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A walk in the Park

This blog is dedicated to everyone who has struggled with Community Medicine. Through my posts I hope to simplify and demystify community medicine. The emphasis will be on clarifying concepts rather than providing ready-made answers to exam questions.

Feedback is crucial for the success of this endeavour, so you are encouraged to comment and criticize if you cannot understand something.

If you want a topic to be discussed sooner rather than later, please let me know via

Facebook: http://www.facebook.com/pages/Community-Medicine-for-ALL/429533760433198  

[Alternatively, you may join the group communitymedicine4ALL: 


Twitter: @DocRoopesh

A single example may not be able to explain 100% of a given topic, so multiple examples may be provided to explain different parts of a single concept.

If something doesn’t seem right:

a. Write to me about it (at commed4all@gmail.com), and

b. Cross check with another source (textbook, expert, etc.)

I hope that my exertions will make your experience with community medicine seem like a “Walk in the Park”

Note 1. Those who wish to contact me on facebook are requested to kindly send a personal message introducing themselves along with the request. This will help save time and effort of all concerned. Please do not expect me to visit your page to try and identify you/ your areas of work/ interest, etc. It is common courtesy to introduce oneself to another when interacting for the first time. I am merely requesting that the same civil courtesy be extended here, too. Henceforth, I may not accept any friend requests/ requests to join the group on facebook unless accompanied by a note of introduction (except when I already know the sender).  

Note 2. Please understand that this blog (and the corresponding facebook page/ group) is maintained in my spare time. I have a full time job, and am available to pursue these activities only after regular working hours (after 5 pm Indian Standard Time). However urgently you may wish to receive a response from me, I will be able to respond only upon returning home from work (I am offline the rest of the time).

Note 3. Please mind your language when interacting with me/ in the group linked to this blog. Rude/ offensive language will result in expulsion from both my friends list and the said group.

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World Hearing Day, 3 March 2021: Hearing For All

March 3 is celebrated as World Hearing Day. This year, the World Health Organization (WHO) will release the first World Hearing Report to coincide with the celebrations.

Background Information:

A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 20 dB or better in both ears – is said to have hearing loss. Hearing loss may be mild, moderate, severe, or profound. It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds.

‘Hard of hearing’ refers to people with hearing loss ranging from mild to severe. People who are hard of hearing usually communicate through spoken language and can benefit from hearing aids, cochlear implants, and other assistive devices as well as captioning.

‘Deaf’ people mostly have profound hearing loss, which implies very little or no hearing. They often use sign language for communication.

Key Messages:

Hearing loss may result from genetic causes, complications at birth, certain infectious diseases, chronic ear infections, exposure to loud sounds, use of ototoxic medicines, and ageing.

Globally, 1.5 billion people live with some degrees of hearing loss out of which around 430 million people require rehabilitation services for their hearing loss.

Nearly 2.5 billion people worldwide ─ or 1 in 4 people ─ will be living with some degree of hearing loss by 2050 and at least 700 million will require hearing rehabilitation

Over 1 billion young adults are at risk of permanent, avoidable hearing loss due to unsafe listening practices.

In children, almost 60% of hearing loss is due to causes such as ear infections and birth complications that can be prevented through public health measures.

Unaddressed hearing loss is expensive to communities worldwide and costs governments US$ 980 billion annually. Interventions to prevent, identify and address hearing loss are cost-effective and can bring great benefit to individuals.

Of those who could benefit with the use of a hearing aid, only 17% actually use one. The gap is consistently high in all parts of the world, ranging from 77% to 83% across WHO regions, and from 74% to 90% across income levels.

An annual additional investment of less than US$ 1.40 per person is needed to scale up ear and hearing care services globally.

Over a 10-year period, this promises a return of nearly US$ 16 for every US dollar invested.

Good hearing and communication are important at all stages of life.

Hearing loss (and related ear diseases) can be avoided through preventative actions such as:

  • protection against loud sounds
  • good ear care practices, and
  • immunization.

Hearing loss (and related ear diseases) can be addressed when it is identified in a timely manner and appropriate care sought.
People at risk of hearing loss should check their hearing regularly.
People having hearing loss (or related ear diseases) should seek care from a health care

Key Messages from the World Hearing Report:

  • The number of people living with unaddressed hearing loss and ear diseases is unacceptable. 
  • Timely action is needed to prevent and address hearing loss across the life course. 
  • Investing in cost effective interventions will benefit people with hearing loss and bring financial gains to the society. 
  • Countries must integrate people-centered ear and hearing care (IPC-EHC) within national health plans for universal health coverage

The Report calls for integration of the H.E.A.R.I.N.G. set of interventions into national health care plans
Hearing screening and early intervention programmes targeting:

  • Newborn and infant screening
  • Preschool- and school- ear and hearing checks
  • Hearing screening for older adults
  • People exposed to noise or ototoxic chemicals/medicines

Ear disease prevention and management through:

  • Good ear and hearing care practices
  • Identification at community level through trained workforce
  • Medical treatment
  • Ear surgery

Access to affordable, high-quality technologies and related services such as

  • Hearing aids
  • Cochlear implants
  • Assistive technologies e.g. loop systems

Rehabilitation services that are:

  • Age-appropriate
  • Multi-disciplinary
  • Family-centered

Improved communication through:

  • Sign language learning
  • Sign language interpretation
  • Captioning services

Noise reduction through regulations for:

  • Occupational hearing conservation
  • Safe listening entertainment venues
  • Safe listening smartphones and audio players

Greater community engagement through:

  • Communication campaigns
  • Strengthening associations of hard of hearing and Deaf
  • Multi-sectoral collaboration to address stigma

Useful Links:

Link to the World Hearing Day WHO site:


Link to the WHO fact sheet on Deafness and Hearing Loss:


Link to the World Hearing Report WHO site: