Bridging the gap in hearing healthcare for Indigenous communities

Through research and a community-driven project, Inuit children now have improved access to learning, thanks to enhanced classroom acoustics made possible by the implementation of Roger™ Soundfield systems in classrooms across Nunavut. However, this initiative underscores the need for a more comprehensive strategy for delivering hearing healthcare in Nunavut.

I am an audiologist working in Ontario, Canada. Since 2015, I’ve had the opportunity to volunteer in Nunavut, in the Canadian Arctic. Over the next decade, I learned not only about the challenges of service delivery in this remote region, but I also had the privilege of experiencing its pristine, vast and beautiful landscape. More importantly, I came to know the people of Nunavut, whose kindness, quiet wisdom and humble yet generous way of life has imparted invaluable lessons. It has been a privilege and an honor.

I hope sharing my experience will inspire others to become allies to Indigenous communities and advocate for better hearing services in their region.


First impressions

Nunavut, Canada’s newest territory, is larger than any U.S. state but has only 45,000 residents, 85% of whom are Inuit. In 2015, only one permanent audiologist served the largest region, and the waitlist for audiology services, including for children, was long. Many children with hearing aids did not wear them consistently. This sparked my interest and led to over 17 trips to Nunavut.

Researching hearing loss in Inuit children

The 2015 Truth and Reconciliation Commission report highlighted the need to close gaps in health services for Indigenous youth.1 After discussions with Nunavut’s Medical Officer of Health, I learned the importance of data to advocate for better hearing healthcare. In 2017, I teamed up with Dr. Elizabeth Fitzpatrick at the University of Ottawa to conduct hearing assessments of 644 children from kindergarten to grade 6 across Nunavut. The research revealed:2

• A higher incidence of hearing loss, with an overall prevalence rate of 23.5%, which is three times higher than that reported for non-indigenous children.

• 93.5% of the children with hearing loss had a loss that was conductive in nature. This is quite different than the type of hearing loss typically found in southern regions and is a direct result of increased incidence of untreated ear infections. 

• 37 out of 124 children (in sample of school-age children in Nunavut) could benefit from hearing aids (based on their audiological profile at the time of assessment). Yet only 5 children were consistently wearing hearing aids. Only 13% of children who could benefit from hearing aids were consistently wearing them.

Monika and Lynne in Iqaluit – March 2024

Addressing the gap: The BHENY Project

Armed with this data, we advocated for a better hearing healthcare model and launched a pilot hearing clinic in Pond Inlet Nunavut in 2019. Unfortunately COVID thwarted any progress of this new delivery model.

This did not stop us from continuing with our BHENY (Better Hearing in Education for Northern Youth) project which was developed in collaboration with the Nunavut Department of Educationto address hearing needs in the classroom. A team of Rotarians, audiologists and educators from both Nunavut and Ontario came together and successfully applied for funding from the Arctic Inspiration Prize, Hear the World Foundation and Rotary clubs.

The goal was to install Phonak Roger SoundField Systems in all elementary schools in the Qikiqtani region, contribute to the development of supporting processes within the department of Education and to train local leaders to ensure sustainability.

Monika and Lynne with Student Support Teacher Karen in Pond Inlet Nunavut – March 2024

The role of Roger SoundField Systems in enhancing classroom learning

We chose Roger SoundField Systems because this wireless technology enhances sound quality and speech understanding in classrooms by amplifying the teacher’s voice and distributing it evenly throughout the room.

Although soundfield systems are not a substitute for hearing aids, the project aimed to improve educational outcomes for northern youth living with hearing loss by improving classroom acoustics.

The BHENY Project

My colleague Monika Nazair, Sonova Canada employee and audiologist, joined the project and over the last decade has helped train educators in 5 of 11 high Arctic communities. Her first visit was part of a Hear the World3 project.

Over a three-year period, we:

  • Facilitated training sessions on the newly installed soundfield systems in twelve communities.Provided training to classroom teachers, student support teachers, student support assistants, principals, and administrators with more extensive training for local leaders for the technology.
  • Provided hearing health fairs for all students in elementary schools and offered family members to join in and learn about hearing and the benefits of soundfield systems.
  • Assisted in the development of supporting processes within the Nunavut Department of Education.
  • Delivered all supporting materials in both Inuktitut and English.
Volunteers Kiki and Sophia using Phonak systems in the classroom

Outcomes of the BHENY Project

In March 2024 Monika and I, along with two volunteers, returned to two communities to measure the project’s impact. We found that 74% and 72% of teachers were using the soundfield systems most of the day. In the survey, staff also identified the need for more consistent training.

The Government of Nunavut has since installed soundfield systems in every classroom across the Territory—a first in Canada! However, there is still a need for more consistent training and a comprehensive strategy for the delivery of hearing healthcare in Nunavut.

To learn more about Roger technology for Education, please visit the Phonak website.

References:

  1. Truth and Reconciliation Commission of Canada. (2015). Honouring the truth, reconciling for the future: Summary of the final report of the Truth and Reconciliation Commission of Canada. Retrieved from https://nctr.ca/assets/reports/Final%20Reports/Executive_Summary_English_Web.pdf
  2. Fitzpatrick, E. M., McCurdy, L., Whittingham, J., Rourke, R., Nassrallah, F., Grandpierre, V., … Bijelic, V. (2020). Hearing loss prevalence and hearing health among school-aged children in the Canadian Arctic. International Journal of Audiology, 60(7), 521–531. https://doi.org/10.1080/14992027.2020.1731616
  3. Arctic Inspiration Prize. (2024). Better Hearing in Education for Northern Youth (BHENY). Retrieved from https://arcticinspirationprize.ca/laureate/better-hearing-in-education-for-northern-youth-bheny/
  4. Sonova. (2024). Hear the World Foundation. Retrieved from https://www.sonova.com/en/hear-world-foundation/




Authors:

Lynne McCurdy, Clinical Audiologist, Connect Hearing, Guelph, Ontario Canada

Lynn McCurdy, AuD, has a varied career spanning over three decades that includes a clinic owner serving adults as well as infants and children with hearing loss through the Ontario Early Hearing Detection and Intervention Program (EHDI); She has also served as an Educational Audiologist in local school boards. She is an active Rotarian and leader of the Better Hearing in Education for Northern Youth (BHENY) volunteer organization serving indigenous communities in the Canadian Arctic.

Monika Nazair, Audiology Support and Specialty Training Manager, Sonova Canada

Monika obtained her Master’s degree in Audiology from the University of Ottawa in 2010, and worked in various clinical settings before joining Sonova Canada in 2016. In her current role within the organization, she especially enjoys facilitating Roger and Lyric training sessions. She is passionate about working with hearing technology that enables those living with hearing loss to stay active and engaged in the activities that bring them joy and fulfillment.

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