Canadian Academy of Audiology

Canadian Academy of Audiology

Official Publication of the Canadian Academy of Audiology

AIM Companies Canada: Helping Children to Hear in Bali Indonesia

Bali is a beautiful tranquil island in the south pacific, famous for its beaches, rice paddies, friendly people, and rich culture. Tourists flock there from all over the world to enjoy the hotels where they receive warm welcomes and pampering by the gentle and generous Balinese. Few seem to notice that their attentive hosts leave the opulence of the tourist hotels at the end of their shifts each day to return to their poverty stricken homes. Our projects in Bali started through the efforts of Nick Liem, who in his retirement, felt compelled to return to his native country of Indonesia and give back to the land of his childhood. An active Rotarian, he had been involved in Rotary International Projects in Africa to assist hearing-impaired children. He realized through his involvement in these projects that the children of Bali desperately needed the same sort of assistance and support. To this end, he made an association with a Balinese owned company called Lumina, and embarked on a mission to procure the necessary training and skills needed to bring hearing care to local children. Fellow Rotarians, who were also involved in the African Projects, Vikki MacKay, a licensed hearing instrument specialist in B.C., and Jim Renshaw, an electronics technician specializing in audiometric equipment joined in the project. The three of them work together in Canada at AIM Instrumentation, a company that specializes in the supply, repair and calibration of audiometric equipment. A plan to construct and equip the Lumina Hearing Centre was soon enacted, staff recruited and trained, and the concept was introduced through the local Rotary Clubs to the community. Very quickly the needs of hearing impaired children in Bali were recognized. Bali has several state-run schools for the deaf, but sadly they have no audiologic support, no hearing aids, and although the country does have its own sign language, it is not taught in the schools. Facilities are “bare bones,” and many hearing impaired children are abandoned by their parents at the school – orphaned because of a hearing loss. Lumina’s cry for help was caught by a humanitarian organization called YKIP (Yayasan Kemanusiaan Ibu Pertiwi) or the Humanitarian Foundation for Mother Earth, which is dedicated to helping the needy in Bali through health and education programs ( Together with YKIP, Lumina has developed several hearing projects and continues to strive to do more. Our Projects Hearing Testing and Hearing Aid Fitting for SLBB Students There are state-run schools for deaf children in Bali that carry the acronym SLBB. Children who do not learn to talk due to deafness are enrolled in these poorly equipped schools, where teachers sometimes must double as parents for abandoned children. Over the past four years, Lumina and YKIP have developed a program that provides hearing tests for each child enrolled the school and hearing aids to those children that would benefit from amplification. Donated hearing aids are gathered from Canada and Australia, tested and issued to children. They are monitored and tested on a regular basis to ensure that their hearing aids are working well and remain appropriate for their needs. To date we are proud to say that we have over 200 children wearing hearing aids in our program. Sushrusa Preschool for Hearing Impaired Children Our work in the schools opened our eyes to the need for much earlier identification and habilitation efforts for Balinese children. We quickly realized that children did not enter the school system until they were between 7 and 9 years old – unfortunately too old for successful language rehabilitation in a country with no universal SLP support. The children we were assisting found good benefit in using their hearing for environmental sounds, but only the very youngest began developing their speech. Lumina and YKIP began the process of developing a pilot project to start a preschool for hearing impaired children. Expert Balinese educational consultants who specialized in teaching hearing impaired children were hired, and together we worked to develop a program that would meet the legal, educational, cultural and special needs of the children we sought to help. Construction of the school began in early 2007, and it was opened in July to welcome its first little class of deaf-mute children. Each child had a hearing assessment and if they did not already have a hearing aid they were appropriately fitted with a donated pocket aid supplied by YKIP. Within six months (the time between our visits) this quiet little group became a very noisy vocal class! They had found their voices – step one in learning to talk! Sound Booth and Audiometric Equipment Installation in SLBB Schools With ever expanding awareness throughout the school system, teachers soon began inquiring if there was anything more that could be done to facilitate the testing of the children in the SLBB schools. Again Lumina and YKIP responded by working together to develop and fund the construction of locally developed and built sound booth facilities. The sound booths are designed by Engineer Nick Liem, to be up to international standards in their specifications, but to be made of locally available products and produced by local craftsmen. They were constructed and installed with a screening audiometer in several schools and are actively used to facilitate the testing of the children. An important spin-off of this project is that these booths are now readily available to the ear-nose-and-throat (ENT) specialists on the island and have been installed in several clinics as well as one local hospital. ENT Physician Education, Support, and Training Sadly, there are no audiologists on the Island of Bali. In fact, at last report, there are no audiologists in the entire country of Indonesia. ENT physicians struggle to make up for this deficit by doing as much as they can to understand the basics of hearing assessment procedures and through Lumina we support their efforts to our best ability. In February of 2008 we sponsored a seminar featuring Indonesian ENT specialists in the field of OAE assessment, ABR assessment, and tympanometry. Many physicians attended and Lumina provided both equipment and training assistance. Much, much more needs to be done here, and I am very pleased to say that we have recently made a connection with the Australian audiology community who has come forward to adopt our cause by offering their much needed and very valuable experience and knowledge! Bali is a favourite vacation spot for Australians; so many audiologists have come forward to donate a day of two of their vacation time, which has made a wonderful difference! We would welcome with open arms our Canadian Audiology community as well! The Initiation of a Universal Hearing Screening Program for Infants In 2007 ENT physicians came forward with a request for assistance in establishing a universal hearing screening program for the Island of Bali. This is our most ambitious project to date and it would not have been possible to even consider it if Viasys Health Care (now a part of Cardinal Health) had not stepped forward with the generous donation of a fully equipped clinical Audera ABR unit and two AudioScreener OAE/ABR screening units. Added to this is a third AudioScreener purchase that was jointly funded by AIM Companies Canada and YKIP. A pilot project was begun in 2008, funded by YKIP, and these units were placed in three major hospitals in Bali. In a coordinated effort headed by Dr. Eka, ENT specialist, babies are screened at birth following a protocol set by a committee of ENT doctors and accepted by the Indonesian government. Results are collected and tracked by Lumina staff and submitted to a central database located at Sanglah Hospital. Identified babies are retested at age three months and again at age six months. If they fail the screening at age six months, they receive an ABR assessment and after medical clearance may be fitted with a pocket aid that is subsidized by YKIP to ensure affordability for the families. Identified children will be tracked, and their families will be given support to understand the nature of the hearing loss and how to help their child learn to speak to the best of their abilities. We are now in the process of fundraising for phase two of this project, in which we hope to be able to place at least one OAE screening unit in each Bali hospital. Development of Career Opportunities for Deaf and Non-Verbal Youths and Adults There is no “social safety net” to assist people who have communication limitations. As a result, once they have left their schools, if their families cannot support them the young adults must resort to begging in the streets. The schools do not provide any training in trades or life skills. We have begun a process to develop a pig farming project to create sustainable employment for hearing impaired adults. At first impression you might say, “Why pig farming? and the answer is simple, it is sustainable, uses already established local knowledge, and has many related industries such as; farming to provide the feed; butchering facilities; meat processing facilities; animal husbandry jobs; and farm maintenance jobs. The more you think about it the longer the list gets. The best part is that most of the jobs do not require that the worker be able to speak – the farm and its related occupations can be substantially staffed by hearing impaired people! Currently we have located some property that may be leased for the purpose and are working to secure it and begin the development of the project. We need volunteers with expertise in pig farming to assist us with this project! Upcoming Projects The establishment of an Audiologic Testing Facility at Sanglah Hospital In order to facilitate the development of programs such as the Infant Hearing Screening Program, ENT training and now the ENT department’s ambitious new Cochlear Implant Program, it is imperative that the Sanglah Hospital be equipped with an audiologic testing facility and receive training for their physicians. To this end we are working through our Rotary Clubs, YKIP, and other donors to raise the necessary $30,000 to pay for and install the sound room and equipment ENT and Hearing Testing Outreach Services to Rural Communities Currently, ENT and hearing testing services are only available in the capital city of Denpasar, which leaves all of Bali’s poor rural population without access unless they can afford to travel. We are raising funds to purchase a van and ENT instruments and equipment to enable the doctors to travel out to the regional health stations to deliver services. Pediatric and Rural Access ENT Clinic Currently there is only one place serving the needs of the rural population and no clinic that specializes in pediatric care for ENT services. Facilities are greatly overloaded. We have secured a location to establish a small treatment centre and are currently raising funds to equip it. Donations of used ENT instruments and portable equipment would be very gratefully accepted! Mobile ENT/Hearing Clinic We have drafted a proposal to outfit a bus with the equipment necessary to become a fully mobile clinic designed to serve the rural areas. This project will cost up to $500,000 to complete so it is an ambitious goal! Who Knows! The Sky is the Limit! There is no limit to what can be accomplished by dedicated people with a good cause! Thank you to everyone who has supported our efforts and welcome to anyone who wishes to join us in bringing hearing health care to the children of Bali! Each and every contribution – no matter how small, makes a positive change in the life of a child! We are especially grateful for good used BTE hearing aids, the shared knowledge of volunteers, ENT equipment, and other invaluable gifts and cash donations. The projects are coordinated on the Canadian side by AIM Companies Canada, home of AIM Instrumentation B.C., AIM Instrumentation Ontario Inc., and AIM Technologies Inc. Jim, Nick, and Vikki work together there and provide financial support, training and ongoing guidance to the staff at Lumina. For more information about the projects or to inquire about donating or volunteering please contact: Vikki MacKay CEO AIM Companies Canada at
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© 2007 Andrew John Publishing Inc. All rights reserved.
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