In Bangladesh, hearing impairment is a significant public health issue, affecting approximately 7.6 million people, or about 5% of the population. For those with severe hearing loss, cochlear implants can be a life-changing solution. Cochlear implants are electronic devices that are surgically implanted into the ear and provide a sense of sound to those who are deaf or hard of hearing.
Under the leadership of Prime Minister Sheikh Hasina, the government of Bangladesh has taken significant steps towards improving the lives of those with hearing impairments through the implementation of cochlear implants.
In 2015, the government launched a program to provide free cochlear implants to children from low-income families. The program has been implemented by the National Institute of Ear, Nose and Throat (NIENT), Combined Military Hospital (CMH), Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka, in collaboration with the Ministry of Health and Family Welfare.
In 2021, the Austrian cochlear implant manufacturer MED-EL won four out of five governmental cochlear implant (CI) tenders in Bangladesh. The program has received support from international organizations such as the World Health Organization (WHO) and the Global Foundation for Children with Hearing Loss.
The program has been a game-changer for many families who previously could not afford the expensive procedure. Since the program's launch, over 1,000 children have received cochlear implants, and the government has plans to expand the program to reach even more children in need.
The government has also taken steps to train doctors and healthcare professionals in the country to perform cochlear implant surgeries, ensuring that those in need have access to quality care. The Cochlear Implant program has conducted 1700 surgeries on disadvantaged people with hearing impairment since 2010. The program started to provide cochlear devices to poor children and adults in 2010 under the project titled “Development of Cochlear Implant” in Bangabandhu Sheikh Mujib Medical University.
Cochlear implants were first introduced in Bangladesh in 2007, but due to the high cost, they were only accessible to a small number of people. The cost of a cochlear implant in Bangladesh can range from Tk15 lakhs to Tk25 lakhs ($17,647 to $29,412), which is unaffordable for most families in the country. The government's program has made it possible for children from low-income families to receive the surgery for free. The program covers the cost of the surgery, the implant, and the post-operative care.
Eligibility for cochlear implant
The eligibility criteria for cochlear implants in Bangladesh vary depending on the age of the patient. For adults, the criteria includes moderate to profound sensorineural hearing loss in both ears and limited benefit from amplification defined by preoperative test scores not exceeding 50% sentence recognition in the ear to be implanted and at most 60% in the opposite ear or binaurally.
For children, the criteria includes severe to profound sensorineural hearing loss in both ears, limited benefit from binaural amplification, and Multisyllabic Lexical Neighbourhood Test (MLNT) or Lexical Neighbourhood Test (LNT) scores below 30% for children aged 2-17 years. Children aged 9-24 months must have profound sensorineural hearing loss in both ears and limited benefit from binaural amplification.
It is important to note that cochlear implants may not be appropriate for every child with hearing loss, and some medical conditions may indicate that a cochlear implant may not be suitable for a child. While the government's program has focused on children, there are also adults in Bangladesh who could benefit from cochlear implants. Efforts are underway to expand access to cochlear implants for adults as well.
The impact of the government's efforts have been significant, with many children now able to hear for the first time in their lives. The program has also helped to raise awareness about hearing impairments in the country and reduce the stigma associated with it. The children who have received cochlear implants have been able to attend school, communicate with their families, and participate in social activities, thereby improving their quality of life.
The procedure for cochlear implant surgery involves several steps. First, the patient undergoes a thorough evaluation to determine if they are eligible for surgery. If they are, the surgery is performed under general anesthesia, and the implant is placed in the inner ear. After the surgery, the patient undergoes a period of rehabilitation and auditory verbal therapy to learn how to use the implant and develop their listening and speaking skills.
Recently, Dhaka CMH celebrated its 500th cochlear surgery, NIENT celebrated its 400th cochlear implant surgery, and BSMMU celebrated its 700th cochlear implant surgery.
In conclusion, the government's commitment to improving the lives of those with hearing impairments through the implementation of cochlear implants is a significant step forward for Bangladesh. With continued support and investment, the country can continue to make progress towards a more inclusive and accessible society for all.
Md Shoeb Adnan is currently working as an audiologist and Speech Language Pathologist passionate in writing and research for special needs children.