The Lives of Others. All About Hearing. Uzbekistan
Nargiza Karimova, audiologist and vestibulologist of the highest category, Candidate of Medical Sciences
RU | EN
RU | EN
— Is there data on the number of hearing-impaired people in Uzbekistan? How does the population in general relate to the problem of hearing and hearing prosthetics?
— Detailed statistics on the problem of hearing loss, unfortunately, are not available. But based on global statistics, according to which 1−2 children per 1,000 newborns have hearing impairment, and in Uzbekistan there is a high birth rate (up to 900,000 births per year), then only congenital and hereditary forms of hearing loss account for up to 900 children per year. At the same time, we should not forget to add to these statistics cases of "gentamicin deafness," the high percentage of consanguineous marriages in our country, and infectious diseases.
As for elderly people and age-related hearing loss, undoubtedly, this problem remains relevant. It is especially worth noting that in recent years, the elderly population has been developing a more conscious approach to the hearing prosthetics process, stereotypes are breaking down, and there is a desire to hear better. This is also related to the appearance of increasingly high-quality digital and affordable hearing aids. This is really encouraging.
It is easy for me to compare because I have been working in the field of audiology for more than 20 years. After all, the most difficult thing for patients with hearing impairments is to accept the problem, and for a long time many people perceived wearing hearing aids very negatively.
As for elderly people and age-related hearing loss, undoubtedly, this problem remains relevant. It is especially worth noting that in recent years, the elderly population has been developing a more conscious approach to the hearing prosthetics process, stereotypes are breaking down, and there is a desire to hear better. This is also related to the appearance of increasingly high-quality digital and affordable hearing aids. This is really encouraging.
It is easy for me to compare because I have been working in the field of audiology for more than 20 years. After all, the most difficult thing for patients with hearing impairments is to accept the problem, and for a long time many people perceived wearing hearing aids very negatively.
— How many hearing aid centers are operating in the country today?
— Today in Uzbekistan, more than 40 hearing prosthetics centers are operating. As a rule, they are located on the basis of representative offices of manufacturers of electroacoustic hearing correction devices. Some of them offer not only diagnostic and hearing prosthetics services to the population in the regions but also training of specialists on the ground.
— What are the data on the number of practicing audiologists?
— It should be noted that with the development and introduction of computer technologies, interest in practical audiology has tripled, and the ranks of audiologists are growing at the same arithmetic rate. In fact, the field of audiology is very multifaceted and complex. It incorporates elements of such fundamental sciences as physics, biophysics, chemistry, psychoacoustics, and linguistics, which makes it complex and at the same time very interesting. Nevertheless, an acute shortage of audiologists remains, especially in the regions. For example, while in Tashkent there are currently more than 20 practicing doctors, in the regions there are only 2−3 people for the entire region. Undoubtedly, this is very few.
— How are things with professional training of audiologists? Where is this specialty taught, and who and how can obtain it?
— Today in Uzbekistan, an audiologist certificate can be officially obtained by completing two-month courses in the discipline "Audiology" at the Center for Advanced Training of Medical Specialists. Courses have also opened at the Research Institute of Otorhinolaryngology, Head and Neck Pathology. In addition, my School of Audiology, Vestibulology, and Post-Cochlear Rehabilitation has existed for five years, where training is conducted with an emphasis on practical skills. For example, specialists from Kyrgyzstan and Kazakhstan come to my center, and there was even a doctor from Krasnodar.
Theoretical knowledge is the first stage, but practice is a more complex and responsible moment. This is especially true for methods of objective diagnosis of children, such as ABR. It requires patience, pedantry, and skills. I am also pleased that our speech therapists — surdopedagogues — are showing interest in training. Of course, working with deaf children and conducting hearing and speech rehabilitation without the basics of audiology is practically impossible, and this is wrong.
Theoretical knowledge is the first stage, but practice is a more complex and responsible moment. This is especially true for methods of objective diagnosis of children, such as ABR. It requires patience, pedantry, and skills. I am also pleased that our speech therapists — surdopedagogues — are showing interest in training. Of course, working with deaf children and conducting hearing and speech rehabilitation without the basics of audiology is practically impossible, and this is wrong.
— How do you assess the population's need for hearing prosthetics and hearing and speech rehabilitation services? Is the demand for hearing aids and cochlear implants increasing?
— Answering this question, first of all, I want to note the role of the state in implementing very effective programs to provide the population with electroacoustic correction (EAC) devices. For example, since last year, up to 10,000 hearing aids have been allocated under the state quota and tender, which children and adults in need can receive free of charge. Moreover, these are digital programmable devices.
Over three years, 11,000 hearing aids were allocated for prosthetics of children — pupils of specialized boarding schools. This was a global project from the ZAMIN Foundation. It should be noted that with each passing year, the state is paying more attention to the problem of hearing and providing financing for EAC devices.
As for cochlear implantation, I cannot hide my "professional emotions" on this issue. As a specialist, I was at the origins when the first private cochlear implantations were carried out in our country in the early 2000s; these were isolated cases. But I didn’t even dream that the era of the state CI program would come so soon.
Since 2014, cochlear implantations have been carried out free of charge for children under 5 years old in Uzbekistan. Personally, I was filled with professional pride and believe that the presence of a state program for cochlear implantation of children is an indicator of the country’s development both economically and medically. Moreover, I am pleased that the number of implants provided is increasing with each year, and to date, more than 3,500 children have been implanted in Uzbekistan at state expense.
Over three years, 11,000 hearing aids were allocated for prosthetics of children — pupils of specialized boarding schools. This was a global project from the ZAMIN Foundation. It should be noted that with each passing year, the state is paying more attention to the problem of hearing and providing financing for EAC devices.
As for cochlear implantation, I cannot hide my "professional emotions" on this issue. As a specialist, I was at the origins when the first private cochlear implantations were carried out in our country in the early 2000s; these were isolated cases. But I didn’t even dream that the era of the state CI program would come so soon.
Since 2014, cochlear implantations have been carried out free of charge for children under 5 years old in Uzbekistan. Personally, I was filled with professional pride and believe that the presence of a state program for cochlear implantation of children is an indicator of the country’s development both economically and medically. Moreover, I am pleased that the number of implants provided is increasing with each year, and to date, more than 3,500 children have been implanted in Uzbekistan at state expense.
— What is the effectiveness of universal audiological screening for newborns and children of the first year in Uzbekistan? How long ago was it introduced? Is there data on its results?
— Audiological screening is the most delicate moment in the entire process of establishing audiological care in Uzbekistan. I am a fairly bold person in my positions, and I admit: we are going through the same "shocking" stages as other countries.
Audiological screening was first introduced with the adoption of the state program for cochlear implantation in 2014. A few years ago, as a moderator of the screening program, I studied this issue in detail. After all, even in developed countries it is not ideal, and the status of "universal" is recognized only, say, in Germany, Japan, and Poland. The issue of universality is very complex in a country with such a high birth rate. This is one of the factors when it is very difficult to cover everyone with screening.
The stage of checking the hearing of newborns in maternity hospitals is the most difficult and labor-intensive, both in organizing the process itself and in executing it on the ground. Nevertheless, in our state, audiological screening in maternity wards is carried out in many regions. It is carried out by nursing staff under the close supervision of a neonatologist.
In the process of implementing screening, a number of problems arise, because the process requires large investments, not only for the purchase of equipment but also for personnel, educational needs, technical support, as well as for the maintenance of a tracking center. This problem is more political and economic in nature, but I really hope that our state will revise the concept of audiological screening in Uzbekistan, make adjustments so that it becomes more effective.
Audiological screening was first introduced with the adoption of the state program for cochlear implantation in 2014. A few years ago, as a moderator of the screening program, I studied this issue in detail. After all, even in developed countries it is not ideal, and the status of "universal" is recognized only, say, in Germany, Japan, and Poland. The issue of universality is very complex in a country with such a high birth rate. This is one of the factors when it is very difficult to cover everyone with screening.
The stage of checking the hearing of newborns in maternity hospitals is the most difficult and labor-intensive, both in organizing the process itself and in executing it on the ground. Nevertheless, in our state, audiological screening in maternity wards is carried out in many regions. It is carried out by nursing staff under the close supervision of a neonatologist.
In the process of implementing screening, a number of problems arise, because the process requires large investments, not only for the purchase of equipment but also for personnel, educational needs, technical support, as well as for the maintenance of a tracking center. This problem is more political and economic in nature, but I really hope that our state will revise the concept of audiological screening in Uzbekistan, make adjustments so that it becomes more effective.