Newsletter
1998-1S - published April 1998
Editorial
Hans Verschuure, Secretary-General
ISA
This issue is a special issue for
the AAA meeting in Los Angeles. It
was, unfortunately, not possible
to compile a full newsletter because I
have been ill and full compilation
and reproduction could not be finished in time.
We wanted to have a newsletter to
distribute at the AAA meeting and
our third newsletter was not particularly
interesting as the greater part of its contents dealt with the changed
constitution.
This newsletter should give you
some idea of what a normal newsletter looks like although it is only half
a newsletter. The presented articles deal with the international aspects
of the work of the International Society of Audiology, its connections
with the developing world through Hearing International and with WHO.
One of the HI-IFOS-ISA Centers is
located in Costa Rica. The aims of these HI-IFOS-ISA centers are to raise
awareness of auditory problems and to find ways to implement services in
the country using its own infrastructure. One of the best examples of such
a service is the Costa Rica Center that has done a prevalence study in
Costa Rica schoolchildren. Preliminary results of this study were reported
on a PASA meeting organized at the AAA meeting in Fort Lauderdale last
year. Here is an update showing how such an initiative can develop into
general acceptance in a country and a good dissemination of knowledge.
Report from Costa Rica
Dr. Juan J. Madriz, MD. (Director
"Costa Rica IFOS/ISA/HI Regional
Centre"; San José, Costa
Rica)
The year 1997 has been a very productive
year in the Central American isthmus, from the point of view of communication
disorders and audiology. Major developments are taking place in the different
countries of the area, in a moment when democracy and development are rapidly
taking over the years of struggle and discontent.
In Costa Rica, the "First National
Prevalence Study on Deafness for School Age Population" completed its data
collecting phases and the data analysis has started in the Hearing Research
Institute (HRI) of the University of Nottingham (U.K.) and in the National
Institute for Deafness and Other Communication Disorders (NIDCS) of the
National Institutes of Health (NIH) in the U.S.A. A presentation about
the preliminary results of this research was done in Boston at the Annual
Convention of the American Speech-Language
and Hearing Association (ASHA) in November.
Major changes are taking place in
the Health Sector in Costa Rica, where the Ministry of Health has engaged
in profound reforms concerning the control and surveillance of disabilities.
The new Division of Health Development created a unit that will take the
"Regional Centre" as a key arm to monitor the status of hearing disorders,
working on prevention of deafness and hearing impairment, promotion of
ear care, continuous education for professionals in the field and from
now on, early
identification activities will
be the direct responsibility of the Costa Rican Social Security.
Several major continuous education
activities have taken place in the region - some promoted by the "Costa
Rica IFOS/ISA/HI Centre" - including lectures on "Otoacoustic Emissions"
(Dr. Ignacio Mora - Mexico), "Screening Methods in Audiology" (Dr. George
T. Mencher - Canada), Prevention of Voice Disorders (Dr. Juan J. Madriz
- Costa Rica). The University of Costa Rica started training a new generation
of technicians in audiometry and the Universidad La Salle graduated its
first generation of teacher for the deaf.
Finally, the first steps have been
taken to integrate the audiological efforts of the region through an initiative
to network the different institutions, agencies, universities and individuals
working in the field of audiology and communication disorders. This is
aimed at creating an inventory of resources in the area, supporting needs
for development of better services, training programs and facilitating
sharing of information through the Internet. The home page (NetSalud) of
the Ministry of Health will start a section of Disability and Hearing Disorders.
1998 looks as a challenging year
ahead and we will show our accomplishments through this ISA newsletter.
ISA and IFOS have been involved
together in trying to establish centers
around the world. Originally this
was done by direct action, later an
organization was founded, Hearing
International. The goings of this
organization has not always been
smooth, particularly not in relation to ISA. On the other hand some enthusiastic
people, primarily from Japan and Thailand have raised interest and money.
A report on the nitty-gritty of international cooperation.
ISA and Hearing International
Hans
Verschuure,
Secretary-General
There has
been an ongoing discussion in the ISA Board about
the cooperation
with Hearing International (HI). This had to do
with the
fact that procedures in Hearing International were unclear and actions
were not accounted for in an acceptable way. Some friction had built
up over the last couple of years.
The governing
principle of the relationship between HI and ISA has always been full support
of the goals of Hearing International. ISA as one of the founding organization
of Hearing International has never questioned the intentions or the goals.
ISA has shown its commitment in the past. After the call for action by
Sir John Wilson at the Santa Barbara congress (1984) the ISA funded
activities of newly formed centers in Bangkok and Mexico.
It was
our perception that the role of ISA was played down and our attitude
was often considered as uncooperative. Our problems had to do with
sharing responsibilities of the work and a lack of accountability.
The issues
were discussed with a group from the Board of HI in Bari and the
ISA group had the impression that our concerns were to a great extent
accepted. Unfortunately this did not result in action then.
After a
change in the Board of HI we discussed matters again with the
new Secretary-General
of HI at the EFAS conference in Prague. The
issues
were recognized and a meeting was proposed between HI and its two
parent organizations, IFOS and ISA. Prof. A. Parving of Copenhagen organized
this meeting that was held in Copenhagen in November. At the same time
a Board meeting of HI was organized to which ISA was invited, although
not represented in the Board.
The issues
were discussed in a group of representative of HI (Prof. Suzuki,
Prof. V. Newton and Prof. S. Prasansuk), IFOS (Prof. P. Alberti, Prof.
E. Offeciers) and ISA (Prof. A. Parving, Prof. G. Mencher and myself).
Most of these people also form the HI Centers’ Committee. Because of preparatory
work the issues were discussed and in a one-day talk the issues could be
settled.
These include:
A new and detailed application
procedure for new Centers was
developed
Criteria
for the acceptance of centers were formulated; a center
should be located preferably
in the developing world, should have a reach-out program, should
have a clear educational goal and should
be well established (financially,
economically and politically) in that
particular country or region
of the world
A procedure for the advisory board
of a center was drafted
A visitation procedure was established
before the actual acceptance
as a center
A review procedure was established
after the first two years and
every four years thereafter
The different membership categories
of HI were discussed. It was
decided that recognized
centers could be no members but would be
targeted as recipients
of support of which reports should be widely
published An auditing
procedure was established
The new rules would
involve more contacts with the centers and this would unfortunately
increase the overhead costs if members of the Centers’ Committee
would always do visitations. It was accepted that ISA or IFOS or
HI members living nearby or on a visiting trip could do the visitation.
These
Rules were accepted at the next-day board meeting of the HI
attended
by Sir John and Lady Jean Wilson, Prof. Hinchcliffe and the
others
mentioned above. Also Dr. A.W. Smith of the WHO office
(PHD-Program)
in Geneva participated in the meeting.
National
chapters of Hearing International and its goal.
A major
issue at the meeting was the establishment of national chapters.
These national divisions are essential for the work of Hearing International.
They are functioning now only in Japan, Thailand and India and one will
soon start in the UK. The significance and role of national divisions was
discussed at length: the major goal of Hearing International is to raise
awareness of hearing impairment and of the consequences for those
suffering from it. A second (but not unimportant) goal is to raise money
for research projects in the country itself and in the developing
world. Such fundraising is usually done in cooperation with service
organizations like Rotaries or industrial companies. One has to realize
that awareness campaigns can only be effective if well-defined and
appealing goals can be formulated. A list of good projects in a number
of countries should be made available. It will give HI the possibility
to present projects to interested service organizations or companies
for research support. Hearing International (and through it IFOS
and ISA) should guarantee the quality of the project and should organize
the monitoring and auditing of the project. In this respect the new
rules for the recognition of centers are important, although projects should
not be limited to the HI-Centers. It is
understandable that good
projects from recognized centers will be
prioritized; good projects
from other centers will be closely monitored and recipients have
to accept monitoring and auditing.
After the
two-days meeting it was felt that partners had come much closer together
and could / should cooperate more. The differences of opinion were
removed and a common position was reached on a number of points.
It was also felt that if HI would not get to a good start within the next
year, we should rethink our strategy.
An example
of a working chapter of Hearing International is Hearing
International
Thailand, which organized a conference and a fund
raising
meeting. A report.
Thailand International
Conference on Pediatric ORL and Otology Update.
Hans
Verschuure, Secretary
General
International Society of
Audiology
In January
1988 Prof. S. Prasansuk in Bangkok organized a
fund-raising activity. Additionally to this fund-raiser a congress was
organized as an update of
the activities of the Bangkok HI
Center.
HRH Princess Mahachakri Sirindhorn opened the congress. A
round
Table was organized to get a survey of the result of 15 year activity
in Bangkok to raise awareness in South-East Asia and to discuss the
relationship between the Bangkok center, Hearing International, Hearing
International-Thailand and the founding organizations IFOS and ISA.
Most impressive
were presentations from Thailand, Indonesia, India, the Philippines
and Malaysia. In these countries audiological services were virtually
non-existent 15 years ago. Now surveys have been carried out and prevention
programs have been started, particularly primary (how can we avoid people
from becoming hearing impaired) and secondary (how can we restore
impaired hearing to normal hearing) prevention programs. Sofar rather little
attention has been giving to tertiary prevention programs (like hearing
aid provision etc).
At the
same time a meeting of the Board of Hearing International took
place. In this meeting the
developments since Copenhagen and the
difficulties of implementing
the changes were discussed, particularly the deviating structure
in the only HI division that really raises substantial amounts of money,
Japan. The decisions of Copenhagen were endorsed and the financial reports
were discussed in view of these decisions.
The importance
of national chapters was reiterated and key persons were identified.
We call upon all our members to think about starting a national chapter
or division. It seems a necessity to raise awareness in the population
and amongst politicians. Hearing impairment is one of the most common health
problems but is not recognized as such in many countries. It should get
its proper place and the foundation of a national division of Hearing International
in which professionals, industry, service organizations and political
organization can work together seems to be essential. Further information
can be obtained from the
Secretary-General of Hearing
International, Prof. Valerie Newton, e-mail: newton@fs1.ed.man.ac.uk
or by mail: Prof. V.E. Newton,
Centre of Audiology, University of Manchester, Dept. of Education
of the Deaf and Speech Pathology, Oxford Road, Manchester, M13 9PL
Manchester, UK
ISA also
participates in consultations with WHO. At WHO is a program for the
Prevention of Deafness and Hearing impairment (PDH). This program
organizes informal consultation each year. This years
meeting was held 3-4 February
1998 at the WHO headquarters in Geneva, Switzerland.
Consultation
meeting of the PDH-program of the WHO
Hans
Verschuure,
Secretary-General
ISA
In a two-day
meeting in which amongst others Hearing International,
IFOS,
the WHO-Centers and ISA participated the results of last-years
activities
were discussed, as was the program for the coming year. Some reports
from interesting activities were given like an awareness campaign in Brazil
and an educational training program was presented. The importance of further
education adapted to the needs of the country involved was stressed.
Further
discussions involved strategic planning. The old concepts of
pathology, impairment, disability
and handicap will be abandoned by WHO as this emphasizes the negative aspects;
positive words like activities and participation will be used instead.
Attention
was given to the themes of the program. In the past the primary and secondary
aspects were strongly emphasized in OME programs and the program
on the use of ototoxic drugs. From the floor (primarily IFOS and ISA) came
the suggestion to start programs on tertiary prevention, which means rehabilitation.
There is a high prevalence of sensorineural hearing impairment and it is
growing through noise pollution and aging. The number of hearing aids in
use is small. The reasons for the discrepancy have to be further
assessed. An important issue seems the lack of an infrastructure
in the majority of the countries. This and cultural problems could even
be more important than the price of an aid. A meeting will be organized
at the end of the year to discuss these problems and to find solutions
for the future.
International
Society of Audiology Membership fee including journal Audiology,
Newsletter and HI newsletter is $66 annually. Apply for membership at secretariat
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