𝐄𝐧𝐡𝐚𝐧𝐜𝐢𝐧𝐠 𝐄𝐝𝐮𝐜𝐚𝐭𝐢𝐨𝐧 𝐓𝐡𝐫𝐨𝐮𝐠𝐡 𝐍𝐚𝐭𝐢𝐨𝐧𝐚𝐥 𝐄𝐚𝐫 𝐚𝐧𝐝 𝐇𝐞𝐚𝐫𝐢𝐧𝐠 𝐒𝐜𝐫𝐞𝐞𝐧𝐢𝐧𝐠 𝐟𝐨𝐫 𝐂𝐡𝐢𝐥𝐝𝐫𝐞𝐧

By Kinzang Lhamo

According to the Population and Housing Census of Bhutan (PHCB) 2017, hearing was the second-highest form of disability in Bhutan. To address hearing disabilities, the Ministry of Health, with support from the Ministry of Education and Skills Development (MoESD), launched the “Hear, Listen, and Speak” program in 2021. This ongoing initiative aligns with the national rollout of universal ear and hearing screening and focuses on ear and hearing disorders, ensuring access to ear care equipment and treatment for all Bhutanese children. Through support from partners and donors, the initiative has provided Bhutan with over 400 ENTraview hearing screening devices, the first earmold lab, and more than 700 digital hearing aids.

As part of the initiative, 491 School Health Coordinators (SHCs) across 19 districts, except for Gasa Dzongkhag, have been trained in ear and hearing screenings using the ENTraview device and Pure Tone Estimation (PTE). These coordinators are responsible for screening students, ensuring the early identification of hearing disorders, and referring them for necessary treatment.

To date, approximately 84,000 children have been screened, with 2,196 diagnosed with ear and hearing disorders and referred to hospitals and care camps in regions such as Punakha, Wangdue, Phuentsholing, Gelephu, and Samtse.
Choening Sherab, Chief Program Officer at MoESD, emphasized that the program, supported by Medtronic Lab and MED-EL, aims to expand nationwide ear screenings and strengthen local capacity for early detection. He stated that data from the screenings will be integrated into a dashboard at the Jigme Dorji Wangchuk National Referral Hospital for further medical attention. Students requiring treatment or surgery will be prioritized, with ear camps organized during winter breaks to avoid disrupting academic activities. He also highlighted that newborn hearing screenings will ensure early detection and intervention for future generations. “We aim to empower students with better hearing health, enabling them to perform better at school and actively participate in the community,” he added.

Ugyen Choden, a school health coordinator at Dunmang Primary School in Zhemgang, noted, “Workshops like these are crucial for giving all children the best chance to succeed, regardless of their hearing abilities.” She further emphasized, “Early detection of hearing loss allows for timely support, which is vital for language development, academic progress, and social skills, helping children keep up with their peers.”

The hands-on training with the ENTraview device has allowed teachers to detect hearing issues that might otherwise go unnoticed in traditional screenings, contributing to a more inclusive school environment.

Bhim Narayan Dhital, SHC of Darla Higher Secondary School, Chukha, stressed the need for routine hearing checkups. “With 931 students from different backgrounds, some may not have the chance to check their hearing at home. We can step in as a bridge to ensure these students get the help they need,” he said, advocating for regular screenings and proper training for school health coordinators.

Recognizing the importance of early detection, Sangay Zam, SHC of Gongzim Ugyen Dorji Central School, Haa, shared the effectiveness of training school health coordinators to screen for hearing issues. “Training school health coordinators to screen for hearing issues helps reduce the burden on hospitals, as we can quickly detect problems and refer students directly for further treatment,” she said.

She further highlighted that a structured approach, including scheduled screenings for both boarding and day students, helps categorize hearing issues and make necessary referrals. She also called for schools to assist families in obtaining hearing devices and to train teachers in sign language to promote inclusivity for students with hearing impairments.

Despite the initiative’s success, challenges remain. Teachers face packed schedules filled with academic and extracurricular responsibilities, making it difficult to allocate sufficient time for screenings without disrupting lessons. Conducting thorough ear screenings requires careful examination, which is time-consuming. With a large number of students to assess, ensuring each one receives adequate attention is challenging. The process is further slowed by the use of a single otoscope, leading to delays in screenings.

Narayan Kumar Mohat, an SHC from Buli Central School, Zhemgang, noted, “The training provided hands-on experience, equipping us with the necessary skills to conduct effective ear screenings and enhancing teachers’ competence in identifying hearing impairments.” He added that working with the ENTraview device helped him recognize common hearing impairments in students that might otherwise go unnoticed in classroom settings. “The training boosted our confidence in handling the device and improved our ability to perform ear screenings, allowing us to identify issues such as earwax buildup, infections, and undiagnosed hearing loss,” he shared.

The “Hear, Listen, and Speak” program is designed to reduce hearing-related disabilities in schools by equipping teachers with the necessary tools and training to screen for and address hearing issues at an early stage. Through this initiative, potential ear problems can be detected early, ensuring students receive timely intervention and treatment. By identifying hearing issues early, the program enables students to succeed academically and socially. This proactive approach fosters an inclusive learning environment where all students, regardless of hearing abilities, have an equal opportunity to thrive. Additionally, it raises awareness about the importance of ear health, promoting a culture of care and inclusion within schools.

The program is a collaborative effort involving a consortium of partners: the Ministry of Education and Skills Development, the United Nations Technology Bank for the Least Developed Countries, Medtronic Labs, and MED-EL, under the Public-Private Partnership Program with the Austrian Development Agency. It has received equipment donations from GNResound and the Hear the World Foundation. The World Health Organization and UNICEF have also provided support to the Ministry of Health.