Children with hearing loss in low-income countries face many obstacles. UK-trained audiologist Chikondi Kuthyola shares her story and Malawi’s strides in cochlear implantation.
Malawi is one of the poorest countries in the world. In developing countries, deaf children and adolescents face additional challenges. This not only includes difficulty accessing adequate services, support and education but also exclusion from society and isolation. Early on, I knew I wanted to help the people of Malawi overcome their hearing issues and enjoy a life with sound.
Figure 1: Chikondi providing audiology services to a Malawian patient.
My story
Originally from Lilongwe (the capital city of Malawi), I moved to Blantyre when I was seven years old. I was initially introduced to audiology in 2012. I decided to study audiology because, at the time, there were no audiologists in the country. We had one ENT doctor (Dr Mulwafu), and he was the only one offering ear and hearing health services, but there was a huge gap. Malawi needed more ear specialists, and I knew that with my training I would be able to provide audiology services to people from all walks of life.
After graduating in 2014, I immediately started working at ABC Hearing Clinic in Malawi as an assistant audiologist. As Malawi didn’t have any schools that offered an audiology degree, the founders of ABC Hearing Clinic, together with an organisation called Sound Seekers (now known as DeafKidz International), arranged for me and two others to study abroad at the University of Manchester, UK. The opportunity included a full scholarship, sponsored by Sound Seekers.
In 2016 I obtained my Master of Science in the faculty of biology, medicine, and health audiology at the University of Manchester. I was excited to pursue my studies in Manchester because it is not only one of the top universities in the UK, but it also embraces international students.
During my clinical placements as a Masters in Audiology student in the UK, I gained much insight into the working environment and observed the importance of medical ethics. Working in different departments allowed me to build relationships with various colleagues and furthered my knowledge of the doctor-patient relationship, hearing screenings, and hearing aid fittings. I found that excellent communication skills are necessary to deliver precise diagnoses, test results, and treatment options. It is also crucial to approach problems impartially whilst providing support to patients and their families.
Cochlear implantation in Malawi
The idea for Malawi’s first cochlear implant was triggered when ENT surgeon Mr David Strachan visited the Queen Elizabeth Central Hospital in November 2013 as part of a four-month sabbatical. From there, an international partnership was formed which pooled expertise from the team at the Yorkshire Auditory Implant Service (YAIS), based in Bradford, UK, with support from MED-EL, the hearing implant manufacturer who donated the cochlear implants used.
Upon returning to Malawi in 2017, I was put in charge of the audiology services for the cochlear implant recipients, which is where I am today. Being the first audiologist to offer services to cochlear implant recipients in Malawi is an achievement on its own, however, in 2023 we additionally celebrated 10 years of providing cochlear implants to patients in Malawi. We now have a total of 19 cochlear implant users in the country. When I look back at where we have come from, there is so much that has been done and so many challenges that have been overcome. Thanks to the ongoing support I receive, I am able to offer a full range of services to patients, including vital rehabilitation services for every cochlear implant user.
Figure 2: Chikondi carrying out a patient mapping.
Our success stories
We also have many success stories to share. The first one is a 17-year-old boy who lost his hearing due to mumps. He has been a cochlear implant user for eight years now and, in addition to his schooling, he has been learning art (pencil drawing) for the past two years. He recently drew a sketch of himself and the Managing Director of MED-EL UK when the patients with cochlear implants were supplied solar panels (Figure 3). The panels, donated by MED-EL, solved the challenge of limited access to batteries to power the patients’ externally worn audio processors. The solar panels now provide unlimited access to power so they can easily recharge their wireless audio processors. He told me, “I was among the children who were privileged to use a cochlear implant. I am grateful for the support I have received from the beginning of my cochlear implant journey up until now.”
Figure 3: A Malawian cochlear implant recipient’s pencil drawing.
Another success story is of a 23-year-old, who also lost her hearing due to mumps. She came to the clinic in July 2018 and was implanted in November of the same year. When she came to the clinic, she was preparing for her final national examination to go to secondary school. She was so worried and anxious about it because she had just lost her hearing and it meant she was going to sit the examination without hearing anything. She sat the exams and, amazingly, she was selected to go to a secondary school - getting selected here in Malawi is a huge milestone! From 2019-2020 she attended secondary school as a cochlear implant user, and she is now studying nursing and midwifery in one of the best schools.
The future
Looking to the future, I hope we can do more cochlear implant surgeries for Malawians from all walks of life. Ideally, this would include incorporating private patients that can manage to pay for themselves, gaining further funding to still implant minority groups as well as possible government involvement.
Seeing the recipients doing so well has been amazing but what I enjoy most of all about practising audiology in Malawi is when my patients say ‘ndikumva’ which means ‘I can hear’. It makes it all worthwhile!
