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Deafness and The Gambia

The total population of the Gambia is approximately 2.05 million. Of these it is thought approximately 39,000 are deaf or hard of hearing (average prevalence of 1.9% in sub Saharan Africa).

Accurate estimates are not really possible as there has never been any routine hearing assessment screening in place. Consequently many people with deafness will never have been diagnosed or treated.

I am often asked if the incidence of deafness is higher in Gambia than in, say, the UK. For the reason just given it is not possible to make an accurate response. However my own impression is that it is not dramatically higher, though one would perhaps expect some increase in incidence as Malaria and Meningitis are more common in Gambia and can cause deafness.

The only scientific study of deafness in The Gambia (see Causes of Deafness section for details), carried out in 1985 did however find a significantly higher percentage of sensori-neural deafness than in Europe and commented on the need for better diagnosis and educational and other support for deaf children.

In more recent times the number of pupils at St John's School for the Deaf has risen from about 150 in 2004 to nearer 250 by 2012. This increase is not necessarily due to an actual increase in the deaf population during that period but is just as likely to be due to increased awareness of the problem and acceptance that deaf children can learn and benefit from attending school.

This trend is likely to continue as the HARK mobile clinic raises awareness around the country and as more people learn about what is available for deaf people in the country through radio broadcasts as well as by word of mouth.

A further study of the incidence and nature of deafness in Gambia today would be a worthwhile and interesting project. Any takers?!

Dr Malcolm Garner

Causes of Deafness in The Gambia

Although there is a relatively extensive system of primary health care in Gambia, patient records are not as complete or precise as in a developed country. As such ascertaining accurate cause of deafness is not always easy.

The only scientific study of deafness in The Gambia was conducted as long ago as 1985* and found that Meningitis, or an illness with 'meningitis type symptoms' could account for up to a third of all known deafnesses.

Some of the latter group may include malaria or measles, as some of the symptoms of these diseases are similar.
Many other cases of deafness, as in the developed world, cannot be accurately attributed and may be familial and genetic in origin.

McPherson also found a higher incidence of otitis media and middle ear infections and deafness among young children.

*B McPherson & C A Holborow 'A study of deafness in West Africa: the Gambian hearing health project'
International Journal of Paediatric Otorhinolaryngology 10 (1985) pp 115-135

There is as yet (Jan 2014) no routine or universal screening for deafness anywhere in the Gambia As such deaf children, where they are diagnosed at all, are usually noticed when they fail to learn to communicate by speech.

This will often not be until they are at least 2 or 3 years of age, sometimes very much later, and this inevitably has an impact on their ability to learn to communicate by speech, or by sign language, as they have to start learning about communication only after an extended period with no understanding or opportunity to hear.

The HARK mobile clinic has seen many thousands of patients since it started visiting clinics at the western end of the country in 2007 and it is hoped that this will have raised awareness of deafness among the population in this part of Gambia.

As yet however it has only made a handful of visits further inland and inevitably there will be many more deaf children and adults in those areas who remain undetected and unsupported, other than by their own families.