Issues that audiologists face in extreme environments

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Written by Amber Morgan, AuD

Imagine you’re in outer space, the ocean, or in the middle of nowhere surrounded by people with hearing issues, in desperate need of audiometric testing. Where do you start? As an audiologist, dealing with unusual and complex situations can be one of the biggest challenges encountered, especially in environments that don’t have the necessary resources.

For the last 11 years, Healing the Children1 (a non-governmental, humanitarian charity), has brought together audiologists, ENTs and nurses from around the globe bi-annually to provide hearing healthcare and training to ENT residents, nurses and children in Ethiopia. One of the biggest issues faced on these visits is being able to help the situation as much as possible with the limited provisions available.


According to the World Health Organization (WHO) 466 million people (6% of the world’s population) has a disabling hearing loss, with 34 million being children.2 Hearing loss in children is most prevalent in South Asia, Asia Pacific and Sub-Saharan Africa.3 These numbers make it apparent that suitable hearing health care is of the utmost importance in order to improve the situation. However, this is easier said than done for many reasons.


One of the difficulties in providing appropriate hearing health care, specifically in Ethiopia, is the lack of appropriately trained professionals. As of 2018, there were only 26 trained ENTs to provide services for the population of 100 million people who live there.4 Only three hospitals offer an ENT service – two of which are in the capital city of Addis Ababa,4 so the scope to offer care to the wider population is very limited. Because of the lack of trained professionals, it is extremely important that the equipment used to train in audiometric testing is easy and intuitive.


Another issue with providing suitable hearing health care, is that only 44% of Ethiopia’s population has access to electricity, according to World Bank data from 2018.5 Those that do have access, can experience weekly if not daily outages that can last for several hours or even days. If generators or other power supply options are not available, it can lead to many wasted work hours and prevent audiologists from being able to do their job properly.

In many circumstances the equipment being used can also be several decades old, with dimly lit screens and complex functionality. Much of this equipment also requires a voltage converter or transformer as they are designed for 110V inlets (standard US voltage) which isn’t compatible with Ethiopia’s power inlets operating on a 220V supply voltage.


These environments also pose the challenge of finding quiet conditions in which to provide audiometric testing. Ethiopia is one of the oldest Christian states in the world, with Orthodox Christian churches located throughout the country.

Quite often Orthodox churches play chants through loudspeakers which can be heard several streets away, making it hard to find a quiet place to test. To try and combat this, inserts are often used with headphones on top to keep the background sounds to a minimum, as well as sound level meter apps which help to find the quietest environment to test in.


In certain parts of the country, towns and villages can be so remote that audiologists need to travel for miles with audiometry equipment, which can also mean being miles away from the nearest power supply. With limited provision for the people in these villages to travel themselves, it is essential to find ways to get to them. As well as this, the equipment used by audiologists can often be cumbersome, so finding solutions that can be carried easily and are also battery-operated or able to work with a portable USB can be extremely helpful.


According to the World Bank, Ethiopia is the second most populous nation in Africa after Nigeria, and the fastest growing economy in the region. However, it is also one of the poorest, with a per capita income of $850. It has an aim to reach lower-middle-income status by 2025.6

Like all the countries of Sub-Saharan Africa, poverty is rampant and the Ethiopian government spends relatively little on education and health. This is why it is so essential for groups like Healing the Children to exist and be able to support these countries. It is also of increasing importance that companies like Amplivox continue to provide affordable equipment to enable audiologists to do their job more easily and effectively in these environments.


Amplivox's range of audiometry equipment is ideal for these challenging test environments. They are not only portable, they also come with multiple power supply options, are easy to use, and affordable – an absolute essential in markets such as these.

Our range of diagnostic screening audiometers and tympanometers can either run on battery, or be used with a USB power supply when a traditional power source is unavailable or unreliable. Plus, each device can work with both 110 and 220 Volts and comes with a travel adapter kit.

The simple-to-use buttons and the ability to have automatic masking on some of the audiometers makes both testing and learning easier, and the audiometers and tympanometers are small enough to carry in your check-in luggage with enough room for plenty of clothing.

Amplivox donates equipment to Healing the Children and other relevant charities on a regular basis to be able to help as many people as possible across the world receive suitable hearing health care.

For more information on our screening and diagnostic products please visit our audiometers webpage, contact our customer support team on +44 (0)1865 880 846 or email.




1Healing the Children. Accessible at:

2World Health Organization (2021). Deafness and hearing loss. Accessible at:

3Mulwafu W, Ensink R, Kuper H, Fagan J. Survey of ENT services in sub-Saharan Africa: little progress between 2009 and 2015. Glob Health Action. 2017;10(1):1289736. doi:10.1080/16549716.2017.1289736

4(PDF) ENT outreach in Ethiopia (

5/6The World Bank. The World Bank in Ethiopia. Accessible at:,per%20capita%20income%20of%20%24850 


"About the author:"

Amber Morgan, AuD