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TEDGlobal 2017

Susan Emmett: This simple test can help kids hear better

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Children who live in rural areas can have a hard time getting to the doctor -- much less to an audiologist's clinic for expensive, complex tests to check their hearing. The result for too many kids is hearing loss caused by ear infections and other curable or preventable problems. That's why ear surgeon and TED Fellow Susan Emmett is working with 15 communities in rural Alaska to create a simple, low-cost test that only requires a cell phone. Learn more about her work and how it could change the lives of children who don't have access to hearing care.

- Ear surgeon
TED Fellow Susan Emmett studies global hearing health disparities in 15 countries and Indigenous groups around the world, in an effort to fight preventable hearing loss. Full bio

Listen to the sounds
of why hearing matters
00:13
to the Alaskan Native people.
00:16
Hearing loss makes it hard
to fish on the open water,
00:18
hunt caribou and harvest berries,
00:22
activities central
to Alaskan Native culture.
00:25
Hearing loss isn't unique to rural Alaska.
00:30
It's global.
00:33
The Global Burden of Disease Project
estimates there are 1.1 billion people
00:35
living with hearing loss worldwide.
00:41
That's more people than the entire
population here in sub-Saharan Africa.
00:44
Over 80 percent are in low-
and middle-income countries,
00:50
and many have no access to hearing care.
00:54
The impact on people's lives
is tremendous.
00:58
Anuk is a three-year-old boy
I treated in Alaska.
01:03
Ear infections started
when he was barely four months old.
01:07
His parents brought him into clinic,
01:11
worried he didn't say much
compared to his brothers.
01:14
Sure enough, many rounds of infections
had resulted in hearing loss.
01:17
Without treatment, Anuk's speech
will continue to lag behind.
01:23
He's more likely to do worse in school,
01:29
have worse job prospects
01:32
and experience social isolation.
01:34
But it doesn't have to be this way.
01:37
The World Health Organization estimates
that half of all global hearing loss
01:40
can be prevented.
01:45
If Anuk's hearing loss
is identified and treated promptly,
01:47
his life and the opportunities
he has as he grows up
01:52
could look vastly different.
01:57
I'm an ear surgeon working
with partners around the world
01:59
on new pathways
for hearing loss prevention.
02:03
This solution comes from my collaboration
with a tribal health organization
02:06
called the Norton Sound
Health Corporation.
02:11
Hearing loss evaluation traditionally
requires testing by an audiologist
02:14
in a soundproof room,
02:18
with a lot of permanent equipment.
02:20
An ear surgeon then examines
Anuk's ears under a microscope
02:23
and decides a treatment plan.
02:26
These resources simply aren't
available in remote settings.
02:29
In a state where 75 percent of communities
aren't connected to a hospital
02:33
by road,
02:37
an expensive flight is required.
02:38
To overcome these barriers,
Alaska has developed
02:42
a state-of-the-art telemedicine system
02:45
that connects over 250
village health clinics
02:48
with specialists who triage
all types of health concerns.
02:51
My colleagues have validated
that ear-related telemedicine consults
02:55
are equivalent to an in-person exam.
02:59
In 2016, travel was prevented
for 91 percent of patients
03:03
receiving specialty telemedicine
in the Norton Sound region.
03:08
Telemedicine has saved over 18 million
in travel costs in this single region
03:12
over the past 15 years.
03:17
Our team is taking the power
of telemedicine to a new level,
03:20
through a project
03:24
funded by the Patient-Centered
Outcomes Research Institute.
03:25
For the first time,
we are merging telemedicine
03:28
with mobile screening technology
03:31
that extends the reach of expert triage
beyond health care settings.
03:34
This cell-based screen,
developed in South Africa,
03:39
costs over 10 times less
than traditional equipment
03:42
and does not require advanced training.
03:46
If I were screening Anuk at school,
03:49
sound-attenuating headphones
and noise monitoring
03:51
would take the place of a sound booth,
03:54
and I would use a phone adapter
instead of a microscope
03:57
to examine his ears.
03:59
In a matter of minutes,
screening and images are done.
04:02
We then apply Alaska
telemedicine technology
04:06
to transmit the data to specialists,
04:08
who connect Anuk
to the treatment he needs.
04:11
Our team is launching a randomized trial
04:14
in 15 communities along the Bering Sea
04:17
to study how well this intervention works.
04:20
Our goal is to prevent childhood
hearing loss across the state of Alaska.
04:24
But the concept is bigger
than a single state.
04:29
The impact is global.
04:32
Mobile telemedicine
can revolutionize access to care.
04:35
In Malawi, for example, there are only
two ear surgeons and 11 audiologists
04:40
for a population of 17 million.
04:45
This technology could empower teachers
and community health workers
04:48
to provide access to care
to children in places like Malawi.
04:52
Scaling up globally
could change children's lives
04:57
who have never had access
to hearing care before,
05:01
using just the power of a cell phone.
05:04
It's time to change the course
of preventable hearing loss.
05:08
Anuk and countless children like him
are depending on us.
05:12
Thank you.
05:16
(Applause)
05:17

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About the speaker:

Susan Emmett - Ear surgeon
TED Fellow Susan Emmett studies global hearing health disparities in 15 countries and Indigenous groups around the world, in an effort to fight preventable hearing loss.

Why you should listen

Susan Emmett is an ear surgeon and public health expert who develops evidence-based solutions to address preventable hearing loss.  She studies novel pathways for prevention and applies digital innovations such as mobile screening and telemedicine to extend access to care to even the most remote communities. Collaboration across disciplines and countries is central to Emmett's research, fueling a global effort to address a neglected public health concern. 

Emmett serves as Assistant Professor of Surgery and Global Health at Duke University in Durham, NC, USA. She has been an invited speaker at more than 20 international and national conferences and has authored numerous articles on hearing health in leading medical journals. She consults for the World Health Organization and leads the advocacy efforts of the Coalition for Global Hearing Health. Emmett spends much of her time in remote communities in northwest Alaska, where she co-leads a randomized trial to address childhood hearing loss funded by the Patient-Centered Outcomes Research Institute. While at home in North Carolina, she provides medical and surgical care to patients with hearing loss and trains the next generation of medical students, residents, and postdoctoral fellows in global hearing health research. She was named a TED Fellow in 2017.

More profile about the speaker
Susan Emmett | Speaker | TED.com