Specialised medical care such as cochlear implants shouldn't only be the reserve of the rich, says KZN Health MEC, as two patients regain their sense of hearing, thanks to the Province's new auditory implant programme

11 May 2023

KwaZulu-Natal Health MEC Ms Nomagugu Simelane says the size of a person's pocket should never prevent them from gaining access to life-changing surgery, such as a cochlear implant, which can help them regain their sense of hearing.

The MEC was speaking at Inkosi Albert Luthuli Central Hospital this morning, amid teary and emotional scenes as 43 year-old Xolani Sikhosana (from Glenwood), and two and a half year-old baby model Uminathi Mafisa (from Pinetown and Newcastle) had their cochlear implants switched on, which enabled them to hear for the first time in months.

They are among the first 10 patients to benefit from the KwaZulu-Natal Auditory Implant Programme (KZN-AIP), since its launch in March 2021.

The programme is a collaboration between the KZN Department of Health and the University of KwaZulu-Natal, and draws on the expertise of Ear, Nose and Throat surgeons and audiologists.

It also includes Deaf community advocates, and is premised on a vision to see people-centered Ear and Hearing Care become accessible to all.

Reacting to the latest cochlear implant switch-on process, MEC Simelane said: "This is something that other provinces have been doing. We're very excited about this programme because it's going to change people's lives.

"The private sector has been doing it, but we're now as Government beginning to provide the service to our own patients."

"We're very excited because it means those people who don't have money, who ordinarily wouldn't have access to this kind of procedure, are going to get it. And that's how it should be.

"The Department has not been able to budget for this service properly, although we do have medical specialists who can do it."

"We've been speaking to them for more than a year now. And you can see the difference from when we started up to now. They've been able to train other specialists, so that it doesn't just become a one man show."

Cochlear implants are electronic devices that are especially useful when a conventional hearing aid has little or no benefit or cannot be used.

Typically, these devices bypass the middle and inner-ear structures, to stimulate the auditory nerve directly.

The implants can give a deaf person a useful representation of sounds in the environment, making it possible to understand speech.

Mr Xolani Sikhosana (43), lost his sense of hearing after developing a certain ailment which may not be disclosed, more than a year ago.

Today, responding to a written message from MEC Simelane before the switch-on, Mr Sikhosana said he was "extremely excited" that this day had come.

Meanwhile, little Uminathi's father Victor Mafisa described the past 18 months as quite strenuous for his family.

But now he cannot wait to play Uminathi her favourite songs, which she's been unable to hear for the past 18 months, after losing her sense of hearing when she was just six months old.

At the time, she was modeling for catalogues of leading clothing retail stores.

"When our daughter lost her sense of hearing, it brought about a lot of distress to our lives. Even when people tried to assure us that we'd get help, we didn't believe them. But the more we did our sessions, the more we started to realise that things are getting better. Even now as we speak, I can't even talk properly, because we're so overwhelmed."

His wife Kwenzelile was full of gratitude, and had to fight back her tears. She urged parents who find themselves in a similar situation not to give up, but seek help.

"Were so grateful to the team from the Department of Health and the University of KwaZulu-Natal. They're the best. They've brought light to a very desperate situation."

UKZN-based audiologist and lecturer Dr Zandile Shezi said conducting the switch-on gave meaning to her job.

"I feel like I'm making an impact in somebody's life. We work with adults and children. When it comes to children, as a result of them having hearing loss, their speech is not developed, so if we provide them with cochlear implants, their speech and language will develop. With adults, some lose their jobs, and their quality of life basically changes for the worst. So, through this work, we are restoring their quality of life. They can get back to work, do things on their own, and be independent.

Dr Andile Sibiya, Chief Specialist and Head: Department of Otorhinolaryngology (which is the study of diseases of the ear, nose, and throat) and Head and Neck Surgery at UKZN, said she was pleased the KZN-AIP was beginning to change people's lives.

She added that its sustainability was paramount.

"When we started this programme, we said, if we're going to do anything, we had to make sure that it's sustainable for the Province, and for our patients. We're balancing two things: the fact that any intervention we give must be for a lifetime, and we have duty of care to make sure we provide that. On the other hand, we work with the public sector, where there are limited resources. So, we have to be conscious of the fact that, anything we start, has to make sense in terms of the yield and benefit to the public as a whole. So, we were conscious of making the programme sustainable in terms of staff members, procurement of the devices, and the care that patients receive afterwards."

She urged people with hearing challenges to seek help as soon as possible, by visiting their local clinic, where they'll be assessed and referred accordingly.

"The sooner we test and know, the better the outcome."

Issued by the KwaZulu-Natal Department of Health

Additional information regarding cochlear implants and how they work:

What happens during cochlear implant surgery

Cochlear implant surgery takes place in a hospital, and lasts about two hours. Patients are given medication (general anesthesia) so that they are asleep during the procedure.

• The surgeon makes a small incision behind the ear and then creates an opening in the mastoid bone to guide the electrode to the cochlea.
• The implant electrodes are placed inside the cochlea.
• The surgeon places an internal processor in a pocket between the muscle and bone behind the ear. The internal processor receives information from an external speech processor that will be worn outside the skin.
• The incisions are then closed, and the patient is moved into the recovery area and watched closely as he or she recovers from the anesthesia.

The patient is then discharged after several hours of observation and can go home to rest.

Overall hearing will be different on the side of the implant right after surgery. The device is then programmed a few weeks later, allowing time to for the incisions to heal.

During this time, the patient will not be able to use a hearing aid in the ear that had surgery.

Cochlear implant activation and programming

When the inner ear has healed enough, the patient will return to the audiologist, who will programme the cochlear implant and show the patient how to use the external processor on the ear. The goal in this regard is to get the nerves and brain used to hearing again.

A series of programming appointments paired with aural rehabilitation sessions over the next few weeks will help the patient understand the sounds coming through the implant.