“They took out the cochlear device from my child’s head and let him enjoy his childhood, playing, running and swimming like the rest of the children, as long as he did not benefit from the device implanted in his head in order to hear. With a promise next time, and with many promises, I raised more than one letter to Jeddah's health and even to the ministry, and I'm still waiting.
The father of the child, Maha, a cochlear implant, wonders, when will these promises end? No, the hospital told us that you do not have the right to obtain the implantation supplies, nor to furnish them, and my financial conditions do not help me every time to buy these supplies in light of their high prices, and I cannot enroll them in the specialized centers for rehabilitation because of their exaggerated prices.
Sadly, the child's father, Saad, said, "I did not expect the situation to reach this extent, and I became frequent at the hospital, but rather begged them to provide me with the needs of my child. Three years have passed since I went from one appointment to another, and from one trip to another, hoping that I would go out once for the three years." Those past are cartons of batteries, but there is no life for those who call, as if they are applying the proverb that says “an ear of clay and another of dough.” I hope that those in charge of the hospital feel our suffering.
This made Ibrahim's father ask another question, which is the length of the number of cochlear implants. Do the hospital administrators have children with cochlear implants?
Umm Fatima picks up the conversation, and says our conditions are difficult, and in order to provide our daughter with the needs of the implant, we start saving on food and drink, because every piece of the implant is expensive, and our conditions are difficult, and we cannot provide it, and we cannot keep up with the prices of rehabilitation. before implanting the implant in her head.
While Father Muhammad described the suffering of his child in one word, which is that his child implanted the cochlea in his head, but he did not benefit from it because he was unable to provide a replacement hearing aid for the disabled, so that his child, who is studying in the second grade of primary school, now goes to school one or two days a week, and misses it. a week or two.
He said, “I thought my child’s life would change and he would enjoy many benefits. The most important of which is his ability to hear better, but all of that went with the promises.”
Sad stories and lost hopes
Touching words, sad stories, borne and painful pains, lost hopes, flying dreams, lost goals, teary eyes and broken hearts, all because of the high prices of cochlear devices supplies and their unavailability from hospitals and the farmers’ lack of continuous rehabilitation that enables them to benefit from the implant with hearing and speech. .
This suffering is a little bit of a lot. We listened to it and hoped not to listen to it in light of our wise government’s keenness to take care of the citizen and provide for his needs, whatever they may be, and because we know with certainty that those in charge of the Ministry of Health are keen to implement the instructions of the rulers to provide all the needs of its children, especially those with special needs. This makes us wonder why all this silence?!
We carried these pains to the Ministry of Health, medical institutions, specialized centers, the Asmaak Association, and specialists in rehabilitating cochlear implants in search of solutions that would restore the hope of benefiting from the implant to farmers and their parents, and return to them the hopes and dreams they drew when they entered the operating room.
Short and long term plans
The beginning of this suffering was lit by the Director of the Master of Science Program in Speech, Language and Hearing Disorders and the Bachelor’s Program in Speech, Hearing and Language Sciences at Dar Al-Hekma National University, Dr. Yasser Noman Al-Saabi, who explained that the role of the speech-language pathologist is one of the most important members of the cochlear implant team and the audio-linguistic rehabilitation process. Whether before or after the cochlear implantation, inform the cochlear implantation team of the child’s progress in the auditory rehabilitation program, develop a short-term plan and a long-term plan to enhance communication skills, provide continuous assessment, assess the child’s speech, language and hearing skills, and train him between the four and six months before The implantation process, by using hearing aids continuously, and this would prepare and prepare the child and the parents after the cochlear implant, followed by introducing the components of the cochlear implant and methods of dealing with the device, including installation, operation and cleaning.
Al-Saabi explained that the maximum benefit from cochlear implantation depends on the age of the child when it is implanted. The ideal age is the first year, and after the third or fourth year, the results are weak, indicating that not using the hearing device (implant) for one day negatively affects his rehabilitation and benefit, stressing However, the role of the family in rehabilitating their children by constantly talking to them and correcting them is necessary and important, along with consulting the coach to develop communication skills.
The implant needs a lot of support
After those warnings, we went to the President of the Saudi Society of Ear, Nose and Throat, President of the Arab Academy of Ears, Director of the King Abdullah Center, Dr. Abdullah Hajar, to find out about the cases of cochlear implants, who began by saying: The decision to compulsory early hearing examination for newborns and linking the cochlear implant program in the Ministry of Health with The National Program for Examination of Hearing Impairment for Newborns, was sufficient to discover cases of early hearing impairment, which in turn helped in solving many cases and finding the best ways to treat them, explaining that sensorineural hearing impairment is one of the most common types of hearing impairment, due to consanguineous marriage, indicating that International statistics estimate that two out of a thousand newborns suffer from severe hearing impairment, either due to hereditary or acquired causes, and that the percentage of infection in the Kingdom reaches approximately 4 per 1000 births out of the total number of births in the Kingdom, which amounts to approximately 600 thousand births per year. About 25% of them need cochlear implants.
And he indicated that the cochlear implantation program should be an integrated program that includes all services for farmers in terms of rehabilitation before and after surgery, while providing all the necessary requirements for the success of the implantation, and this is located in the King Abdullah Ear Specialist Center; Which provides integrated services in cochlear implantation and rehabilitation of cochlear implants, as the center is equipped with auditory and linguistic rehabilitation specialists and clinics equipped for the rehabilitation and programming process. It is an implant that needs a lot of rehabilitation support in order to bear fruit and show the desired results, through educational lectures and rehabilitation consultations that are mandatory before implantation. For this reason, the King Abdullah Ear Specialist Center is distinguished in the field of hearing disability, implantation of hearing devices, and a unique medical reference in the provision of services and an edifice For scientific research and court studies, and a pioneer for international forums in this field.
Regarding the complaint of some parents about their inability to rehabilitate their farming children due to the high cost of training in private centers and the lack of training centers in the health sector as required, Dr. Highlighting the importance of linguistic rehabilitation after transplantation, as it is considered the first building block in the success of transplantation, and enhances the pivotal role of the family in the success of rehabilitation through cooperation with rehabilitation specialists to implement the desired goals and results.
Overpriced rehabilitation sessions
To find out what the specialized centers for rehabilitation think about what is reported about their exaggerations in the prices of rehabilitation sessions, we knocked on the door of the person in charge of one of the specialized centers, Rana Mirza, who vehemently denied this, stressing that their prices are not high. And she said: «On the contrary, the hour does not exceed 190 riyals, as the centers have many obligations until they reach the goal of rehabilitating the cochlear implant by providing specialized cadres in the various fields required for rehabilitation, explaining that she sensed through the cases that were recorded in the center that she did not benefit from cochlear implantation due to the lack of obtaining the required qualification.
She attributed this to the length of the time periods for the review and to another factor that is more important because the existing ones are not specialized as a result of the fact that their studies are general and not specialized. And because medical institutions are also referred to as exaggerating their prices, the sales official in a medical company specialized in securing cochlear implants and providing spare parts for them, Sameh Abdullah, said: Our prices are according to the legal pricing, although they are not cheap when imported, and we as a national company cannot go beyond the instructions In this regard, we lose 30 years of our presence in the market, and our role as suppliers is to fully coordinate with the medical authority to which the parts for implants are supplied based on the conditions of government competitions, and the guarantees that the company provides to the beneficiaries of the implants are known guarantees and are in accordance with the conditions of government competitions. Regarding the fact that the specialized medical institutions are obligated and responsible for providing the implantation requirements for free in its first year, he said: The required parts are supplied based on the terms of government tenders. Regarding the cessation of their previous attempts with some hospitals to provide cadres to qualify farmers, he stated: “The company always seeks to provide specialized training to government medical agencies to provide the best service, and this is done on a regular basis.”
Prices are not high
A sales official in a company specialized in providing cochlear supplies sounded the alarm about the price increase, saying: “The cost has increased and prices will rise at the beginning of next year. The current prices are not high, and they are reasonable, but we bear parts of their basic value.” He denied rumors that they were obligated to provide spare parts for implantation supplies in the first year free of charge, explaining that it is the planting hospital that is obligated to provide them, and not the companies that sell implants.
Pass the qualification for farmers
Because the Cochlear Implants Association (I hear you) has become a haven for some to resort to to provide cochlear supplies, especially for cases that are unable. The executive director of the association, Fahd Al-Subaie, said: “The main goal of the association is to pass qualification for implants before they reach the age of six and enroll them in public education, and from this standpoint the association It is keen to follow up on every sower registered with it, and the beginning was in the Riyadh region, and currently we have expanded and the number of registered in Gharbia has reached nearly 200 cochlear implants.
Al-Subaie revealed that, by following up on some cases, they noticed a weakness in rehabilitation, which he attributed to the lack of cadres and after the times of the reviews, and from here the association provided special clinics for rehabilitation in the locations in which it is located, including Makkah Al-Mukarramah by providing four clinics for rehabilitating behavior, speech, pronunciation and communication, which will start Soon, with the aim of the farmer obtaining a linguistic outcome and improving his behavior, hoping that the association will continue to be supported until it implements its goals.
He explained that the reasons for their focus on a specific area in providing the needs of farmers, is due to the fact that the donor stipulates that in granting him that, indicating that the prices of spare parts are exaggerated, and yet they entered into partnerships with each other to reduce the prices of some parts, concluding that the association planted 8 cases in the last period for non-Saudis.
Shortage of qualified personnel and specialists
And after all the monitoring, it was necessary to know the opinion of the first person in charge of the cochlear implantation program at the Ministry of Health, an otolaryngology consultant, an auditory nerves consultant, and the leader of the cochlear implantation path in specialized centers, Dr. Ahmed Al-Dhafiri, who revealed a shortage in the number of qualified cadres and specialists in some centers. Cochlear implant.
He attributed the reason to the difficulty of obtaining them, pointing out that this shortage exists in many countries, and that the Ministry of Health is currently working to cover the need in various cochlear implant centers in the Kingdom. Dr. Al-Dhafiri explained that the number of centers is 13, and the number of cases that were transplanted in 2021 is more than 400 cases, and on consumables and maintenance, he said: “It depends on the warranty period of the device,” indicating that the planting hospital and the company are responsible for the device, and for the transplanted patients during the warranty periods. The Ministry has sought to raise the warranty years for new devices from one year and three years to five years in the upcoming devices. As for those that are out of warranty, the hospital is responsible for transplant patients with the capabilities available to it, and we are currently working with cochlear implant centers on an initiative to organize procedures regarding the exchange of consumables. related to post-warranty implants and facilitating patients’ access to them. He added: “With regard to damage to the external cochlear implant processor, the patient must visit the hospital to examine the device in cooperation with the selling company for treatment. with the capabilities available to them.
Finally, we wished to close the file on the suffering of cochlear implants by sharing the opinion of the Health Affairs in Jeddah, which received our inquiries in this regard 20 days ago, but hinted to us that these inquiries were sent to the Ministry and did not receive answers from them.
Mohammed Al-Hattar (Jeddah) @alhattar