By UNICEF Rwanda.
Hearing is one of our bridges to the world, connecting us to voices, music, laughter to enjoy life, and the education we need to access opportunities. However, hearing impairment so easily disrupts that connection, delaying development and/or dampening many children’s dreams and aspirations. In Rwanda, a UNICEF-supported programme is changing lives and giving hope to children with hearing impairments and their families.
Meet Murava, a 19-year old young man who has had a severe hearing disability from early childhood and, as a result, was unable to speak. On a sunny afternoon, he joins some schoolmates to attend a programmatic visit with UNICEF staff at Nyabihu School for Deaf Children, a specialized school nestled in the highlands of the Northern Province. As the visit progresses, he narrates a sad story with a bright smile on his face — a stark contrast between the story and the storyteller.
Derided and often bullied, Murava had found it hard to enjoy the simple pleasures of childhood that his peers with no hearing disability easily could.
“I could not hear anything in class,” he says, his words backed up by sign language. “And when I would walk around the neighborhood, people would throw stones at me as if I was crazy, shouting at me, but I couldn’t what they were saying,” he adds.
Murava, 19, was born with a hearing impairment. He was among the first children to receive digital hearing aids procured by UNICEF as part of the Ear and Hearing Care programme aiming to improve ear and hearing care for children and adolescents in eight districts in Rwanda.
Photo: UNICEF/Rwanda/2023/Angelo
With his peers advancing from one grade to another, Murava was left behind, year after year. Eventually, he would be promoted simply because he could not stay in the same class forever.
“I tried enrolling him in a school where staff would speak louder for children who are hard of hearing, but even that did not help,” says Martine, his mother, who accompanied him and is standing next to him. “I would strain and lean in closer to listen, but that changed nothing,” he adds.
A medical check-up by an Ear, Nose, and Throat (ENT) expert revealed that his condition was congenital. His hearing was impaired, but not completely absent. His mother finally enrolled him in the Nyabihu School for Deaf Children, a special school for children with hearing impairment, where his education journey took a turn for the better as he learned sign language and met more children facing challenges like him.
The UNICEF-supported Ear and Hearing Care (EHC) programme, also known as “Winsiga Ndumva” (translation: “Don’t leave me behind, I can hear”) was introduced in 2023 to provide comprehensive ear and hearing care services to children with hearing impairement, including access to digital hearing aids. In the previous pilot phase which ran from 2022 and covered four districts , Murava was identified through his school and went through the testing and screening process. The audiologists determined the level of his hearing loss, and he received digital hearing aids programmed to suit his hearing level, free of charge.
Belyse, 12, from Huye District in Southern Rwanda, is another child who faced a hard time because of her hearing impairment, not just at school and with neighborhood friends, but with her own family too.
“I assumed she was being disobedient or negligent when she didn’t follow my instructions or didn’t answer when I called,” says her mother, painting a picture of how often she would punish Belyse.
“My teacher thought the same,” says Belyse, with tears in her eyes, “I was always getting punished for not doing what I did not know I was expected to do.”
Fortunately, the problem was identified, and she enrolled in a school that catered to her needs. The programme eventually reached her through the school administration. Tested, screened, and fitted, she, like Murava, was ready to embark on a new journey made possible by improved hearing.
There are approximately 54,417 people, five years and above, with hearing impairment in Rwanda and different studies conducted in the city of Kigali showed a 13 per cent prevalence of hearing disability among school-aged children, with the expectation of an increase if no interventions are made. In the previous pilot, 495 children in four select districts received digital hearing aids through the programme.
Belyse, 12, carries her younger sister at Butare Center for the Deaf. With digital hearing aids programmed to suit her level of hearing loss, she can now communicate better with her family members and play with her friends in the community and at school.
Photo: UNICEF/Rwanda/2023/Angelo
When detection and treatment of hearing disability in an infant or young child gets delayed, the child stands a risk of permanently losing their hearing, yet research has shown that more than half of all hearing loss cases are avoidable. Skilled primary healthcare workers including community health workers, nurses, general physicians, emergency and ENT professionals are key to timely prevention, early identification, and management of hearing loss.
After almost two years with hearing aids, Murava can now recognize and identify some sounds, which has enabled him to learn how to speak.
“He listens and imitates,” says his mother, with a proud smile on her face. “His friends at school and his teachers have been instrumental in this journey. Being in an environment that links the sounds he hears to the sign language he understands speeds up his learning. I hope to also learn sign language so that he can continue to improve even when he comes home from school,” she acknowledges.
Unfortunately, not all children with a hearing disability like Murava get the chance to learn basic sign language and receive the support they need to thrive. Some live in profound silence. And among those who receive hearing aids, not all can learn to speak thereafter. Learning how to speak when older typically requires intensive, specialised attention, and, so far, there is only one specialised speech therapist in Rwanda.
But there is hope. With support from ATscale, The Global Partnership for Assistive Technology, UNICEF is working with the Government of Rwanda through the Rwanda Biomedical Center (RBC), and partners like The Umbrella of Organizations of Persons with Disabilities in the fight against HIV&AIDS and for Health Promotion (UPHLS) to reach more children with hearing impairment. The newly launched three-year Winsiga Ndumva programme will identify, test, and screen around 9,000 children from 0-18 years old, intervening to prevent severe, preventable hearing loss. Of those, approximately 1,200 or more will receive hearing aids. A full integration of the program into the national healthcare system will equip primary healthcare workers with the skills and equipment necessary to identify ear and hearing conditions and offer appropriate and timely care.
Children like Murava will receive hearing aids and learn to speak at a younger age; Murava is now in secondary school and can keep up with his classmates and learning. Children like Belyse will be able to communicate with their family and friends, participating fully at school and on the playground.
However, our mission is far from over.
We invite partners from the public sector, private sector, and development organizations to invest in disability-inclusive health services and assistive devices. We can bridge the financing and capacity gap to:
Ensure every child accesses the world around them.
Unlock the potential of children with disabilities.
Enable children to study in inclusive mainstream schools.
Create a future of inclusivity and equal opportunities.
Together, we can make the world better for every child.