Audiological care in tough conditions

Rwanda, the “land of a thousand hills”, is considered to be one of the poorest countries in the world. Civil war and genocide – those are the two buzzwords associated with Rwanda. 800,000 people died and two million were expelled when the conflict between Hutu and Tutsi escalated in 1994. The children particularly are still suffering to this date from the consequences of war. According to information from Unicef, approximately 600,000 children are growing up in extreme poverty. Many of them have to survive alone without parents in “children’s households”.

Place & Year

Rwanda, 2010

Project Partners

Rwandan Disabled People are Rehabilitated and Reintegrated in their Rights (HRD)


Main Focus

Children Providing audiological care for children in low-income countries is a focal area of the Hear the World Foundation’s activities.
Professional training The Hear the World Foundation supports projects that enable continuous audiological training for professionals on site.
Prevention of hearing loss The Hear the World Foundation globally promotes awareness for the topics of hearing and hearing loss and thus actively contributes toward the prevention of hearing loss.
Programs for parents & families By supporting self-help groups for parents, the Hear the World Foundation makes an important contribution, thus ensuring that affected parents receive specific help and assistance.

The ambitious project of the Rwandan Disabled People are Rehabilitated and Reintegrated in their Rights (HRD) of Australian audiologist April Lyons has set itself the goal of establishing audiological care, precisely in this difficult environment. She received the Richard Seewald Award from Hear the World for her commitment in 2010.

Early detection of hearing loss

With 85,000 inhabitants, Gitarama is the second biggest city in Rwanda. 34 year old audiologist April Lyons works here towards ensuring that reduced hearing in babies and small children is detected at an early age. Two methods of doing so are applied: The VROA (visual reinforcement orientation audiometry) behavioural test observes how the small patients turn their heads towards the loudspeaker in a soundproof cabin. The procedure is appropriate for children aged between seven months and three years. Even more effective is the BOA (behavioural observation audiometry) test that allows even new born babies of under seven months to be tested, as the younger the age in which hearing loss is detected, the better the prognoses for development, the chances for school attendance, social integration and later economic independence.

The search for many children with hearing loss

90 per cent of Rwanda’s inhabitants live in rural areas. Thus, a clinic in the city can naturally only offer limited help, as very few people find their way there or even have an inkling of its existence, which is why, in addition to the centre in Gitarama, ten more outposts – the so-called “antennas” – have been established, which help to ensure national coverage. Using the latter as their base, HRD employees visit families and speak to parents directly if it is suspected that their child has hearing loss. Simple hearing tests are immediately performed onsite. If necessary, the children are sent to Gitarama for a final diagnosis and the corresponding hearing aid fitting.

Richard Seewald Award


The Richard Seewald Award is named after Professor Richard Seewald, renowned for his decades of tireless commitment in the field of pediatric audiology. He carried out comprehensive pioneering work in the development of the internationally recognized fitting method for hearing aids for children, the Desired Sensation Level (DSL). He is also a co-founder of the National Centre for Audiology in London, Ontario, Canada, and a member of the advisory board of the Hear the World Foundation. The Richard Seewald Award carries a prize of 20,000 US dollars. The annual award is presented to an established institution, dedicated to the detection in and audiological care of hearing impaired children and babies, in order to promote measures for improvement there, for example in the areas of diagnosis and the fitting of hearing aids. The recipients of the award must fulfil the following criteria:

  • Extremely professional and committed management of the institution
  • Offering their services to all children, regardless of their economic background
  • Offering students the opportunity to acquire practical experience
This project very clearly reflects the necessity of measuring both the hearing ability and the in-situ amplification of hearing aids using modern procedures and state of the art devices. It will lay the required foundation stones to allow children with hearing loss to optimally benefit from the fitting of the amplifier.»»
Prof. Dr. Richard Seewald