Thirteen years ago, Jackie Clark, PhD, CCC-A, F-AAA, was part of an innocuous conversation at her local church. That conversation has since become the inspiration for an annual mission of healthcare, education and charity.
| Jackie Clark, PhD, CCC-A, F-AAA, (right) poses with
her PhD student, Lindsay Bondurant, MS, CCC-A,
during a trip to Mozambique.
In 1997 Dr. Clark, a clinical assistant professor at the University of Texas at Dallas, decided to join the church group on a trip to Mozambique--a southeastern African country annually rated among the poorest in the world in categories like life expectancy, infant mortality and human development.
To raise money for the trip, Dr. Clark embarked upon a letter-writing campaign that would ultimately yield donations from fellow audiologists and others. "Different groups would donate hearing aids, audiometers and other supplies," she recalls.
By July of 1998, Dr. Clark was finally ready to make the trip to Mozambique.
"And I've been back every year since."
An Annual Project
At first, the idea was simple--Dr. Clark set up a hearing clinic at a hospital in Mozambique and set about not only treating patients but training local professionals in treatment.
"There's no audiology over there," she explains, "My goal was to train the medical technicians to perform diagnostic testing to a point where they could ultimately be the ones to dispense the hearing aids."
But education for people with disabilities is severely lacking in Mozambique. It wasn't until 1999 that the country formally agreed to begin educating deaf children. Luckily, by that time Dr. Clark's program had grown to the point that she was able to involve social workers in doing hearing screenings. "The social workers were often the ones to identify the children who might have hearing difficulties," she reasoned. "So we provided them with the necessary equipment to provide screenings."
The next step was aligning with a school for deaf children, which in Mozambique consisted of children ranging from completely deaf to slighter degrees of hearing difficulties. The teacher at this particular school, however, had only 2 weeks of sign language training with which to educate the children.
"I was able to get some deaf educators to enrich their sign language abilities," Dr. Clark says, "while still keeping our other programs functioning."
The school and educational process in general hit some predictable bumps along the road, but Dr. Clark knew she was on the right track a couple of years ago when she met with one of the first students from the school.
"I had to speak to him through a translator," she recalls, "but he told me that he'd decided he wanted to be a teacher of the deaf, so he was starting to take school more seriously."
To Dr. Clark, this served as validation of the job she'd done. In Mozambique, education for people with disabilities, including the deaf, is virtually non-existent. "There are grown adults over there who are still in [the equivalent of] first grade," Dr. Clark says.
She feels that endeavoring to become an educator is a lofty and encouraging goal for a child who grew up in such an unstructured environment.
The Next Step
Around this time, Dr. Clark began to realize just how little she and other researchers knew about hearing loss in the African countries and in Mozambique in particular.
Thus, Dr. Clark and others embarked on a nearly 2-year project of screenings and data collection at the primary school, which at the time educated about 1,200 kids. They found a great deal of otitis media and other conditions that provided the beginnings for solid documentation on each case.
Over the past dozen years, Dr. Clark has done studies in the nation of South Africa, as well as in Mozambique. Outside of an audiologist's perspective, she says the most shocking thing is the overwhelmingly high rate of HIV/AIDS in those countries--Mozambique in particular.
"Seventy-five to 80 percent of babies are born with HIV/AIDS," she says. "One town we stay in has an 80 percent rate of infection. So I walk down the street thinking that four of every five people I see won't be here in 5 years."
Under such alarmingly morbid conditions, one might ask what inspires Dr. Clark to continue addressing the hearing needs of people whose predicted life spans are incredibly pessimistic. That's where her role as an educator comes into play.
As her program grew, Dr. Clark realized what an excellent learning opportunity the annual trip could be for aspiring audiologists. So in 1999, she took her first group of audiology students to Mozambique and has followed with a different group from UT-Dallas, as well as a select few from other programs, on subsequent missions.
"The learning experience is great for our students," she reasons. "Where in the United States can you see active leprosy, tuberculosis. they have the chance to work with conditions they'd otherwise never see. We go from triage to fittings of hearing aids to working with translators."
"I was really impressed with the work the South African audiologists were doing both in urban settings and in rural regions," says Lindsay Bondurant, MS, CCC-A, currently a PhD student at UT-Dallas. "We really enjoyed seeing what was different and what was similar about audiology education programs in South Africa compared to the U.S."
What's more, the students have the opportunity to do some educating of their own, both with translators and people with hearing loss, on how to properly use hearing aids and get optimal usage from the devices.
"One of the students told me, 'I never knew I could do diagnostics or counseling under a tree!'" recalls Dr. Clark.
"We truly got to know the meaning of flexibility, as some of the areas we worked in lacked running water and electricity," adds Bondurant. "We found that there is a lot that you can do with a little advanced planning and on-the-spot troubleshooting."
Due to some political complications, Dr. Clark has been unable to return to Mozambique since 2008. While she admits to missing her friends, she also can see the benefits of beginning a transition in which she and her program of peers are relied upon to a lesser degree.
As such, Dr. Clark has developed what she calls her exit strategy-identifying places where Mozambicans can further their education and gain certification to dispense hearing aids. A distance-learning program, based in South Africa, provides these educators with a means to supplement their education and prepare them for treating those with hearing loss in Mozambique.
"Then they can take on the political battles," Dr. Clark reasons, "because they know their country. They know the culture and the political landscape-I don't know the nuances."
She admits she'll miss the natives, but the past 12 years have shown Dr. Clark the vast potential of African nations in the world of audiology-with or without her.
"They are just so understaffed," she laments. "So it's important for us to develop as many audiologists as we can. There's a whole world of possibilities."
Rob Senior is managing editor at ADVANCE and can be reached at RSenior@advanceweb.com.