June 2023

Last week, four audiology students from the University of Melbourne, along with lecturer Chris Waterworth, travelled to Cambodia to undertake a week-long placement at the Children’s Surgical Centre (CSC) in Phnom Penh, a tertiary teaching hospital that specialises in low-cost surgery for economically disadvantaged Cambodians. Patients at CSC often travel from regional areas and in many cases rely on donations to cover the cost of surgery and treatment.  

We worked with the Ear Nose and Throat team at CSC, led by Dr Davy Touch, which provides audiological services alongside ENT services. We were able to observe consultations and tympanoplasty surgeries, which as audiology students was a valuable insight into the day-to-day demands of ENT work. We also provided training to the ENT team to advance their skills in areas such as pure tone audiometry, visual reinforcement audiometry, and hearing aid fitting.  

From an Australian audiology perspective, it was interesting to see the differences in patients’ audiology results at CSC compared to what we generally expect to see in clinic in Melbourne. The patients that we tested often had severe-profound hearing loss in at least one ear, and the hearing loss was often mixed and/or conductive as a result of middle ear disease. Often patients were seeking ear care for the first time, despite experiencing symptoms for several years or more. In Australia, especially in metropolitan areas, presentations such as these are rare. 

These differences in patient results can be explained in part by barriers faced by Cambodian patients, including public awareness of ear and hearing problems and available treatment options, as well as cost of treatment and travel. As part of a semester two project, the University team interviewed patients to find out about their ear health journey and what led them to seek care at the CSC. These interviews provided some first-hand experience from patients about the ways in which these barriers have impacted their journey to accessing care.  

Finally, we had the opportunity to visit the Krousar Thmey Deaf School in Phnom Penh, where we met the students, learnt about Khmer sign language and provided hearing aid maintenance and other hearing aid-related resources.  

It was a fantastic learning experience for all of us as students and a great opportunity to see how ear and hearing care is provided and accessed in Cambodia, including the barriers that exist in this area and the efforts being made to reduce them at a local level.