Untreated ear infections, exposure to loud noise, and the putting sharp objects in the ear are among the common causes of hearing problems affecting both adults and children in Rwanda.
ALSO READ: Ringing in the ears? It could be tinnitus, an often-ignored problem
According to the World Health Organization, over 430 million people worldwide live with disabling hearing loss, including millions of children. Up to 60 percent of hearing loss in children is preventable.
ALSO READ: Infections of the ear
Causes
Dr Aaron Gasore, an ear, nose and throat (ENT) specialist at Humanhood Clinics, said children are the most affected, mainly due to earwax buildup and middle ear infections, known as acute or chronic otitis media.
He explained that acute otitis media develops from untreated colds or sinus infections. If not treated, it can progress into chronic otitis media, leading to persistent ear discharge and temporary hearing loss.
Gasore added that children inserting foreign objects into their ears, such as beans or small stones, and sustaining ear injuries are also common and preventable causes of hearing problems. Teaching children not to put objects in their ears and ensuring safe removal of foreign bodies can reduce many cases.
Dr Tasinimu Agasaro, an audiologist at University Teaching Hospital of Kigali (CHUK), said many parents do not realise their child has an ear infection until it is advanced or has become chronic. When left untreated for long periods, ear infections can lead to permanent hearing loss.
She also warned against self-medication and the use of traditional remedies inside the ear, as well as exposure to loud music.
Agasaro explained that many young people use headphones and AirPods at very high volumes for long periods without understanding the long-term consequences.
"Noise exposure in workplaces such as construction sites, factories, and the transport sector, and frequent attendance at loud social events without ear protection, puts many workers at risk daily,” Dr. Agasaro said.
"Unfortunately, many are unaware that they have the right to regular hearing screening. In many workplaces, employers do not consistently provide routine hearing tests or adequate hearing protection devices, which increases the risk of permanent damage.”
She added that ototoxic medications, which are harmful to the ear, can also pose a risk if taken without proper monitoring.
The audiologist further noted that many people use sharp objects such as hairpins and matchsticks to clean their ears, which can damage the ear canal or eardrum.
She added that public awareness about safe listening practices is still limited, making education critical.
Dr. Gasore noted that natural age-related decline, referred to as senescence, is also a risk. Though age-related hearing loss cannot be prevented, he said hearing aids can help, and in severe cases, cochlear implants can restore some hearing.
"Rwanda has successfully carried out cochlear implants at King Faisal Hospital, though the procedure is expensive and not yet covered by Community-Based Health Insurance (Mutuelle de santé). Cochlear implants are small electronic devices that help people with very severe hearing loss hear sounds when regular hearing aids are not enough,” he said.
Statistics show that hearing loss is still a serious issue in the country. A 2012 Rwanda Population and Housing Census found that 0.4 percent of the population has hearing impairment, rising to 16 percent among people with disabilities.
"A 2009 study in Kigali schools reported that 1.4 percent of children aged six to 13 had hearing problems, with 18 percent affected by earwax buildup. Hospital studies also show that chronic ear infections are common.
"At Rwanda Military Referral and Teaching Hospital in 2019, 18.4 percent of patients who sought care for ear problems had hearing loss, mostly due to chronic infections and perforated eardrums (holes in the eardrum),” Gasore said.
He said that early care and proper treatment can prevent or manage most hearing problems, and that protecting the ears early helps maintain good hearing later in life.
Signs of hearing loss
Dr. Agasaro said parents should watch for early signs of hearing loss in children, including delayed speech, failure to respond to their name, frequently asking "what?”, misunderstanding instructions, and poor academic performance.
"In Rwanda, many parents only realise their child has hearing loss when they are two years old or older, usually when speech delays become noticeable. The lack of newborn hearing screening and limited awareness of early warning signs delays identification,” she said.
For adults, she noted that hearing loss may appear as difficulty following conversations in noisy environments, frequently asking people to repeat themselves, ringing in the ears, or turning up the television or radio volume excessively.
"Recognising these signs early is important because timely intervention, through hearing aids, medical care, or therapy, can help preserve hearing and improve communication,” Agasaro stated.
Challenges
Dr. Agasaro said one of the major challenges is late diagnosis, especially in rural areas where access to hearing care services is limited.
She added that Rwanda has very few audiologists and specialised hearing clinics, which affects early detection and management.
Effects of hearing loss
Agasaro said hearing loss can affect learning, communication, and mental health. Children may struggle in school, while adults can face difficulties at work or socially, sometimes leading to isolation or anxiety.
The audiologist advised the public to seek medical care for ear infections, avoid inserting objects into the ear, limit exposure to loud noise, and undergo hearing screening when warning signs appear.