Deafness and diminished hearing are rampant in the North -

Deafness and diminished hearing are rampant in the North

The shortage of audiologists is not helping matters

Hard of hearing

Photograph by Kristen Murphy

The teachers in Iqaluit, the territorial capital of Nunavut, now wear wireless microphone headsets to amplify their lessons in speaker-equipped classrooms. So do their colleagues in the Nunavik region of northern Quebec, though some complain they feel like they’re working at a McDonald’s drive-through. The reason for the headsets: deafness and diminished hearing are rampant in the North.

One study in 14 eastern Arctic communities found only 56 per cent of the adults tested had normal hearing, Winnipeg audiologist Jim Selinger told the national conference of the Canadian Hard of Hearing Association in Yellowknife last June. Another study of children in the western Arctic found 67 per cent of Inuit children had some degree of hearing loss, said Selinger, who has worked extensively in the North. By some estimates 20 to 30 per cent of Inuit children with middle ear infections suffer hearing loss, compared to two to six per cent in the non-Aboriginal population, he said.

There are a host of causes for the poor hearing, many indicative of the generally poor health and lowered life expectancy of Canada’s Arctic Aboriginal people, says Dr. Geraldine Osborne, chief medical officer of health for Nunavut. In children, the greatest cause is chronic ear infections, which often follow from respiratory infections.

“It really boils down to our living circumstances, our low socio-economic situation, overcrowding, poor nutrition, a high prevalence of smoking and environmental tobacco smoke,” says Osborne. In adults, noise-induced hearing loss is triggered by failing to wear ear protection when firing hunting rifles, riding snowmobiles or operating the grinders used in soapstone carving, she said. In the Northwest Territories there have even been challenges empanelling juries because of the number of citizens who say they have a hearing disability. And too often, a downward spiral of social isolation and dysfunction rooted in childhood deafness puts people on the wrong side of the law.

Dr. Radha Jetty, an Iqaluit-based pediatrician, sees the problem first-hand, and its devastating impact on children. In infants, hearing loss delays motor and language development. In school, undiagnosed hearing loss can be mistaken for learning disorders or attention deficit. Aggression and defiance can often be traced back to hearing loss, she said, “likely because they’re frustrated because they can’t hear either what their teacher is saying or their peers are saying.”

Compounding the problem is an acute shortage of audiologists. Most cycle in and out of the North on short-term contracts. “When a mother tells me Johnny isn’t listening and he’s having trouble in school, I suspect he’s having hearing problems,” said Jetty. “But I need to refer him to an audiologist to have the actual hearing test done, and also to get the hearing aids for the child.”

Chronic ear infections and hearing loss are a marker for poverty and poor health outcomes the world over. It was an eye-opener for Jetty, coming to Nunavut from Montreal as a pediatric resident in 2005. “It was only when I came up here during my training that I realized that our health problems, the severity of our health problems, are comparable to developing countries in other parts of the world.”

Reversing hearing loss means “chipping away” at all the causes of poor health, said Osborne. Since 2002, all infants receive pneumococcal vaccinations to combat infections. She has initiated a “child health surveillance system” to track and tabulate the results of all pre- and post-natal visits. As well, there are campaigns to encourage mothers to return to breastfeeding, a known protection against infection. Nunavut has also launched an aggressive anti-smoking campaign. About 60 per cent of adults there smoke, despite $15-a-pack cigarettes, an expense better put toward nutritious food. “Tobacco has no place here,” is the message currently filling TV airwaves in a campaign to denormalize smoking, which contributes to respiratory and ear infections, underweight babies and shortened life spans. Overcrowded housing, with residents trading infections, is an intractable problem.

After 10 years in the North, Osborne has reluctantly learned patience. “You just have to celebrate small successes,” she said. “There are solutions. Change will come—slowly.” The first step to fighting deafness: getting people, and their governments, to listen.


Deafness and diminished hearing are rampant in the North

  1. The doctor asked , “Is your husband native ?” , “No , why?” she asked . “Because your baby has such nice high iron levels I thought he was native.”
    Doctors are well aware , or one is at least , that natives are prone to high iron levels.
    Natives , coincidentally , also have one of the highest diabetes rates as anyone alive.
    Diabetes and elevated iron have been so closely linked the NIH is conducting a study of iron reduction for diabetes and NAFLD.
    “Iron Depletion Therapy for Type 2 DM and NAFLD”
    Increased iron leads to increased infection.
    “Iron, mycobacteria and tuberculosis”
    “Iron Availability Increases the Pathogenic Potential of Salmonella Typhimurium and Other Enteric Pathogens at the Intestinal Epithelial Interface ”
    Increased iron has been shown to cause deafness.
    “Superficial siderosis: A potentially important cause of genetic as well as non-genetic deafness.”

  2. A constant change in health workers doesn’t help…  Starting when my son was just a year old he started to get ear infections.  The nurse would say next time we will refer him, then it would be next time and a different nurse saying the same thing.  If this happens again we will refer him.  This happens so often and not only with ear infections.  My son had finally been seen by a specialist when he had been in the school system for a couple years.  By then both his ears had holes. 

  3. My family and I have lived in Canada’s high arctic for a number of years. What we have learned is that the Inuit people believe that allowing an ear infection to drain is the best thing to do rather than take the child to the nurses station to get antibiotics. They believe that the fluid coming out of the ear indicates that things are healing when in fact it’s the total opposite.  Education and teaching on proper health care is what is most needed. Those so called health officials need to wake up and get it together and stop blaming everything on cigarette smoke, overcrowded housing, bottle feeding rather than breast feeding etc. etc. etc……., Please, please look at educating  the parents/caregivers about treating these infections with antibiotics first rather than taking the easy way out and attacking their lifestyle. 

    • I agree with you.Health education is very important. Have it done yet?