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.