What?'

'Could you repeat what you said?'

'Huh?'

Sounds -- pun unintended -- like a hearing loss problem.

Doctors say around 10 to 12 per cent of the Indian population suffers from some degree of hearing loss. Delays in detection and taboos attached to using hearing aids are further compounding the problem. "Now, alarmed at the numbers, the government has chalked out a National Hearing Conservation Programme to help early detection and treatment," says Dr T S Sidhu, head, department of ENT, Ram Manohar Lohia Hospital, New Delhi.

"Various surveys are being conducted nationwide to ascertain the extent of the problem," he adds. "Once the National Hearing Conservation Programme is announced, we will have specialised doctors and funding to deal with problems related to hearing loss." The programme is being designed along the lines of the National Blindness Control Programme, which has proved to be a success.

Hearing loss is the most neglected ailment today, especially in rural areas where there are no specialised doctors available at the primary level. "Most of the time, these people are unable to reach the secondary or tertiary level," says Dr Sidhu, noting that untreated middle ear infections, poor check-ups, wax in the ears, bathing in dirty water and upper respiratory tract problems only make things worse.

"Surprisingly, the situation is no better in metros," says Dr Rajiv Nangia, ENT consultant, Fortis Jessa Ram Hospital, New Delhi. "Parents visit paediatricians or physicians for ear ailments, but never an ENT specialist. Surveys have shown that only five to seven per cent of people suffering from ear ailments or hearing loss are willing to go to an ENT specialist."

Then there are those taboos related to hearing aids. Young people are, first of all, not ready to accept the fact. Secondly, they shy away from wearing aids. While a number of cosmetic aids are now available, their price is also a prohibiting factor.

Educating the masses about this neglected ailment holds the key to countering it.

Loud music and noise pollution aren't helping. Also, people are living longer and those above 50 years do develop some degree of hearing loss.

"In children, congenital hearing loss varies from one to four per 1000 live births. Here, too, it is vital to detect the problem as early as possible," says Dr A K Lahiri, head, ENT, Ganga Ram Hospital, New Delhi.

Parents, especially in big cities, are willing to get hearing aids for their children if necessary, but that alone isn't the solution. First find out the degree of hearing loss, then chalk out the treatment strategy -- hearing aid, surgery or, as a last resort, a cochlear implant.

"Rehabilitation, which includes speech therapy, has to be done too, so a child's speech and hearing can be coordinated and he can lead a normal life," says Dr Lahiri. "Unfortunately," he adds, "even big hospitals lack speech training and rehabilitative centres."

This is a problem that only gets worse. Urgent steps are necessary. Which is why you shouldn't put off that check-up.