A volunteer trip by Australian audiologist mates SANDRA LEE and SACHINTHYA DONA has had a big impact on hearing services in Fiji including upskilling staff, supporting a hospital ear health department launch and adapting the Kendall Toy Test to a local language.
When the “father of special education in Fiji”, teacher Mr Frank Hilton noticed students dropping out of school because of hearing and vision problems, he decided to do something about it.
Hilton founded Project HEAVEN (Hearing and Vision Enhancement) in 1997 to provide early diagnosis of ear and eye impairment in school aged children across Fiji by providing on site screening services.
In the past 30 years, the project has screened more than 200,000 school children. This dedicated work leads to detection and referral of over 1,400 cases of eye and ear conditions each year including hearing aid fittings and provision.
Hilton, an English teacher who migrated to Australia in 1958, was head teacher at Nepean School for Crippled Children in Sydney before moving to Fiji with his wife Nora in 1967 to become head teacher at Suva Crippled Children’s School. The Hiltons have since dedicated their lives to setting up services and helping local disabled children.
Assisting Project HEAVEN’s work is EARS Inc, an Australian Christian not-for-profit association of audiologists, audiometrists, allied health care professionals and others dedicated to training and equipping health workers in developing countries.
For 27 years, EARS Inc has assisted hearing impaired people to receive help and rehabilitation. These people would otherwise not have the capacity or opportunity to overcome their disability.
“We provide ongoing training and support to local workers at health clinics, hospitals, deaf schools and mission groups in developing countries,” a spokesperson said. “Through this training, our volunteers are equipping local workers with the necessary skills and resources to provide a sustainable local service to rehabilitate people with hearing loss and help them become self-sufficient and independent.”
EARS Inc came about after Mr David Pither, a Melbourne audiometrist, established an earmold laboratory in Vanuatu. He later went on to establish 40 more in low- and middle-income countries over the next 20 years, along with training local teachers and health workers to make earmolds, test hearing and manage hearing aids.
Mr Peter Barlett, a Ballarat audiologist, joined Pither on a trip to the Philippines and they founded Ears Inc in 1998. Despite few volunteers and limited financial resources, thousands of people’s lives have been changed by EARS Inc, most of whom would not otherwise have had access to audiology and hearing aid services.
In 2025, Ears Inc put out a call for audiologists to help with the hearing program in Fiji.
Screening, staff training and a world first
Melbourne audiologist Ms Sandra Lee from Victorian Hearing, and Gold Coast audiologist Ms Sachinthya (Sacha) Dona responded. The pair worked together at Attune Mornington 10 years ago and kept in touch. They aspired to deliver better healthcare in regions of the world that had less and this seemed the perfect opportunity.
They planned the trip for June 2025 through Ears Inc’s audiologist member Dr Donna Carkeet, who has dedicated many years with Ears Inc and is the regular audiologist in contact with Fiji.
In Fiji, Lee and Dona contributed to screening programs and staff training, focusing on empowering local healthcare workers to build long-term capacity. They also brought a refurbished donated tympanometer and trained staff in tympanometry, air and bone masking and air conduction school screenings.
Lee says Project HEAVEN projects rely on funding and grants and when there’s none, workers must stop work until the next round of funding.
“With the help of Project HEAVEN and our local Fijian workmates, we achieved a world-first culturally appropriate adaptation of the Kendall Toy Test (KTT) into the local iTaukei language, one of the most spoken languages in Fiji,” Lee says.
“This milestone will help bridge gaps in paediatric hearing assessments, ensuring more children receive the care they deserve in a culturally meaningful way. This was an exciting achievement.”
The KTT is a speech discrimination test used in paediatric audiology to assess a child’s ability to identify spoken words by pointing to or handing them familiar toys. Performed with visual cues removed, the child is asked to “show me the [toy’s name]” as the words are spoken at varying, quiet sound levels to determine their hearing threshold.
“Local nurse Akanisi travelled 1.5 hours to spend two days with us to learn the basics of ear anatomy, middle ear pathology and hearing tests, so she could start an audiology department in Tailevu Sub Divisional Hospital,” Lee says.
“She was in the process of setting it up and we were proud to assist her with the launch of this ear health department.”
The Australians also worked with the Frank Hilton Organization which offers critical services for children with disabilities in Fiji, including early intervention, audiology, speech pathology and physiotherapy.
Working out of the Frank Hilton Organization office, they supported the paediatric audiology program at Fiji’s main public hospital, Suva’s Colonial War Memorial Hospital. They upskilled and trained audiometrist Ms Shabina Dean and hearing aid technician Mr Desmond Tabu.
“They’d started an audiology department and ear mold lab themselves from scratch and to see them make in-house ear molds for children with hearing loss needs was eye opening and resourceful,” Lee says.
“It’s one of only two centres in Fiji that offers hearing aids to the public. The other is an independent audiometrist called Tukana. And there are only two audiometrists in Fiji!”
Booth built from scratch
Lee says Dean was a strong advocate for hearing health and rigorous training. Together with her CEO Sureni’s forward-thinking vision, they built Fiji’s first comprehensive hearing booth with diagnostic equipment such as TE/DP, OAEs and ABR. They established processes with Dr Carkeet from Ears Inc coaching and guiding her.
“Shabina’s inspirational; her daughter was the first Fijian to receive a donated BAHA surgery via Cochlear,” Lee adds.
The Australians provided hands on and one-to-one training on air and bone conduction masking, troubleshooting and hearing aid training, mainly with behind-the-ear-devices but also ADHEAR non-surgical devices that use bone conduction to help users hear.
Additionally, they assisted with newborn infant screenings at the CWM Hospital and created otoacoustic emissions (OAE) protocols. Dona says they were grateful for the opportunity to contribute to the impactful initiatives taking place in Fiji.
Donated hearing aids
She says Dr Carkeet dedicated many years to supporting local staff.
“I believe the diverse skills Sandra and I brought helped build on the strong foundation Dr Carkeet established,” Dona says.
“We assisted in refining and streamlining existing processes such as record keeping and patient follow-up.
“One particularly meaningful aspect was being able to put donated hearing aids from our own clients to good use.
“Knowing that these devices could directly improve lives overseas gave our clients the chance to be part of something bigger and it’s a powerful reminder we can share with them about just how valuable access to hearing aids truly is.”
Dona found the experience eye-opening and says it broadened her perspective on what’s possible in audiology.
“I’m excited about continuing to support the dedicated staff we trained, whose eagerness to learn was inspiring and encouraging,” she adds.
Lee says she’s incredibly grateful that her employer, Victorian Hearing, believes in accessible hearing heath care beyond its clinic walls and that its clients were so generous with their hearing aid donations.
“It wouldn’t have been possible without them, and the assistance of Ears Inc to connect us to Project HEAVEN and the Frank Hilton Organization,” she says.
“We were told Frank noticed students dropping out of school because of hearing and vision, so he started the initiative. Over the years it expanded to school screenings and device fittings.
“To give the gift of hearing and bring over donated medical equipment is remarkable.”
The Australians were also impressed with local hearing screener Ms Luisa Natadra who has visited schools in Fiji for 20 years.
“She recalled stories of the early days when they travelled hours on foot with an audiometer and a generator on horseback to reach remote communities,” Lee says. “They would push the school tables together, pull a blanket over the top, and rest there for the night before starting a second day of screening.
“To reach some schools even today takes six hours by boat one way. It’s inspiring the work they do.”
Outreach grounds you
The need is great and it’s sad to hear that when funding runs out, some parts of organisations have to lay off staff until more funding comes through, Lee says.
“They’re always keen to have audiologists visit and teach them so they maintain their clinical skills,” she adds.
“I would recommend outreach to remote communities for any audiologist to be grounded in why it is we do what we do; to help people hear and live connected lives with their community.”
*Ears Inc is always on the lookout for dedicated volunteer audiologists to help. If you would like to inquire, please email admin@earsinc.org.
