Pediatric ear and hearing care disparities in global health USUALLY don’t get the attention they deserve, especially in low and middle-income countries. But did you know that the World Health Organization (WHO) states that 60% of pediatric hearing loss is preventable?
To us, that signals a clear opportunity to make a measurable, lasting impact on the lives of countless underserved communities worldwide.
And we’re proud to say that we’re taking action. In collaboration with ADA, Medtronic LABS, The United Nations Technology Bank (UNTB), and MED-EL have joined forces to revolutionize pediatric ear and hearing care in Bhutan through our Hear, Listen, and Speak program.
Arun Khanal, our Country Operations Manager in Bhutan, has spearheaded Hear, Listen, and Speak to expand hearing care access nationwide. Since the start of 2022, his team has helped 40,000 children and youth get screened for hearing loss across nine districts. And the numbers indicate that we’re on track to reach roughly 74,000+ children and youth in nine districts in the near future.
In this blog post, we sit down with Arun for an exclusive 1-on-1 conversation about Hear, Listen, and Speak, how the program got started, and where it’s heading.
Let’s dive in!
Arun, thank you for speaking with us today. Can you tell us about your role at Medtronic LABS and your work in Bhutan?
Thank you for having me! As the Country Operations Manager in Bhutan, I represent the Hear, Listen, and Speak program consortium, which is a collaborative effort between LABS, UNTB, and MED-EL under PPP with the ADA.
I was born in Bhutan and have spent a significant part of my life in India. Before joining Medtronic LABS, I worked in hospitality, which I enjoyed immensely. But there came a point when I wanted something that would take me beyond the confines of an office – something that could make a profound impact. That’s when I found Medtronic LABS.
It was certainly a risk transitioning from a comfortable job in a familiar industry to an entirely new field and role. Yet, I felt a powerful urge to do something for my community. So, I took the plunge, and despite the steep learning curve, I’ve never looked back.
My role at LABS involves managing stakeholders, liaising with government agencies, partners, and funders, and assisting with resource mobilization activities, and capacity-building initiatives. It’s a comprehensive and rewarding role, and I’m thrilled to be able to make a difference in community healthcare in Bhutan.
Hear, Listen, and Speak has made significant strides since its launch. Can you take us through the program’s evolution and key milestones?
Absolutely. Hear, Listen, and Speak was proposed and then launched with the blessings of the Bhutan government, and since then, we’ve accomplished quite a bit.
We’ve divided the program’s initial launch into three phases:
Phase 1
Between January to June 2022, we primarily focused on establishing stakeholder relationships and procuring devices and technologies to fill the gaps in care we identified.
Phase 2
Phase two, July to December 2022, saw a continuation of the procurement process and emphasized strengthening our operations on the ground. In partnership with in-country stakeholders, we instituted and analyzed field operations, standard operating procedures, and treatment protocols. T
his phase also witnessed the launch of the first in-country ear mold lab by the Health Minister in August 2022 and the initiation of school screenings. We trained our clinical team on the donated screening technologies, which was a significant milestone.
Phase 3
Phase three, which we’re currently in, aims to address the remaining technological gaps and strengthen the capabilities of surgeons in Bhutan. This has involved conducting the first in-country cochlear implant surgery, which was supported by MED-EL in collaboration with Charité Berlin.
Impact-Drive Since the Start
Since the start of 2022, we’ve also trained 248 school health coordinators across nine districts on screening technologies from Medtronic LABS. These teachers, now equipped to screen students for otology disorders, have already begun screening in schools in nine districts.
Cases identified or deferred are referred to the point of care, thus kicking off the care continuum activities supported by our in-country field operations team. This period also had a significant moment when the leadership from Medtronic LABS met with the Health Minister, garnering momentum and visibility for the program.
How did the program come to be? What’s the story there?
The genesis of Hear, Listen, and Speak lies in its comprehensive mission to fortify the entire care continuum for pediatric ear health. We’re diligently working towards enhancing audiology capabilities in Bhutan’s regional hospitals in order to equip them to manage cases, and fit hearing aids more efficiently. Considering the limited number of clinicians and the enormous task of screening students, we have trained school health coordinators and built community-based resources to help screen and identify students with ear disorders.
A pertinent study was the 2017 Population and Housing Census of Bhutan, which found that 2.2% of the surveyed population experienced hearing difficulties. Although this figure might seem small on a global scale, with Bhutan’s population of about 700,000, it’s actually quite significant. The need for the program is palpable, and our initiatives are aimed at addressing technology gaps, building screening capabilities, and, above all, catering to the urgent needs on the ground.
What distinguishes Hear, Listen, and Speak from similar programs?
What makes me immensely proud about Hear, Listen, and Speak is its comprehensive approach that delivers improved patient outcomes at all levels of the care continuum. The program is holistic, enabling a child’s journey from being screened, diagnosed, referred to treatment, and provided with a personalized ongoing care plan. We provide the necessary technology to address major gaps, including hearing aid fittings, surgical capabilities, and aftercare rehabilitation.
Furthermore, Hear, Listen, and Speak’s scalability sets it apart. We’re progressively expanding, starting from three districts and extending to nine, with the eventual goal of covering all 20 districts in Bhutan and screening over 110,000 students. Hear, Listen, Speak ensures that no child is left behind. In addition, the program also assures measurable, tangible outcomes—we’re not just identifying problems but also providing solutions, whether through hearing aids, advanced technology, or groundbreaking facilities like the first-ever EMR lab.
What is the most rewarding aspect of your involvement in this program?
The most rewarding aspect of this program is undoubtedly the fieldwork, where I get to implement our strategies on the ground. It’s an absolute joy to interact with teachers, students, and community members. These encounters are far more than just conversations; they’re opportunities for me to spur meaningful changes in their lives. For instance, by conducting screenings in schools, even those in remote regions, we save children and their families from having to undertake long journeys to hospitals. Every time we can help a child in such a way, it feels like a major victory.
I also love working with children. Observing their curious eyes light up as they get the chance to see images of their own eardrums—a feature made possible by our technology—brings me immense joy. There’s also a great deal of fulfillment in witnessing students receive the crucial hearing aids they need, thanks to our partners like Resound and the Hear the World Foundation. Being part of a process that significantly enhances a child’s hearing experience is incredibly rewarding.
However, perhaps the most rewarding aspect is seeing the transformation these interventions make in the lives of these children. When we upgrade a child’s analog hearing aid to a digital one, we aren’t just changing their device; we’re changing their life. The joy of being in the community, interacting with children and their families, and seeing the tangible impact of our work—that’s the best part.
Hear, Listen, Speak: Transforming Hearing Care in Bhutan
We hope you enjoyed this conversation with Arun Khanal, our Country Operations Manager in Bhutan, and an overview of the Hear, Listen, and Speak program he’s spearheading on the ground.
Medtronic LABS’ holistic approach to healthcare, with its emphasis on sustainability and scalable solutions, serves as an inspirational blueprint for other organizations aiming to make a lasting difference.
If this conversation resonates with you, please share it within your network. You can peruse our previous team member Q&As on our blog, along with other compelling insights and stories.
To engage with us, please visit our contact page. Together, we can revolutionize global healthcare systems and deliver critical care to those who need it the most.
