The day sound returned to Kisumu as families celebrate life-changing ear surgeries

Surgeons operate on a patient's ear during a free Ear Nose and Throat medical camp at the Nakuru Level Five Hospital on September 7, 2023. [File, Standard) For 17-year-old Hillary Midenyo, every day used to begin with pain a sharp, throbbing ache in his ear that never seemed to end. Nights were worse, marked by sleeplessness, fever, and the constant discharge of pus. His childhood has been punctuated by pain, endless hospital visits, and missed school days. Hillary's guardian, Carolyn Onzare, knows the story too well. She has been both a mother and a nurse to him, watching helplessly as the little boy battled a condition she barely understood. "My name is Carolyn Onzare," she begins softly. "I'm the auntie to Hillary, and I've been taking care of him since he was a child after his mother passed away. He was only two years old when he first complained of pain in one ear and had a high fever. I thought it was just a normal infection that would heal with time but I was wrong." The next day, Carolyn recalls, Hillary's ear burst, releasing a thick discharge of pus. "At first, I thought maybe he had injured himself inside the ear," she says. "I took him to a nearby hospital where they gave us antibiotics. The doctor said he would be fine in a few days. But things didn't improve. The pain got worse, the pus continued, and my child could barely sleep." She went from one facility to another, spending money she didn't have, hoping for a cure. "At one point, I thought he would go deaf," she says, her voice cracking. "He missed so much school. There were days he couldn't even stand the pain. It broke my heart." Life became a cycle of pain, medication, and uncertainty. Carolyn, who is unemployed, says the condition drained both their energy and finances. "For years, we lived from one prescription to another, praying something would work," she recalls. When she heard about a ear surgery camp at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu, she wasted no time registering. "When they told me there was a medical camp for children with ear problems, I felt it was an answered prayer," she says. Doctors diagnosed Hillary with Chronic Otitis Media (COM) a persistent ear infection that causes a hole in the eardrum, constant pus discharge, and progressive hearing loss. Left untreated, it can cause severe complications, including meningitis. Globally, COM affects an estimated 65-330 million people, with up to 60% experiencing significant hearing loss. The World Health Organization reports the highest prevalence in the Western Pacific and South-East Asia, followed by Africa. In Kenya, a study by the National Library of Medicine found that among children aged 2 to 15 years, the prevalence of chronic suppurative otitis media (CSOM) was 15 per 1,000, with rural Rift Valley children most affected. Most cases begin before the age of four, highlighting the urgent need for early prevention through proper ear care and vaccination to reduce long-term hearing complications. Today, Carolyn is grateful. Hillary successfully underwent ear surgery during the JOOTRH camp and is recovering well. "The surgery was like a miracle for us," she says with a smile. "The pain is gone. The discharge has stopped. He can hear better and is now more active. For the first time in years, I feel peace. I know things will be okay." At another corner of the ward sits Lydia Akoth, 38, a hospital staff member at JOOTRH. Her daughter, Stancy Adhiambo, has lived with the same condition for more than 13 years. "It all started with her scratching her ear," Lydia recounts. "At first, I thought it was just irritation. She used to complain about mild pain, and for a whole year, we assumed it was nothing serious." But the mild pain turned into a nightmare. "She started crying at night, saying her ear hurt and something was coming out. I panicked and took her to the hospital. They told me she needed surgery. In 2003, she underwent an operation, but unfortunately, it wasn't successful. After a few months, the pus returned," Lydia recalls. For years, Stancy lived on antibiotics. "We visited countless hospitals. Every time, doctors would prescribe more medicine. She missed so many classes that her school performance dropped. She had to carry packets of cotton to school to block the discharge," Lydia says. She pauses, holding back tears. "It's painful to watch your child suffer and not be able to help. Sometimes she couldn't hear unless I shouted. It's a disability that creeps in quietly." When Lydia heard about the ear surgery camp at JOOTRH, she saw it as her daughter's second chance. "I registered immediately," she says. "After the surgery, Stancy's condition has greatly improved. No more pus, no pain. She's healing and can finally focus on her education. I am beyond grateful." The five-day surgical camp, which began on October 27, has brought new hope to dozens of patients like Hillary and Stancy. Organized by JOOTRH's Ear, Nose and Throat (ENT) Department in partnership with the Ear Drop Foundation from the Netherlands, the camp offers free ear surgeries targeting patients with long-term ear infections and hearing complications. According to Dr Neville Okwiri, an ENT Surgeon at JOOTRH and one of the camp's coordinators, the initiative's main goal is to provide relief to patients who have suffered from chronic ear diseases for years some since childhood. "This camp mainly targets patients with long-standing hearing problems caused by chronic infections," Dr Okwiri explains. "Our main objective is to give them a safe and dry ear one that does not discharge pus or cause pain. In some cases, we are also able to improve their hearing, but that's secondary. What we want most is to make sure the ear is healthy and safe." The camp runs for five days, from October 27 to October 31, performing between two and three surgeries each day depending on the complexity. "Some procedures take up to four hours," Dr Okwiri notes. "They are delicate and require precision." He explains that Chronic Otitis Media occurs when there's a permanent perforation of the eardrum, often resulting from a middle ear infection that was either untreated or poorly managed during childhood. "It's a major concern because it can lead to constant discharge, reduced hearing, and in severe cases, infections that spread to the brain," he says. Dr Okwiri says the condition is particularly common in developing countries due to overcrowding, poor nutrition, and limited access to specialized care. "It's not hereditary," he clarifies. "However, it is associated with factors such as malnutrition, living in congested environments, and low immunity." He emphasizes that prevention is just as important as treatment. "Childhood immunization plays a huge role. Good hygiene, nutrition, and timely medical attention can prevent such conditions from developing," he says. Despite its prevalence, many families are unaware that surgery is the definitive treatment. "For patients with a permanent eardrum perforation, surgery is the only solution," says Dr Okwiri. "Antibiotics may help when there's active infection, but they do not heal the perforation. Without surgery, the condition persists." He adds that the camp not only offers free treatment but also builds the capacity of local medical staff. "Through collaborations like this one with Ear Drop Foundation, we get to share expertise, train young surgeons, and improve ear care services in the region," he says. The Ear Drop Foundation, based in the Netherlands, has been partnering with Kenyan hospitals for over 40 years to improve ear and hearing care. This is their first time working in Kisumu, though they have previously supported similar programs in Nairobi and Mumias. Dr Michelle Engel, one of the visiting ENT surgeons and board members of the foundation, says their mission is to empower local specialists and restore hearing for children suffering from chronic ear infections. "We've been coming to Kenya since 1983," Dr Engel says. "Our goal is to train ENT surgeons so that they can independently perform ear surgeries and help children with chronic ear diseases. We started in Nairobi, moved to Mumias, and this is our first time in Kisumu." The team comprises two ENT surgeons and several audiologists. "Every year, we come twice to Kenya to give training and perform surgeries. We work closely with hospitals like Kenyatta National Hospital and now JOOTRH," Dr Engel explains. She describes Chronic Otitis Media as a common yet neglected condition. "It's basically a middle ear infection that causes pain, discharge, and hearing loss because there's a hole in the eardrum," she says. "During surgery, we remove the infection and close the hole, allowing the patient to hear better and live without discharge." Each surgery, she says, can take between three and four hours. "We must be extremely careful because the structures inside the ear are very delicate. If we make a wrong move, we can damage the facial nerve or even cause deafness. So we take our time to ensure everything is done safely." Dr Engel notes that in Kenya and other developing countries, many patients endure this condition for years due to delayed diagnosis or lack of access to antibiotics. "If infections are not treated early, they become chronic," she explains. "Some patients live with ear discharge for ten or more years. In severe cases, the infection can spread to the brain and become fatal." She urges parents to seek medical help early. "If your child has ear pain, discharge, or trouble hearing, please visit an ENT clinic. Antibiotics can help in the early stages, but once the eardrum is perforated, surgery is necessary," she says. The foundation's collaboration with Dr Okwiri, she adds, was inspired by his dedication and expertise. "We've known Dr Okwiri since his training days in Nairobi through our previous ear surgery courses. He invited us to Kisumu, and we're glad we came. The local team is passionate, the environment is beautiful, and the patients are incredibly resilient." Dr Engel says they have already performed several successful surgeries since the camp began. Chronic ear disease, though often overlooked, carries a heavy social and economic burden. For children, hearing loss affects not just education but also speech development and social interaction. For adults, it limits employment opportunities and quality of life. "Imagine a child who can't hear properly in class," Dr Okwiri says. "They struggle to follow lessons, fall behind, and may eventually drop out. This is not just a medical issue it's a developmental one." He explains that many cases could be prevented or managed early if communities had access to simple interventions such as topical antibiotic ear drops, awareness about ear hygiene, and regular checkups. "The burden is huge," he says. "But with initiatives like this camp, we're making progress." The surgeries are expensive, requiring specialized equipment such as microscopes and high-speed drills. "That's why partnerships like this one are vital," says Dr Okwiri. "They help bridge the gap between medical expertise and access to care." For Carolyn and Lydia, the transformation is already evident. Hillary now laughs freely, no longer clutching his ear in pain. Stancy, now a Form Three student, talks about catching up in school and dreams of becoming a nurse someday. "I want to help others like me," she says shyly. Both Dr Okwiri and Dr Engel believe the fight against chronic ear infections requires a mix of awareness, preventive healthcare, and surgical intervention. "This is not a rare condition," Dr Okwiri stresses. "It's very common in developing countries. The earlier we treat it, the better the outcomes." Dr Engel adds, "Our biggest message is: don't ignore ear infections. Seek help early. Ear health is as important as any other aspect of health." SIDE BAR BY RODGERS OTISO The severe shortage of ENT specialists in Kenya has been noticed by medics. Out of a population exceeding 55 million, there are only about 100 ENT surgeons in the entire country. The shortage has created an accessibility crisis, leaving many counties with either one specialist or none at all. "In some counties, you'll find only one ENT surgeon, while others don't have any," Dr Aden Mahat an ENT resident surgeon at the University of Nairobi explains. "Patients travel long distances from rural areas to access treatment. The scarcity of human resources is the main reason why many suffer in silence." In most county hospitals, ENT departments are either understaffed or nonexistent. Patients from remote areas often rely on clinical officers or general practitioners who lack the equipment and training to manage complex ear diseases. This gap in specialized care means that conditions which could have been treated early become chronic, leading to complications such as deafness or brain infections. One of the most common conditions treated during the Kisumu medical camp is chronic otitis media a persistent infection of the middle ear. It presents with ear discharge, pain, and reduced hearing, and can have a strong, unpleasant odor when advanced. "The condition usually starts as an ear infection caused by bacteria," says Dr Mahat. "It's first treated with antibiotics or ear drops, but when these fail, surgery becomes necessary. The aim is to create a safe ear sometimes it also improves hearing, but the main goal is to stop the infection." The surgery, however, is delicate. ENT surgeons must work carefully around the facial nerve, which controls facial movement. If complications occur, they can result in paralysis, abscesses, or even life-threatening infections that spread to the brain. "It's a condition that affects all age groups children, adults, and the elderly," Dr Mahat adds. "But it's largely ignored because few people understand it, and there are very few specialists to raise awareness." Even where ENT specialists are available, lack of essential medical equipment often hampers effective treatment. ENT surgeries require advanced microscopes, endoscopes, and precision instruments that many county hospitals cannot afford. "ENT surgery is very different from general surgery," says Dr Mahat. "It needs specialized instruments and high-precision tools. Unfortunately, most hospitals don't have this equipment, and the few that do find them too expensive to maintain." He believes the government, both at county and national levels, should prioritize investment in ENT infrastructure. "The University of Nairobi is currently the only institution training ENT surgeons," he explains. "If the government can equip hospitals and support training in other universities, we can bridge this gap faster." The cost of establishing ENT units is high, but the burden of untreated ear disease is higher. Many Kenyans continue to live with preventable hearing loss simply because their local hospitals lack the tools for early intervention. Operation Eardrop, the initiative that brought Dr Mahat to Kisumu, has become a beacon of hope for patients struggling with ear diseases. The program brings together a team of Kenyan and Netherlands-based doctors who travel to various hospitals across the country conducting free surgeries. "This is our first time in Kisumu," says Dr Mahat. "We've been operating since Monday and will be here for a week. The hospital has given us immense support, and the local surgeons have been very welcoming." He says such camps are not just about treatment but also about skills transfer and mentorship for local health workers. "We hope these collaborations will continue and even expand to other regions, especially Northeastern Kenya," he adds. "I come from Garissa and work in Wajir County, where the burden of ear diseases is equally high. I hope Operation Eardrop can also reach those areas." While outreach programs provide temporary relief, many patients with hearing loss remain disadvantaged due to the high cost of hearing aids and related devices. Dr Neville Okwiri, an ENT surgeon at JOOTRH, believes government policy could make a difference. "Hearing aids are still prohibitively expensive for most Kenyans," he says. "If the government can zero-rate taxes, import duties, and VAT on them, we can make these devices accessible through public hospitals. That would transform lives." Dr Okwiri also emphasizes the role of prevention in reducing ear diseases. He explains that chronic ear infections often start as upper respiratory tract infections such as flu, which can worsen in children with weak immunity or malnutrition. "Most bacteria that cause ear infections, like Streptococcus pneumoniae and Haemophilus influenzae type B, have available vaccines," he notes. "When children are vaccinated, these infections tend to be milder and less likely to become chronic. Prevention is better than cure." He urges parents to ensure their children complete all childhood immunizations and maintain good nutrition. "No child should be left behind when it comes to vaccination," he insists. Both doctors agree that the solution to Kenya's ENT crisis lies in a combination of increased manpower, better equipment, and stronger public awareness. "The government has made progress, but more needs to be done," says Dr Okwiri. "Each county should have at least one fully equipped ENT unit. That would drastically reduce the burden on referral hospitals." Dr Mahat adds that continuous training of ENT specialists and investments in diagnostic tools are critical steps toward long-term improvement. "It's encouraging that the University of Nairobi continues to train residents, but we need more universities to join in," he says. "We can only meet the country's demand if training is expanded and resources are made available." Operation Eardrop's model shows that partnerships between local and international medical teams can help bridge healthcare gaps. The collaboration not only brings treatment closer to patients but also raises awareness about preventable ear diseases. "The ultimate goal," says Dr Mahat, "is to make ear, nose, and throat care accessible to every Kenyan, regardless of where they live. We want patients from Garissa, Wajir, and Turkana to receive the same quality care as those in Nairobi or Kisumu."

The day sound returned to Kisumu as families celebrate life-changing ear surgeries

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