title: Service, training and outreach--the EARS Inc. Model for a self sustainable hearing program in action.
abstract: OBJECTIVE
  EARS Inc. is a faith based not-for-profit organization established in 1998. As an organization, it has consistently maintained a goal to provide both short-term and long-term projects in low and middle income countries. One specific project undertaken by EARS Inc involved developing a hearing health program in the Dominican Republic.
  
  
  METHODS
  This article is a review of the challenges and successes encountered on the road to establishing improved access and affordability of hearing aid technology for the hearing impaired in Domincan Republic.
  
  
  RESULTS
  Despite the challenges, after 12 years of local programming, the hearing health services in the Dominican Republic were successfully implemented. The development of these services included the simultaneous development of a training program, earmould laboratory, hearing aid repair services as well as calibration services and sales of batteries and accessories.
  
  
  CONCLUSIONS
  As demonstrated in this review, it is possible to develop sustainable and comprehensive diagnostic and rehabilitation hearing services in a developing country. It is clear that training, equipping and empowering local staffs are instrumental to the success of the program.
  
  
  CONCLUSIONS
  A good hearing aid fitting is more than supplying technology. Patient education and the clinician fitting the hearing aid are important. Access to follow-up services including battery supplies, hearing aid adjustments and hearing aid repairs is essential for a hearing aid fitting program in low and middle income countries to be sustainable. Check the WHO guidelines for hearing aid provision in developing countries when planning a program. When working in a country, co-ordinate with local professionals involved in hearing health where available.
authors.affiliation: EARS Inc. , New South Wales , Australia and.
authors.forename: Donna
authors.initials: D
authors.lastname: Carkeet
authors.forename: David
authors.initials: D
authors.lastname: Pither
authors.forename: Margaret
authors.initials: M
authors.lastname: Anderson
mesh_terms: D003906:Developing Countries; D004293:Dominican Republic; D006293:Health Promotion; D006297:Health Services Accessibility; D006310:Hearing Aids / Q000191:economics / Q000600:supply & distribution; D034381:Hearing Loss / Q000534:rehabilitation*; D006801:Humans; D017146:Models, Organizational; D009937:Organizational Objectives; D009939:Organizations, Nonprofit; D016730:Program Development; D015397:Program Evaluation
keywords: Audiology; developing countries; hearing aids; hearing health; hearing technology; humanitarian; sustainable hearing programs; training