Hearing impairment: What are the causes?


Esperance Mukakalisa’s hearing became fainter in her right ear with each passing day.

Mukakalisa used to regularly clean her ears with cotton swabs, or other small objects, to avoid the accumulation of earwax.

“It started with the right ear, I had trouble listening to a conversation. As time went by, I lost hearing in that ear completely, and then it also started to go down in the left one,” she recalls.

She says she always cleaned her ears and thought that the issue with hearing was a result of dust and earwax, but the situation only worsened and so she decided to go to the hospital.

“After consultation, they decided to check my ears. They pulled out, from each ear, what looked like a small pile of cotton. The medics told me that they were fine particles that stayed in my ears for a long time and accumulated in the eardrum,” she says.

Luckily, she regained her hearing and now only cleans the outer of her ears. When she feels like something is not right, she goes to the hospital for a check-up.


Using cotton buds to remove earwax can cause permanent deafness, doctors have warned.

Dr Kayitesi Batamuliza Mukara, an ear, nose and throat specialist, says putting objects in the ears, like sticks, can have many negative consequences on one’s hearing sense.

They can destroy the eardrum, which plays a big role in receiving and sending sound into the ears.

If this is damaged, hearing capacity is affected.

Many people use cotton for ‘hygiene purposes’, however, this is not healthy because it increases the risks of ear infections, she says.

“When you put cotton swabs in the ears, you create small wounds as the skin in this part of the body is very soft, and this creates a conducive environment for microbes which cause various ear infections,” she explains.


Dr Jules Ndayisaba, the in-charge of non-communicable diseases at Rwanda Biomedical Centre, says there are liquids produced by the body to protect the ears.

If you have a problem with earwax, go to the hospital and they will help you, if it is necessary.

“You might find it unusual, but medics find it normal and so they don’t act on it. The way forward is to always seek medical advice in case of any concerns. If not, you risk suffering permanent hearing loss,” he says.

Hearing loss is when the ability to hear is reduced or lost and it becomes more difficult for people affected to respond to sound. Some may lose hearing capacity completely, and others may regain it if helped in time.


When it comes to ear infections, some are communicable and others non-infectious. If one suffers from hearing infection and doesn’t go to the hospital, it could lead to loss of hearing, Dr Ndayisaba says.

Hearing loss may also be a result of meningitis, and if children survive it, most of the time, they remain with incapacities.

Hearing loss can also be a result of an accident that affected the hearing sense.


Dr Kayitesi says hearing aids help amplify sound for a person with injured hearing ability.

“There are people with absolute hearing loss and others who can hear if the sound is loud. The hearing aids help to raise sound as it enters the ear,” she says.

However, these aids can’t help people with definitive hearing loss. It means that people who are born deaf, or suffer complete hearing loss later in life, can’t use them, she says.

Drugs like gentamicin and streptomycin, antibiotics used to treat several types of bacterial infections, or used to treat tuberculosis, can also cause hearing loss.

Diseases like otitis attack the ears but hearing capacity is not lost completely.

When a child is given hearing aids at a tender age, he/she can have a conversation well,” she says.

When children are diagnosed with hearing loss at a late stage, they suffer speech impairment.

”For example, if a child is diagnosed with hearing loss at the age of three, he/she can’t speak. However, if they are given aids early, they learn how to speak,” Dr Kayitesi says.

Dr Kayitesi says parents should start to worry if a child sleeps a lot even in a noisy environment.

“Normally, when people make noise, or slam a door, babies tend to wake up. For children with hearing loss, they will continue to sleep peacefully. Parents take it as a good thing, but it may be a complication. It is a sign of hearing loss. If you talk to the baby and he/she doesn’t show signs of listening, then you should worry,” she says.

Dr Kayitesi says parents and caretakers should also watch children and keep them from putting objects in their ears.


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