Dec 2016 Sydney Morning Herald

Latoya Terry couldn't understand why her toddler Saraya was ignoring her. When the mother-of-two called her daughter, she would get no response. "I thought she wasn't listening to me," Ms Terry said. "Turns out she literally couldn't hear.” Like a disproportionately large number of Aboriginal children, Saraya had hearing loss brought on by a severe middle ear infection (otitis media). Saraya, now five, had contracted ear infections every couple of months for the first years of her life.  "They would be quite painful for her and she was on antibiotics a lot," said Ms Terry from Wagga Wagga. The run of infections meant Saraya didn't have her hearing tested until she was four, when she was referred to a specialist. She needed grommets, tiny tubes inserted in the ear to help drain fluid from the middle ear. "Saraya knows she can't hear properly … she'll say 'my ears, mum, I can't hear'" Ms Terry said. "For me it was a big relief [to get a diagnosis]. I was going crazy not knowing.
Latoya and SarayaLatoya and Saraya

More than 40 per cent of urban Aboriginal children under eight have significant ear problems and speech and language impairments, according to the SEARCH study, the largest long-term analysis of health and wellbeing among this demographic.  The rate of ear disease and hearing loss among Indigenous Australians is 10 times that of the non-Indigenous population.  Hearing infections left untreated can lead to hearing loss, speech and language delays, and can severely handicap their ability to thrive in school.

Darryl WrightLeft: Chief Executive at Tharawal Aboriginal Corporation in Campbelltown Darryl Wright has seen first-hand families struggle to access services for ear disease.
Professor Kong

Right: ENT Surgeon Associate Professor Kelvin Kong said ear disease in Australia was "diabolical". Photo: The University of Newcastle

Aboriginal families, even in Australia's capital cities, struggled to access care, and waiting lists for speech therapists and surgery stretched into years, said Darryl Wright, the chief executive at Tharawal Aboriginal Corporation in Campbelltown. "I see first-hand the long-term impact of ear health problems and the struggles that families face in accessing the services to address this issue in a timely manner," he said.  "When kids can't hear in school and can't properly participate in society, it creates all kinds of problems."Their language skills don't develop as quickly, they don't sleep well, they have to take more time off, they can misbehave and their education can fall behind."

But a NSW Health-funded program, the Hearing Ear Health And Language Services (HEALS), is bridging the gap for Aboriginal families struggling to get their children's hearing problems addressed.  HEALS has provided speech and language services and surgery to almost 800 urban Aboriginal children since it was launched in 2013 in partnership with Aboriginal community controlled health services, SAX Institute researchers and the state's hospitals.  "[HEALS] offers a model to help close the gap that has been shown to work," Mr Wright said. "It's a good news story for improving urban Aboriginal child health."  

Hearing problems among Aboriginal youth have been linked to the high Indigenous incarceration rate in Australia. "Their language skills don't develop as quickly, they don't sleep well, they have to take more time off, they can misbehave and their education can fall behind," Mr Wright said.

About 94 per cent of Indigenous prisoners in the Northern Territory suffered impaired hearing, compared with 45 per cent of the wider Indigenous population. The Royal Commission into the Protection and Detention of Children in the Northern Territory recently heard that six out of 10 boys at Don Dale Youth Detention Centre suffered hearing impairment.

"The problem with ear disease in Australia is diabolical," said Indigenous ear, nose and throat surgeon Kelvin Kong. "I'm sad, as an Aboriginal man, to see our kids are enduring the health stats of a Third World nation.” Dr Kong has seen the consequences of allowing ear disease to fester for decades.  "I looked after a 40-year-old Aboriginal gentlemen who had maggots in his ears," he said. "He was dishevelled, unemployed, he had been in and out of jail and he had maggots. In an urban centre. We're not talking about out in some regional area. It's disgraceful. I wonder if we met this gentleman when he was two years old and got him educated could he have avoided the incarceration and the social injustices he endured.” The HEALS program allowed Aboriginal community controlled health organisations to accelerate children in need of care through what can be a labyrinth of health services, waiting lists and interventions. "I look after so many kids with these kinds of issue and, when you correct the learning deficit, the parents are so thankful, the kids smile and it's the most rewarding thing about my job," Dr Kong said.  

The program fully funded six months of weekly speech and language therapy for Saraya, a service Ms Terry would not have been able to afford.  "She has completely lost her lisp," Ms Terry said. "She's been able to do really well at school because we've put that work in. It's why she has improved so much.” With $805,000 in NSW Health funding for the 2016-17 financial year ($2.238 million since 2013), Ms Terry hopes Saraya will have her grommets by June. 

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