Breaking the Silence: Three Doctors Addressing Hearing Aid Stigmas in Barak Valley

Hearing issues are a significant but often overlooked health concern affecting many people. These issues vary from mild hearing loss to complete deafness and can result from multiple factors such as ageing, noise exposure, infections, and genetics. In India, a considerable portion of the population relies on hearing aids to manage their hearing loss. The World Health Organization estimates that around 6.3% of the Indian population suffers from significant hearing loss, with about 30% of individuals aged 60 and above requiring hearing aids.

In rural areas like the part where I live, many people have traditionally been reluctant to use assistive devices such as eyeglasses or hearing aids, often due to the fear of being judged or looking old. However, there has been a noticeable shift recently, especially regarding eyeglasses. More people in my village are now wearing them without hesitation, which has helped improve their daily lives. Unfortunately, the stigma around hearing aids remains strong. It’s still rare to see anyone using one, even when they clearly struggle to hear.

In remote parts of our valley, our grandmothers would still prefer using hacks and gharelu nuskhe (home remedies) like herbal oil over seeing a doctor who studied a significant part of their academic life and holds expertise in making their lives better. Despite the availability and effectiveness of hearing aids, many people are reluctant to use them due to misconceptions and societal stigmas. ENT specialists point to two main reasons for this: the fear that hearing aids will make them appear old and the belief that they are unattractive or unfashionable. These stigmas prevent many from seeking the help they need, leading them to endure hearing loss rather than face potential social judgment.

Hearing issues are not limited to the elderly; a significant number of young adults aged 18-25 in India also experience hearing impairment. However, hearing aid adoption among this group remains low due to associated stigmas and a lack of awareness about the benefits of early intervention. And the scenario in Barak Valley is no different.

To explore this issue further and underscore the importance of hearing aids, Barak Bulletin spoke with three ENT specialists from Barak Valley: Dr Kripamoy Nath, Dr Nandita Nath, and Dr Biswa Pratim Dey. They provided insights into the challenges of addressing these stigmas, shared strategies for encouraging patients to use hearing aids, and discussed the positive outcomes their patients experience once they begin using these devices. These expert doctors addressed the stigma, emphasised the importance of early intervention and highlighted how advancements in hearing aid technology have addressed both functionality and aesthetics.

“Wear hearing aids and improve your social life, take part in conversations, and get your life back. Don’t compromise with it.” Dr Bishwa Pratim Dey

Dr Kripamoy Nath shared his experiences with patients facing hearing loss, noting that most of them are elderly, suffering from age-related senile degeneration often accompanied by nerve damage. “Among my patients, mostly we see the elderly who face hearing loss because of senile degeneration, which is caused due to age and accompanied by nerve damage issues,” he explained. However, he also encounters younger patients with conditions like chronic otitis media or otosclerosis, as well as those who have been unable to hear since birth. “Sometimes we find young patients as well suffering from chronic otitis media and sometimes otosclerosis. Occasionally, we find patients who are unable to hear since birth. These are some of the different types of patients whom we evaluate and proceed with treatment,” he added.

Dr Nath highlighted a pervasive stigma in society, comparing it to the way some patients with tuberculosis (TB) are reluctant to disclose their condition. “The stigma is prevalent in our society. Many patients with TB tend not to disclose the fact that they have it. Similarly, they hide the facts regarding their hearing issues as well. Young patients definitely try to hide it and avoid wearing hearing aids,” he said. While some adults come to terms with their condition, others struggle with the social implications of wearing a hearing aid.

To address this, Dr Nath often uses the analogy of eyeglasses to help patients understand that using a hearing aid is just as normal as wearing glasses to correct vision. “I explain to them by contrasting between eyes and ears. If they have issues with their eyesight, they do use eyeglasses to fix it, and the case of hearing loss is similar,” he noted. He explains that there are now many sophisticated hearing aids available, some of which are barely visible, though they can be costly. “Now we have so many different kinds of sophisticated hearing aids which are barely visible, although they are costly. If they can afford the cost, then people have many options,” he said. For those on a budget, behind-the-ear hearing aids are a more affordable option, though they may not be as effective in noisy environments.

A common concern among patients is that wearing a hearing aid will make them appear odd or lead others to treat them differently. “People find wearing hearing aids odd; according to them, it doesn’t look good on them. That is the primary stigma. In public places, they don’t wish to be seen wearing hearing aids as they believe people will not treat anyone with hearing aids normally,” Dr Nath observed. He reassures them that this is not the case and that hearing aids do not need to be worn all the time—only when actively engaged in work or social situations. “Apart from this, they also think that if they use hearing aids, they will be totally dependent on them, which is not really the case. You don’t have to wear it most of the time,” he emphasized.

Dr Nath’s patients who have taken his advice and started using hearing aids often express gratitude, recognizing it as one of the best decisions they’ve made. “My patients, after listening to my professional opinion and finally taking a hearing aid, have thanked me and regarded it as one of their best decisions,” he shared. Those who invest in high-end devices tend to be particularly satisfied with the quality of sound they experience, though even the more affordable options can significantly improve the quality of life for those with hearing impairments. “Some of those who had used the lower-priced ones had issues with noise in certain environments. But overall, these are still very helpful and good for those who are having hearing issues and can’t afford to buy those sophisticated hearing aids,” he noted.

Dr. Nath strongly believes that anyone experiencing hearing loss should consider using hearing aids as early as possible to prevent further deterioration of their hearing. “In my opinion, if someone is having hearing loss and is not able to conduct their day-to-day activities indoors and outdoors, it’s better for them to take hearing aids as early as possible. If they delay it, it may create further problems for them,” he concluded.

Dr Nandita Nath, another ENT specialist, echoes these sentiments, particularly regarding the younger population. “Hearing loss is a common presentation in the geriatric age group,” she notes, but adds that sensorineural hearing loss also affects younger individuals, especially those with diabetes or a family history of hearing loss. Dr Nandita frequently encounters hesitation among younger patients, who are often reluctant to accept hearing aids due to social stigma. “In those cases, we have to do elaborate counselling to make them understand the effectiveness of the hearing aids, break their fear, and help them grow self-confidence,” she explains. She takes pride in seeing patients regain their hearing and confidence, especially young children who begin to speak and learn after using hearing aids. “For many years, there have been many success stories, not just one or two,” she says, emphasizing that hearing aids are not a stigma but a powerful tool for improving quality of life.

Dr Biswa Pratim Dey highlights that hearing loss is a widespread issue today, with two primary types: conductive and sensorineural. “Conductive hearing loss occurs when something blocks the ear, hindering the ability to hear clearly,” he explains. “Sensorineural hearing loss, the more common type, especially affects the elderly. As people age, just as they may struggle with their vision, they also face difficulties with hearing. This is largely due to the auditory nerve, which carries hearing signals to the brain, gradually slowing down with age.”

Dr Dey observes a curious contrast between how people treat vision and hearing problems. “We see many people easily wearing eyeglasses, but when it comes to hearing aids, they tend to back away,” he notes. Some individuals, even without significant vision problems, will wear eyeglasses, yet when faced with hearing loss, they often seek alternatives to hearing aids, asking if they can be treated with medicine. Dr. Dey stresses the importance of recognizing that “the ability to hear is as important as the ability to see,” urging those struggling with hearing loss to use prescribed hearing aids, which can also help prevent further deterioration.

One of the primary stigmas associated with hearing aids is the fear of being perceived as old. “That is a taboo which keeps them away from it,” he acknowledges. Additionally, hearing aids are often dismissed as unfashionable. “Cosmetically, hearing aids aren’t considered fashionable,” he says, but he also points out that modern hearing aids have evolved. “Nowadays, we have many good hearing aids which are almost invisible and can help with both the stigmas.”

Dr Dey also addresses common misconceptions about hearing aids, particularly the belief that they are noisy or disruptive. “Although it was the case once upon a time, now this aspect of hearing aids has been totally discarded as many good hearing aids do not have this issue,” he clarifies, noting that some even offer Bluetooth connectivity. Many of his patients, initially reluctant to use hearing aids, have found them life-changing. “Earlier, they could not hear a simple conversation, and now they can be a part of a conversation easily,” he shares. Others have successfully managed professional responsibilities, like one patient working in an NGO who has been able to perform his duties well after using a hearing aid.

In his medical practice, Dr Dey emphasizes the importance of early intervention. “Using hearing aids will prevent the progression of the issue. Otherwise, in about ten years, their ability to hear may go extremely down,” he warns. He advises his patients to focus on the benefits of hearing aids, helping them adopt a positive outlook. His message is clear: “Just like you take care of your sight and to improve it, you wear eyeglasses, do the same for your ears. Wear hearing aids and improve your social life, take part in conversations, and get your life back. Don’t compromise with it.”

In conclusion, hearing issues are prevalent across all age groups, and despite the effectiveness of hearing aids, societal stigmas continue to hinder their adoption. As emphasized by Dr Kripamoy Nath, Dr Nandita Nath, and Dr Biswa Pratim Dey, these misconceptions must be challenged. The specialists stress the importance of early intervention and the advancements in hearing aid technology that address both functionality and aesthetics. By dispelling these myths and embracing hearing aids as a normal part of healthcare, individuals can significantly improve their quality of life. The collective message is clear: adopting hearing aids not only enhances hearing but also prevents further auditory deterioration, allowing people to fully engage in and enjoy their lives.

One of my neighbours had struggled with hearing loss for a long time but had resisted using a hearing aid. Recently, however, he decided to try one, which has greatly improved his quality of life. Although the device isn’t always flawless, it has allowed him to participate in conversations and connect more with others. This shift suggests that the stigma around hearing aids is gradually diminishing, though it persists.