Are you sometimes guilty of daydreaming at work, staring off into the distance and mindlessly clicking your pen? The Ear Team from the Cataract Foundation Philippines, Inc. (CFPI) do this a lot. They, however, do it for a good reason.

Clicking a pen at random intervals while sitting 1 metre behind someone can provide a basic test of whether or not they can hear sounds at a normal volume. Finding dry, hard walls of earwax, food, and a variety of insects in ear canals, are also part of the day's work during school and community screenings. By inspecting ear canals and performing very basic hearing tests the Team aim to  detect when a person has a hearing problem (impairment) and try to reduce or eliminate the disabling effects (disability) by providing information, medicine and referral advice.

Although CFPI's name implies only eye services it has evolved through the years, and is now providing services to address eye, ear and communication problems. The overall goals of the Foundation are to provide education, prevention, identification, and intervention for eye, ear and communication disabilities. The school and community screenings that CFPI regularly conducts provide a snapshot of how CFPI seeks to achieve these goals.

“Cotton buds are evil!”  
“Turn down the music or you will turn down your hearing!”  
“Don't ignore it!  A simple cold can become a damaging ear infection.”  
These are some of the messages that the Team repeatedly tell people at screenings. Screening is not just about detecting problems that are already happening. Equally or even more importantly, screenings are about creating awareness about how to protect your ears and your hearing so that future problems can be avoided.

CFPI is all about prevention – preventing existing problems from worsening, and preventing potential problems in the future from developing. When the Foundation was first established in 1992 it was with prevention in mind. The founding members recognised that cataracts were a common, but easily treatable cause of blindness. Someone who has cataracts may experience severe disability due to their blindness. Fortunately, however, the disability can be reversed, and vision restored through inexpensive eye surgery. Surgery recipients are identified through the process of screening, referrals from other organisations, or from previous surgery patients.

Jo administering the 'whisper test' to a patient.

Health care services in the Philippines are mostly paid for privately, which makes them difficult to afford for much of the country's population. One of the guiding principles of CFPI is to provide services that are either affordable or free to those who are marginalised. Screenings are free and no one is excluded – staff have screened day-old babies to presidents (of the local government council, that is). One CFPI staff member explained: “We reach people who would otherwise miss out, and help prevent problems from getting worse, or even happening. That's what motivates me to work.”

Screenings are not stand-alone events at CFPI. When someone is identified with a disability in seeing or hearing, there is follow-up. For the Eye Team this may mean referring the person on to one of the many doctors who have an agreement with CFPI to provide surgeries and consultations at minimal or no  cost, or providing low cost reading glasses, eye glasses for the children with errors of refraction, and education about how to manage vision problems. For the Ear Team follow-up may include recommending further hearing tests, providing free medicines for ear infections and education about caring for ears and hearing. And finally, the Ear Team may recommend referral to a Speech Pathologist.  

Most children who have hearing impairments also have difficulties with speaking and understanding. This is because it is hard to develop speech and language skills when you can't hear clearly what people are saying. In recent years CFPI has had Speech Pathologists working under the Australian Youth Ambassadors for Development (AYAD) program to help address the issue of communication disability. Joanna Leane, an Australian Speech Pathologist, was on assignment with CFPI as an AYAD and has now returned to CFPI as a VIDA. The role includes training CFPI staff to work with families of children with hearing and other communication impairments. Further afield, Joanna works with her CFPI colleagues to train families, health workers, and educators to help children develop communication skills. Through simple activities such as singing, reading books, playing with playdough and blowing bubbles almost anyone can be taught to create an environment that stimulates understanding and talking, and gradually minimises the effects of a communication disability.

Whether staff are clicking pens, checking eyes for cataracts, singing nursery rhymes, or training a hall full of volunteer health workers, there is no doubt that  the work takes patience and persistence. Working towards preventing and minimising disabilities is a long, often slow process. Although CFPI staff strongly promote the adage “prevention is better than cure”, everyone still needs to be reminded sometimes that there are no quick results – long-term commitment is essential. In a country where 10% of the population works overseas, and thousands of new workers leave everyday, it is vitally important to have organisations and people who are committed not only to reducing the effects of disabilities today, but also preventing disabilities that may occur in the future.

© VIDA Connect 2009