Making an impression

A nonprofit startup is using 3D printing to help children in Jordan hear for the first time.

Disabling hearing loss is a problem that affects 430 million people around the world today, eight percent of them children. And for those living in low and middle-income countries, where audiologists are few and far between, access to treatment remains an expensive luxury.

Not being able to hear properly keeps children out of school, adults out of work, and traps families in never-ending cycles of poverty. And according to the World Health Organisation (WHO), just three percent of the people living in lower-income countries who need hearing aids actually have them.

In Jordan, where there are only 27 licensed audiologists for a population of more than 11.3 million people, there are few education options for children with hearing loss, with the exception of the newly built Marka School for the Deaf, funded by KOICA (Korea’s international aid agency).

This is despite Jordan hosting an estimated one million refugees from neighbouring Syria, Iraq, and Palestine, where prolonged conflicts have led to an elevated incidence of hearing difficulties, particularly among children.

One nonprofit startup is working to change this. Using 3D printing technology and portable 3D ear scanners, 3DP4ME (3D Printing for the Middle East) is able to create lower-cost hearing aids for young refugees and low-income Jordanians in half the time and cost it takes to make traditional ones by hand.

The NGO launched its Hearing Express pilot in early 2023, thanks to funding from tech giant Intel, global consulting firm Accenture, and German chemicals company BASF. By April, it had fitted 103 high-quality customised 3D-printed Phonak hearing aids and offered essential speech therapy services to 52 children aged six to 12.

“The North Star for us is to see these kids in school and having a real pathway forward to an inclusive education environment and then opportunities in the future for work and to participate in society in a full sense,” explains Jason Szolomayer, 3DP4ME founder.

After quitting a well-paid finance job in California for a stint of volunteering in the Middle East, Szolomayer found himself working at a school for the deaf and blind in Jordan, helping supply hearing aids to people living in the country’s refugee camps.

“The North Star for us is to see these kids in school and having a real pathway forward… to participate in society in a full sense.”

Jason Szolomayer, founder, 3DP4ME

Frustrated by how long it would take to assess patients, make devices by hand, test, and fit them, Szolomayer turned to technology. “There were all these people waiting in line, and I thought, there really has to be another way,” he tells Philanthropy Age.

Years of research followed and resulted in a partnership with Harvard audiologist Brian Fligor (pictured above) and his company Lantos Technologies, which means 3DP4ME has been able to bring state-of-the-art 3D ear scanning technology developed by the Massachusetts Institute of Technology (MIT) to Jordan to make customised hearing devices.

Unlike the conventional process of injecting foam into the patient's ear to create the mould for custom hearing aids, 3DP4ME’s portable 3D ear scanner operates like a balloon, inflating inside the ear and capturing more than one million data points in just two minutes.

This data is then uploaded to customised CAD (computer-aided design) software and subsequently sent to the 3D printer, which can produce 10-12 moulds in just 40 minutes - significantly more than the five a day Jordan’s traditional labs produce.

The speed of the 3D printing keeps costs low, and its portability means NGOs like 3DP4ME can reach more remote and vulnerable communities in harder-to-reach areas.

For audiologist Fligor, hearing loss is akin to a “broken link” in a child’s developmental chain because it affects speech and limits access to education and other activities. “If we can just replace that one link, we're going to be able to create whole people,” he says.

Breaking through

Sham was born a refugee in Jordan after her family fled Syria in 2012. Her parents first noticed something wrong with their daughter's speech development when she was four. They took her to see a therapist but her response to the treatment was minimal, and the family gave up on the sessions due to their high cost and the onset of the Covid-19 pandemic.

It wasn’t until a year later, when a kindergarten teacher suggested Sham visited an audiologist, and the family discovered the extent of her hearing disability. “The news was very difficult for the whole family," explains Sham's father, Khalid, who says he was forced to take a bank loan to pay for the hearing aids and their batteries.

Bullied by other children who teased her about her hearing aids, which eventually broke, Sham found herself stuck at home, looking out of the window at the neighbours’ children walking to school, desperately asking her parents if she would ever get to go.

When Khalid heard about the 3DP4ME initiative, he applied for Sham, and in April 2023, the now-seven-year-old was given new 3D-printed hearing aids. 

The change has been dramatic. “Her hearing is improving significantly,” says Khalid, who adds his daughter’s comprehension has grown from 20 to 70 percent, her vocabulary is expanding rapidly, and she’s becoming more independent. “She asks to go by herself to the convenience store to buy things for herself and can now say ‘I want chips’ or ‘I want juice’, even the shopkeeper has told me he has seen a change,” Khalid says proudly.

Sham, pictured left, was invited to dress like a princess after her hearing aid fitting. Photo: 3DP4ME.

Although ubiquitous in many parts of the world, thanks to companies such as Sonova Group in Switzerland (which owns Phonak), DETAX in Germany, and Formlabs in the United States, the technology is still groundbreaking in Jordan, where only one company, hearingTec, is known to offer customised 3D printed hearing aids. 3DP4ME, however, is the only nonprofit providing them pro bono or at reduced costs to lower-income communities in the country.

“One of our partners in Germany, they do 3,000 of these a day,” Szolomayer explains. “We’re not there yet but if can scale and build our capacity, we could be.”

3DP4ME was registered in the United States as a 501c(3) nonprofit organisation in 2016, but it took a further four years for the organisation to get an NGO license in Jordan.

Initially, it relied on referrals from Jordan’s Institute of Family Health (IFH), which conducted three days of free medical examinations at two locations in the country, including Baqa'a refugee camp – the largest camp in Jordan housing 131,630 registered Palestinian refugees.

But to optimise efficiency, the organisation has since broadened its scope to accept referrals from other established NGOs that already maintained lists of individuals in need of hearing medical assistance, avoiding unnecessary duplication of efforts.

In addition to IFH, which operates under the King Hussein Foundation, 3DP4ME also works with Prince Mired, who heads the Higher Council for the Affairs of Persons with Disabilities (HCD).

Grant-funded, 3DP4ME’s work to-date has been paid for by corporates and some bilateral aid.

After the success of the pilot, a second round of fittings is planned for later in 2023, if additional funding is secured, also targeting approximately 50 children, and if finances allow, a third in 2024 aims to reach 200, says Szolomayer.

With an eye on longer-term sustainability, the NGO is looking at introducing a blended payment model; with those who can afford it paying a subsidised amount for the hearing aids, while families on the lowest incomes continuing to get the service for no charge.

“The first part of our dream is to build some real capacity here in Jordan, but our hearts’ desire is really to go inside Syria because of all the bombing campaigns there over the years, the needs are immense,” says Szolomayer.

The NGO is also exploring the possibility to expand into 3D printing for lower limb prosthetics, another much needed service in a country hosting higher-than-average numbers of children wounded by conflict. - PA