By 1Lt Jennifer Tay
By 1Lt Jennifer Tay
When I was asked to join the Wilford Hall Medical Center Otolarynogology humanitarian mission to Honduras last July, I must admit that I was skeptical about my role as an audiologist on an otology mission. After all, I was only bringing a portable audiometer with me—how much could I really do? Further, several staff ENT’s questioned my role on the team. They had never needed an audiologist before—why now?
As it turns out, we were all wrong! My portable audiometer proved to be an invaluable tool, and I was able to provide the mission with a great deal of support beyond the audiometer. In Honduras, audiologists are actually physicians that specialize in audiometric evaluation. There are not many physicians in the country, and patients have to travel far for any sort of medical care.
When we arrived in San Pedro Sula, the residents triaged patients and sent potential surgery candidates to me for audiological evaluation. Soon, there were at least 20 patients waiting outside for a hearing test—and most of them with a huge conductive component in at least one ear. This was just the beginning of a very long day!
I was fumbling through the first few patients with the aid of an interpreter when the local ENT physician brought over a patient’s hearing test (from a Honduran physician) that conflicted the results that I had just obtained. The physician had found an air–bone gap, while I didn’t find one at all! My first thought was that the bone oscillator was off, so I told the doctor to send the patient back over for a re–test while I completed a biologic check. The biologic check was fine, and I again found no air–bone gap. I informed our physicians and they performed a tuning fork test—and the results agreed with my evaluation.
Amazingly enough, this patient, and five more like her, was tentatively scheduled for surgery before we arrived in the country. Using my test results, in coordination with tuning forks, we saved those patients from medically unnecessary surgery. Staff physicians, who had originally questioned my presence on the team, we’re now celebrating the fact that an accurate audiogram was available. Additionally, my skills as an audiologist were put to the challenge as I tested patients with nightmarish audiograms and I emerged as a stronger audiologist.
Beyond audiograms, I was put in a unique situation as families traveled from several hours away just to meet with me about their child. Many of these kids had a hearing impairment that could have easily been taken care of with a hearing aid, but resources do not permit for such luxuries when many families are struggling to eat. There were also a couple of families with profoundly deafened children that came to ask what I could do. What could I do? These children often do not attend school, learn to read or write, and they communicate via limited sign language.
It was certainly an eye–opening experience to travel to a third world country. The little things that we take for granted are very difficult to come by most anywhere else. An audiometer, a hearing aid…how easy it would be to help many families with just a few items.
