Prevalence and impact of hearing loss in South Africa

If the World Report on Hearing 2021 is used as a guideline, informative trends emerge that closely affect all South Africans.

As can be seen on the schematic diagram, approximately 20% of the SA population experiences some degree of hearing loss which can range from mild to total. The World Report on Hearing 2021 is, in my opinion, the only objective and reliable source on the incidence of hearing loss that is available in South Africa.

As indicated, 9.24 million people in South Africa experience a mild degree of hearing loss. It is important to note that some of these people may legally be considered people with disabilities. The reason for this is that mild hearing loss can, under certain circumstances, result in a moderate functional limitation. A proper diagnostic evaluation can determine the degree of loss that the person concerned may experience, what type of sound reinforcement the person needs, the impact it has on the person concerned, as well as what possible reasonable accommodations he or she can claim. Persons with a mild loss can, for example, be vulnerable in an environment where there is background noise. The person may struggle with speech at a distance or behind, and may struggle with telephonic conversations. The person can therefore benefit from wearing hearing aids, assistive listening devices, and/or living devices. In the workplace, those involved may, in line with legislation, codes, and guidelines, claim, for example, a quiet working environment with good lighting and acoustics. However, everything will depend on the situation in question. Early identification of hearing loss and proper diagnostic evaluation, as well as the provision of a functional report are important. The degree and type of hearing loss, as well as the functional impact, will ultimately determine whether the person concerned can be considered as having a hearing disability. Please consult experts in this field?

As the person’s hearing loss deteriorates, his or her need for support and associated reasonable accommodations increases.

As indicated, 2.1 million South Africans experience moderate hearing loss. The use of hearing aids, assistive listening devices, and a combination of speech-reading aids and alternative forms of communication are important here. A proper diagnostic evaluation can determine whether the impairment is substantially limiting.  Usually, people with moderate hearing loss are considered as having a hearing disability depending on the specific case in question. The person may miss more than 50% of speech and can therefore claim reasonable accommodations due to the resulting disability, for example, under the Employment Equity Act. The provision of a functional report is important in all cases, as reasonable accommodation is impossible without proper functional reporting.

806,000 South Africans experience moderate-to-severe hearing loss. This group of people depends to a large extent on support and reasonable accommodation. The person may miss 80% of speech. The higher the degree of loss, the greater the communication challenges, and the more the person depends on a combination of methods to communicate. These persons may claim additional forms of reasonable accommodation as defined in legislation, codes, and guidelines. Experts in the fields of audiology, labour relations, and disability rights should be consulted for guidance regarding functional needs. The provision of a functional report by the relevant health expert in the field of audiology is of crucial importance. A functional report is usually compiled with input from experts in the fields of disability law, occupational therapy, and the like.

According to guidelines provided by the WHO, 248,000 people experience a severe degree of loss, and 124,000 people experience profound hearing loss in South Africa. These people may find it difficult to follow conversations. These two groups benefit less and less from the use of hearing aids and depend more and more on written text, subtitles or captions on television, speech-reading, and alternate forms of communication. Participants may benefit from lip-speakers or note-takers as part of reasonable accommodations. For those who use Sign Language, South African Sign Language interpreters are part of reasonable accommodation.

According to the WHO, there are an estimated 124,000 people in South Africa who experience total hearing loss. Some of these people lost their hearing later in life; others were born deaf or lost their hearing at an early stage in their lives before the acquisition of a spoken language. Those who were born deaf and who use Sign Language are, of course, legally entitled to South African Sign Language interpreters and all other appropriate forms of reasonable accommodation. Those who experience total hearing loss later in life and who do not use a signed language are entitled to access to, for example, lip speakers, captions, note-takers and alternate forms of communication. There are approximately 600,000 South African Sign Language users and between 4 and 5 million people in South Africa with a hearing impairment and accompanying hearing disability who use other forms of communication as indicated above.

It is crucial to ensure that all persons who have hearing impairments or deafness are accommodated in emergency situations, specifically evacuation. All call centres, for example, must be accessible by means of text communication as prescribed in legislation, codes or guidelines.

Written by:

Fanie du Toit
Adult Basic Education Practitioner
Senior Specialist hearing impairment and deaf affairs
National Council of and for Persons with Disabilities

Sources:

• UN Convention on the Rights of Persons with Disabilities 2007
• South African White Paper on the Rights of Persons with Disabilities 2015
• Employment Equality Act
• Technical Support Guidelines and Code on the Employment of Persons with Disabilities 1997
• The UN World Report on Hearing 2022
• SA Census 2022