Background
The World Health Organisation (WHO) estimate a disabling hearing loss prevalence of 3.6% across Africa and in Malawi, the prevalence is thought to be even higher at 11.5% [1]. The impact of poor hearing is well understood with significant individual and societal aspects [2]. WHO estimates the cost of hearing loss to be $27.billion dollars to African economies and argues hearing health must be a global priority [1].

The Malawi hearing project represents a global health partnership between ENT and paediatric clinicians from the UK, professionals from Queens hospital in Balantyre and Azanthu – a Malawian charity for those with hearing loss. The introduction of a novel bone conduction hearing aid with solar charging has enabled access to hearing technology in remote regions.

Methods
Through a series of ‘ear camps’ communities have benefitted from ear assessment, basic treatment and triage for receiving bone conduction headsets. Data was collected on demographics, clinical history, examination findings and audiograms.

Results
A total of 288 people were screened, 56% female, 44% male with a median age of 15 and a range of 3-92 years. 160 people underwent audiometry, 35 people were found to have a conductive or mixed hearing loss. 56 (19.4%) people had active or chronic ear infections. Twenty-four people received bone conduction headsets, the majority of which were children.

Conclusion
This study reports the outcomes of a series of ‘ear camps’ in Malawi aimed at identifying people who may benefit from bone conduction headsets and the feasibility of introducing and distributing bone conduction headsets.

Background: The management options for hearing difficulties and the indications for implantable hearing devices have expanded greatly over time, providing an opportunity to treat most hearing disabilities. However, the current clinical practice can miss a large number of potential candidates due to improper referrals. Up until today, the referral criteria in most healthcare systems are not well defined and depend on the judgment of the referring practitioner.
This study aims to provide a guide for the referral of patients with hearing difficulties. Materials and Methods: An expert panel of practicing professionals formed a core committee to carry out the process of developing this study.
A comprehensive review was carried out to identify the current best evidence on the topic and to guide the core committee in developing the statements. For statement evaluation, we employed the Delphi consensus method, where the practicing otologists were invited to vote. Results: Seventeen preliminary statements were included in the original draft. Thirty‑seven otologists were invited to vote, out of which 33 provided their responses. In the first voting round, consensus was reached on
16 statements (94%). The mean level of agreement was 95% (±5) for all the preliminary statements.
Conclusion: This paper includes recommendation statements developed and approved by the SORL Society after review of the existing literature, using the Delphi consensus process. These statements may provide utility as evidence‑based guide to improve patients’ access to hearing care services.

Microtia in México is counted in 7.3 of every 10,000 born children, but in medical practice it was non treated or guided so children got to the age of 6, 8, 10 with no hearing help and a lot of speech and language pathologies that could have been prevented. With the support of different groups and valuable alliances, we present you the results of an 8 year program and the results of informed decisions made by parents and how information became accessible, easy to digest and to transform in facts, with kids being diagnosed, treated and included. A microtia with speech pathologies is a mistake, lets change the future.