Here are some real life stories from our work in Uganda
Josephine, our Paediatric Audiologist, joined LTCH in 2014 as a volunteer and has grown with the team. She is a soft spoken, determined, unstoppable go-getter who loves cooking, business and going to church. Josephine is an audiologist with a background in nursing and has acquired skills in management and leadership. She is very dedicated to her work and it is clearly evident that she loves working with children. She develops a good rapport with her hearing aid clients and strives to provide the best care possible for every child that she sees in the clinic. To the rest of the team she is affectionately called Jojo.
Ruth our administrator spoke to Jojo and this is what she had to say.
What inspired you to do Audiology?
I was invited to attend a 6 month basic audiology training course organised by a team from the Netherlands called Kentalis Academy. I was among the few students that had this opportunity and this experience totally changed my life. I picked interest in this particular field and decided this was something I would love to do. My cousin Josephine Likichori has also been a very big inspiration to me.
How has your journey in Audiology been so far?
It has been like a dream because the cost of the course was very high and I wasn’t sure where I was going to get all the money from but somehow the money came through. We were only 3 students in our class. The course meant balancing work with the academic school work. It included a lot of reading and hard work. Overall it has been an exciting and fulfilling journey studying something you are passionate about.
How has your work with LTCH contributed to your Audiology journey?
LTCH was a divine opportunity that came my way. It has been a platform for me to learn more and have hands on paediatric experience during my training which many don’t have the opportunity to get because of the nature of this field. The opportunity for me to work with and learn from senior audiologists from the UK has really gone a long way to giving me a lot of good exposure to paediatric audiology. The bigger plus was the opportunity to be employed immediately after school. I am forever grateful to LTCH.
Future dreams. Where do you see yourself in the next few years?
I see myself developing in audiology with a special interest and expertise in paediatrics. I would love to grow and also get involved in consultation work and doing tutorials. This is my future aspiration.
Josephine graduated with a Diploma in Audiology 2 months ago as the best performing student not only in her class but in the whole institution. LTCH is proud to have Josephine as part of the team. Her dedication to her work and to the children is inspirational.
Daniel Ssebagala our nurse highlights a case from the ear clinic where we treat and manage children with common ear diseases.
I get to deal with various kinds of cases but I had never seen something this severe. It was already 5pm, we had cleaned up and were preparing to head home when this little 2 year old boy was brought to the health centre. Because we particularly deal with children, we are often mistaken to be the Paediatric Department. We thought of sending him to the outpatients department but we knew he wasn’t going to get any help based on the time he had arrived. His whole body was covered with wounds which were becoming septic with a bad smell. The worst was in the ears. He was diagnosed with an outer ear infection (Otitis externa) and generalised bacterial infection. The little boy kept scratching his body.
The mother brought him wrapped in a bed sheet because he couldn’t wear clothes as they would stick to the wounds and get mixed with the blood. When asked whether they had got any treatment, the mother told me they had been going to a nearby clinic. The child had been getting injections for over a week with no improvement but they had no idea what medicine they had been administering. They had spent a lot of money. We managed it in our clinic with open dressings and cleaned all the wounds with antiseptic solution. We gave him oral antibiotics, and some antibacterial, antifungal and steroidal cream to apply to the wounds.
By the 2nd visit, the child was much better, and his wounds were drying up. He actually came wearing clothes. I was excited to see how the child was progressing well. You could see the smile on the mothers face. Experiences like this make me enjoy my work at the ear disease clinic. People from different places are being referred to ear clinic because of the kind of quality service being offered. With more health workers being trained to manage common ear diseases, many more children will be able to access these kinds of services. Thank you to everyone who supports us in our work.
This story demonstrates to those that give and support our organisation that we are making a difference to the lives of children like Tonny.
Katende Tonny is 8 years old. He was brought to the clinic by his mother who had concerns about his hearing. She hadn’t been living with her son for a certain period of time because of the nature of the work she was doing. Tonny was born with normal hearing but the period when he wasn’t living with his mother couldn’t be accounted for. Tonny would respond to his name but could barely say a word. The necessary assessment and diagnostic tests were carried out by our audiologist which indicated that he had bilateral severe to profound hearing loss.
Due to our limited supply of reconditioned digital hearing aids we have to assess the suitability of each child and the benefit if any,that they are likely to gain. However with the recent donation of brand new analogue hearing aids we decided to trial them on Tonny. Surprisingly, Tonny had made so much progress when he returned for his review appointment. His mother reported that while wearing the hearing aids he would say simple words like girl, yes mummy (wanji mama),come here (jangu),give me (mpa).
He could also count from 1 to 5. He is no longer the shy boy we met the first time he came to the clinic, he is much happier,confident and very excited. We believe with the support of our speech and language therapist, Tonny’s confidence and communication skills will improve further. He is currently awaiting assessment.
Tonny’s parents were encouraged and told to prepare to get him back to school but that he would need a lot of ongoing support to pick up where he left off. His mother is spending a lot of time with him at home to teach him basic words. Tonny’s hearing levels will be closely monitored as he continues his rehabilitation. In the future he may be considered a suitable candidate for digital hearing aids.
Our story of the month for January is a personal one!
Ruth is our administrator in Uganda and has a son called Jethro Christian who is 16 months old. She would like to share her recent personal experience about how the knowledge she has gained while working with IHCC has opened her eyes as a mother of a young child.
‘During the month of January, my son fell sick, he tested positive for malaria and had an infection. While at the hospital, the doctor instructed the nurse to put my son on an intravenous drip but I had no idea what medicine was going to be administered through the drip.
I kept prompting the nurse to let me know what medicine she was administering but in vain. After a long struggle, we got to know he had been put on Quinine. My experience of seeing the severe effects of this drug, such as sudden onset of irreversible hearing loss in some of the children that have come to the clinic, had made an impression on me and I knew there were other options available.
We requested that another drug be used and we made sure he took a lot of fluids. Currently the government in Uganda is no longer recommending quinine as a frontline drug for management of malaria apart from severe and complicated malaria and where there is no other drug of choice. It also has to be administered in the correct dosage.
Gentamicin was also given to my son to manage the infection but with the experience at the clinic I knew it also had to be administered with precaution. My son has recovered but I intend to bring him to the clinic for a hearing test just to check his hearing is ok. I am sure the story would have been very different if I still lacked the knowledge I have now gained. Unfortunately, some of these things are still happening in our communities therefore there is a continued need for more education and vigilance throughout all sectors of our community’.
Activity in our clinic was winding down with only a few more days before we would close for the Christmas break. It was a quiet afternoon at the Health Centre and not so many children were coming to the clinic. We heard a very excited group of people outside our clinic who had decided to take a few pictures in front of the door We were wondering what the excitement was really about and went to see. Then we understood why, it wasn’t just one baby but 3 beautiful newborn baby girls. Yes triplets had just been discharged from the maternity unit and were just having their photos taken before going home. After their ‘Kodak’ moment, the family were invited in to the clinic to have their babies’ hearing screened before going home. They consented to the test and asked many questions.
It was a great opportunity to provide health education to the mum around the issue of childhood hearing loss The babies were born at full term and there were no identified risk factors for hearing loss. The babies were screened, one of them passed the test while the other two didn’t We asked the mum to bring them back, which she did, and the other two babies passed their second screening test. The mum was very happy to hear this good news. However this is just the beginning and we encourage all mothers to continue to monitor their child’s hearing throughout childhood'.
One of the most important aspects of newborn screening is that it provides a platform on which to educate new mothers about their child’s hearing and language development. Our aim is to ensure that every mother leaves our clinic with information about their child’s hearing and the services we offer. This information is clearly being spread throughout Uganda, among friends and relatives.
We are beginning to see a change in health seeking behaviour; parents are beginning to access earlier intervention for suspected hearing loss.This is great news!
Not every child we see has a hearing problem but we see lots of children who are referred to us for assessment to exclude hearing loss. Many such children have other problems like behavioural disorders, delayed milestones and neurological disorders. Martin is one such child who was referred to our hearing clinic from another health centre. His mother reported that Martin had contracted Meningitis at two days old and was treated in hospital for a month. She also reported that he was slow to reach his developmental milestones and took long to learn to walk. He has no speech but his mum did not initially worry because his overall development had been slow. It is only recently that she had become concerned and decided to seek help. Martin is a very happy boy with a cheeky smile but is also very active and his attention span is limited. As a result of his behavioural problem the parents are now separated and Martin is separated from his older brother.
Martin visited us on three occasions for hearing screening and assessment.It took some time to get any meaningful results but eventually with a lot of persuasion and persistence we confirmed that Martin has normal hearing levels and his mum could clearly see that he was able to respond to sound.We discharged him from our clinic and referred him to a Paediatrician for further management. Mum was advised that in the future if she has any concerns regarding Martin's hearing then she can always come back to visit our clinic.
The theme for September's 'Child of the Month' celebrates the launch of our newborn hearing screening pilot programme which started at the beginning of September. These are collectively some of our 'Babies of the Month'.
The uptake for newborn screening has been very good and the mothers are very happy and grateful for the new service that we are providing. We are screening babies at one health centre on a Monday and Wednesday mornings, screening on average about forty babies per week. This is a good start and a major step forward in the development of our early intervention programme.
Auma Teddy is our Child of the Month for August 2017
Teddy’s story demonstrates the important role our mobile clinic plays in reaching out to children in the wider communities within Kampala and beyond.
Teddy is eleven years old, a quiet soft-spoken girl who attended one of our recent community outreaches which took place in one of the city suburbs.
She was accompanied by her step mother who reported that Teddy had been having recurrent ear infections for many years but in the village she did not have access to proper treatment. She was not aware of any other history. A year ago she brought Teddy from the village to Kampala to get her a better education. There was a concern of hearing loss in both ears. She does have normal speech but her poor hearing had affected her school work and her teachers had previously raised some concerns. In the mobile clinic she had her hearing screened which identified a possible hearing loss and she was referred to our clinic in Kisenyi Health Centre for further assessment.
Further tests showed she had bilateral moderate hearing loss meaning she would benefit from hearing aids to improve her level of hearing. Teddy and her stepmother were fully counselled regarding the results and proposed future management. It was agreed that Teddy would trial a hearing aid on one ear first to see how she adapts to it and for us to monitor her progress and commitment to the rehabilitation programme.
Teddy is wearing her hearing aid and so far her guardians have shown a lot of commitment and have consistently brought her to the clinic for all follow up appointments. It is hoped that we will soon be able to fit Teddy with her second hearing aid. We are confident she is going to benefit greatly from her hearing aids.She will continue to attend the clinic for review of her progress and adjustment of her hearing aids as required. Teddy is attending school and is currently under performing being two classes below her expected learning age. However with better hearing we hope she will begin to improve and any further decline in her school performance will have been prevented.
Ryan is a 6 month old baby who was brought to our clinic by his mother who had concerns that her son was not responding to sound as well as other children of his age. More importantly in this case she took action and brought him to our clinic for early assessment.
We have previously observed that many parents in Uganda do not seek early intervention of hearing loss and many believe that hearing may improve with age.This can lead to poor hearing outcomes and delayed speech and language development.This story highlights that attitudes are beginning to change.Increased awareness throughout Kampala and beyond of our early intervention programme is beginning to have a positive impact on the lives of many children in Uganda.
Ryan developed Jaundice and Malaria one week after he was born, both of which are risk factors for hearing loss.He has been under the care of a Paediatrician at Mulago Hospital and was referred to our clinic for a hearing assessment.At his first consultation it was noticed that Ryan has poor muscle tone and is unable to support his neck well.His mother also reported that he cries a lot of the time.Ryan failed his initial screening tests but the environmental conditions were not ideal for testing nd he therefore required another appointment.Two days later Ryan was re-screened and his right ear passed all the tests.The results for the left ear were inconclusive and could not be completed due to Ryan waking up and becoming restless.His story is ongoing and Ryan will be followed up very soon to complete the tests so that we can obtain an early diagnosis.
Ryan was our child of the month for July 2017
Newton is 18 months of age and was born with a condition called Microtia which is a congenital deformity of the outer ear. Both of his ears are affected but the right is more deformed than the left.
Newton first attended our clinic for an initial hearing assessment in April last year when he was just 3 months of age. His mother had been to see a Consultant Plastic Surgeon regarding his ears and was referred to us for hearing assessment. He will undergo reconstructive surgery for his ears at a later date.
On examination both ear canals were present but very narrow. A hearing assessment revealed that he had moderate to severe conductive hearing loss in both ears. The main priority was to provide Newton with a better level of hearing to enable him to develop speech and language. Because he has near normal hearing via bone conduction he needed a special bone conduction hearing aid. These are special hearing aids that can be worn on the end of a headband and placed over the bones behind the ears. Sounds are then transmitted via the bone
Such hearing aids are not available in Uganda so we began looking at sourcing them from other countries.
In the meantime as he had a reasonable shaped outer ear on the left side, we provided him with a conventional hearing aid which was programmed to his level of hearing. This would at least improve his hearing in the left ear until we sourced a bone conduction hearing aid.
Newton initially did well with the hearing aid fitted on his left ear. He was responding to sounds and ‘babbling’. Later on he kept removing it and his mother reported that the hearing aid was not working well. She took long to return to the clinic for a follow up appointment due to the distance of her home from the clinic.
In April this year, Newton came back to the clinic with his mother who reported that she felt Newton could now hear better even without the hearing aid. We repeated some of the tests in one ear which so far indicate real improvement in his level of hearing. We are waiting to repeat all of the tests so we can decide future management. Newton has recently been sick so this has delayed his return to the clinic.
We first assessed Newton’s hearing when he was just 3 months of age and as he has grown bigger it would appear that his ear canals have also enlarged enabling sound to be transmitted normally via air conduction to the inner ear.
It is such great news when we are able to report improved hearing outcomes especially a naturally occurring improvement due to normal growth and development.
Newton was our child of the month for June 2017
Nine year old Mpangi Kassum has shown great progress since first visiting our clinic four months ago.
At the age of 3 years, Kassum's mother noticed that her son was very slow to react when called.She made an initial visit to an ENT doctor but no subsequent follow up appointments were made .Six years then elapsed until a friend recently referred her to our clinic at Kisenyi Health Centre.
His mother reported that Kassum didn’t have a healthy social life because he was bullied a lot. Kassum was diagnosed with severe to profound hearing loss and it was decided that he would benefit from a Hearing Aid fitted on his left ear.
Luckily Kassum had developed some speech prior to his hearing loss.
A Hearing Aid was fitted and Kassum's progress continues to be closely monitored. Follow up appointments have revealed that he fully utilises his hearing aid which is great news!.He is now becoming more confident and his speech is improving.
He is able to attend normal school,is doing well and is enjoying a great social life.His mother is very supportive and she says her son's hearing has greatly improved. His teacher at school gives positive feedback about Kassum's progress.
It’s always a pleasure to have Kassum visit us at the clinic for his follow up appointments and to see the difference that has been made to his quality of life.
Mpangi was our child of the month for May 2017
Janessa is 10 years old and is a happy little girl with an infectious smile. She always comes to the clinic with her mother and younger brother.
At the age of 3 years, her mother noticed that Janessa had poor hearing. She moved to many places trying to find a solution to her daughters hearing problem but the costs elsewhere were very high.Last year she was referred to our hearing clinic at Kisenyi Health Centre.
When Janessa came to the clinic she was diagnosed with severe-profound hearing loss.Her speech wasn’t appropriate for her age and she had difficulty pronouncing certain words.It was decided that she could only benefit from a hearing aid in her right ear.
A hearing aid was fitted and Janessa has since been back for review. She is now a happy confident young girl and her speech has greatly improved. She is attending normal school ,is doing well and has a great social life. She wears her hearing aid regularly and now depends on it.
Her mother says the hearing aid has greatly improved her daughters hearing, she speaks more confidently and doesn’t have to communicate with signs any more.
Janessa was our child of the month for April 2017
6 year old Fatuma has made great progress since being fitted with hearing aids 5 months ago.
The first time she visited the Hearing Clinic, Fatuma, had poor speech and spoke very loudly.At the age of 3 years her father noticed that her hearing and speech weren’t normal and sought help from an ENT specialist but to no avail.
At the clinic various hearing tests were carried out and Fatuma was diagnosed with severe hearing loss.It was decided that she would benefit from hearing aids to improve the level of her hearing and to aid the development of her speech.
Fatuma has the support of a loving family and has returned to the clinic for several follow up appointments since being fitted with hearing aids. She is now an amazing,confident and soft spoken girl. Her speech has greatly improved and she is doing well at school. Her dad is a happy father knowing his little girl has been given a chance to reach her full potential in life.
''With your support, you brought back hope to our little girls’ world.Our family will be forever grateful''.
Fatuma is the first child to be named as 'our child of the month' which started in March 2017.
David is 9 years old and has recently moved to live with his Aunt Fiona and her family after spending much of his young life living with various family members.
His mother is a single parent with several young children who are all being cared for by other family members.
David had recently been living with his grandmother. He had been going to school but his academic performance was poor and he was falling behind his peers. He can speak but has difficulty pronouncing some words. The family realised that David’s hearing was not good and this was having a devastating impact on his development.
When David attended the clinic for his first hearing assessment he was very withdrawn and apprehensive. A detailed history taken from his aunt revealed that David had suffered meningitis as a young child which is a risk factor for hearing loss. When David was spoken to he was slow to respond and appeared very apprehensive. On several occasions he began crying.
Following a further assessment, David was diagnosed with moderate to severe hearing loss and was recommended hearing aids in both ears. He was still very emotionally fragile and communication was difficult but we felt that we were slowly beginning to gain his trust. Hearing aids were fitted and David returned for a follow up a month later. His aunt reported that he was definitely hearing better and responding well. His hearing was tested with his hearing aids fitted and there has definitely been some improvement. Because David does have some speech and moderate hearing loss in one ear, hearing aids should hopefully help him to communicate better.
David came back to our clinic to show us some of his school work. He has been having some home tuition arranged by his aunt who appears very motivated to help him. He is doing very well and his confidence is growing. Communication with David is getting easier. He is obviously much happier and has settled down well living in his new family. He has been enrolled in school. His aunt is very aware that David needs to have some stability in his life in order for him to do well in all aspects of his future development.
6 year old Gilbert first came to our ear clinic with pus discharge from his right ear and a large polyp which was visible in the ear canal.
He was prescribed some antibiotics and referred to the local national referral hospital by one of our health care workers. His father took him to see the ENT doctor and a CT scan was requested to ascertain the extent of the ear disease caused by his chronic ear infections. The scan incurred a cost and Gilbert’s father could not afford to pay for it so he returned home.
Home is a small wooden shack in a local slum. The family are very poor. Gilbert is one of 4 children and his father is a single parent with no regular employment.
By this time the ear infection had worsened with persistent offensive pus discharge. The smell was so bad that Gilbert was reportedly turned away from school.
It was now vital for Gilbert to have the CT scan in order to confirm the diagnosis. If the disease spreads through to the inner ear he could be at risk of firstly developing serious and potentially life threatening complications such as a brain abscess and meningitis. Secondly he is at risk of developing hearing loss.
Gilbert was given some more oral and topical antibiotics to treat the infection and arrangements were made to get him back to the hospital for the scan. Our medical team escorted Gilbert and his dad to the hospital and the charity paid for him to have the CT scan. The following day the Village Health Worker took them to see the doctor with the scan result. The doctor removed the polyp there and then in his clinic without anaesthetic and Gilbert was very brave. He was referred back to our clinic to be given a further course of ear drops after which he will need an operation called a Mastoidectomy. Since removal of the polyp, the pus discharge from the ear has reduced and is less offensive.
Gilbert’s father is very happy that we have been able to help his son.
I decided to join LTCH and be trained as part of Primary Ear Hearing Care Programme (PEHC) as I was interested in acquiring new skills and learning more about ear problems.
I wanted to understand the treatment of hearing problems including hearing tests on children enabling me to provide holistic care. It has been an interesting experience! I am glad and very appreciative to have been included in this programme.
I enjoy teaching and often give health promotion talks to parents attending the health centre with their children, creating awareness about ear problems in children and the services we offer.
I started working with LTCH to give me the experience that I don’t get in my everyday working life as an audiologist in Uganda due to lack of resources.
I enjoy the multidisciplinary approach of seeing children, especially communicating with parents and relatives.
Working with the resources IHCC have been able to provide I have been equipped to effectively assess children, ensuring they receive early intervention and rehabilitation.
I came to work with LTCH as a driver for the charity in Kampala. I soon became more than a driver and became involved with helping out where I was needed.
Being a pastor I enjoy public speaking and I am now very much involved with the community outreach programmes. I help organise them and give out leaflets. Using the megaphone I call parents to bring their children with ear problems to be checked.
I am happy to turn my hand to anything to support the charity and have recently painted the clinic room in Kisugu Health Centre.
Able to help or want to join our fundraising team please get in touch firstname.lastname@example.org
Community outreaches target children living in the slums