Centre and The National Health Policy in Nepal are educating rural communities.