Global Audiology/Asia/Palestine

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General Information

Palestine, officially the State of Palestine, is a partially recognized sovereign state in the Levant region of Western Asia. It encompasses the Israeli-occupied West Bank, including East Jerusalem, and the Gaza Strip, collectively known as the Palestinian territories. The territories share the vast majority of their borders with Israel, with the West Bank bordering Jordan to the east and the Gaza Strip bordering Egypt to the southwest. Arabic is the official language of the State of Palestine, specifically the Palestinian Arabic dialect. Hebrew and English are also widely spoken.

History of Audiology

Audiology is a relatively new health profession in the West Bank and Gaza. The field has expanded gradually over the past three decades through university programs and the establishment of local clinics. Some hearing care services have also been supported through collaborations with international organizations, enabling the provision of hearing aids, cochlear implants, and otologic surgeries. Despite these developments, many towns and villages still lack dedicated audiology clinics, leaving large segments of the population underserved.

Incidence and Prevalence of Hearing Loss

To date, no national epidemiological survey conducted by the Ministry of Health has comprehensively measured the incidence or prevalence of hearing loss across the West Bank and Gaza Strip (Annual Health Report, 2024). However, the only sustained newborn hearing screening initiative to date was established by Caritas Baby Hospital in Bethlehem. Between September 25, 2006, and December 31, 2011, Caritas screened more than 15,000 newborns, reporting a higher-than-expected prevalence of infant hearing loss compared with global estimates, highlighting the urgent need for a national screening system.

Information About Audiology

Hearing Care Services Professionals Audiology and hearing services are provided by audiologists, speech-language therapists, and ENT (otolaryngology) physicians across governmental, NGO, and private settings.

Audiological Services

• Diagnostic services: puretone audiometry, tympanometry, acoustic reflex testing, otoacoustic emissions (OAE), and auditory brainstem response (ABR).
• Hearing aid services: fitting, programming, maintenance, repair, and earmold production.
• Cochlear implant services: mapping, troubleshooting, and device maintenance.
• Hearing rehabilitation: auditory training and speech-language therapy.
• Vestibular assessment: limited availability of videonystagmography (VNG) in a few private clinics.

ENT / Otologists / Otoneurologists ENT surgeons provide a range of surgical and medical services, including cochlear implantations and middle-ear surgeries. Some CI surgeries are conducted through collaborative or mission-based programs. Services—such as balance and tinnitus evaluation—exist but remain limited and unevenly distributed.

Primary Health Care Primary care centers refer individuals suspected to have hearing impairment; however, universal newborn hearing screening (UNHS) is still not implemented nationwide.

There is no dedicated national law regulating audiology practice. Clinicians providing hearing care must hold a valid license, and all clinics require Ministry of Health approval.

Scope of Practice and Licensing

Education and Professional Practice Most audiologists hold a Bachelor’s degree in Speech Therapy and Audiology, with some holding diplomas from institutions accredited by the Palestinian Ministry of Higher Education, including An-Najah National University, Birzeit University, Bethlehem University, Arab American University, Al-Quds University, and Al-Terra College. However, there are no fully specialized or advanced audiology degree programs (Master’s or PhD) currently offered.

Professional and regulatory bodies Audiology and speech-language therapy are not yet overseen by a unified national regulatory body. Licensing is processed through the Palestinian Ministry of Health for graduates of approved programs. A new requirement introduced in October 2025 obligates newly graduated or previously unlicensed practitioners to pass a licensing examination.

Audiologists’ scope of practice typically includes diagnostics, hearing aid services, and rehabilitation. Surgical interventions remain the domain of ENT specialists.

Professional and Regulatory Bodies

There is no dedicated national research society for audiology. Research efforts are fragmented and largely driven by universities, hospitals, or individual graduate students. Only a small number of studies related to hearing and audiology have been conducted, and many have not been formally published.

Research in Audiology

There is no dedicated national research society for audiology. Research efforts are fragmented and largely driven by universities, hospitals, or individual graduate students. Only a small number of studies related to hearing and audiology have been conducted, and many have not been formally published.

Challenges, Opportunities and Notes

Challenges

• Uneven geographic distribution of specialized services, with many remote areas underserved.
• Heavy reliance on external funding for hearing aids and cochlear implants.
• Absence of universal newborn hearing screening and standardized early detection protocols.
• High genetic burden of hearing loss due to consanguinity, increasing the need for genetic counseling.
• Growing number of audiology graduates versus a limited number of clinics.
• Limited validated data and research on hearing health.
• Lack of public awareness and early intervention advocacy campaigns.
• Insufficient clinical training opportunities and hands-on practice for students and new graduates.
• Weak regulatory oversight of clinics and professionals; some centers employ unqualified people.
• Movement restrictions and import limitations affecting the access of hearing equipment and care.
• Scarcity of specialists with advanced degrees in audiology.
• Financial barriers for families seeking hearing aids or cochlear implants.
• Social stigma surrounding hearing devices, contributing to delayed intervention and detection.

Opportunities

• New academic programs in audiology at Palestinian universities open the way for more local professionals
• Collaboration with NGOs and international partners to implement newborn hearing screening and protocols
• Development of a national regulatory body to standardize practice and licensing.
• Strengthening Palestine Ministry of Health oversight and accountability.
• Establishing additional hearing care clinics through local or international partnerships.

Impact of the war on hearing loss

Prolonged armed conflict, repeated military incursions in the West Bank, and the ongoing war in the Gaza Strip have had profound and cumulative effects on hearing health, particularly among persons with hearing disabilities. Continuous exposure to high intensity noise sources—such as airstrikes, artillery fire, sound bombs, live ammunition, and explosions—has been linked to acoustic trauma, tinnitus, and temporary or permanent hearing loss among both children and adults [UN News, 2024].

In Gaza, the low flying military aircraft, drones, and surveillance planes that operate continuously, sometimes for 24 hours a day, have been argued to contribute to persistent tinnitus, auditory fatigue, sleep disturbances, and stress related auditory symptoms. Recent local reports estimated that as many as 35,000 individuals in Gaza are experience hearing problems attributable to the extreme exposure from bombings, underscoring the severity of war-related auditory impacts on civilians.

Reports from international and local organizations indicate that the documented prevalence of hearing loss in Gaza and the West Bank significantly underestimates the true burden, as access to audiological assessment, diagnosis, and rehabilitation services is extremely limited or entirely unavailable during periods of active conflict. Persons who are deaf or hard of hearing are particularly vulnerable during bombardments, as they are unable to hear warning sounds, explosions, or approaching danger, placing them at elevated risk of injury.

The prolonged siege on Gaza and restrictions on medical supply entry have severely disrupted access to hearing aids, cochlear implant processors, batteries, spare parts, and routine maintenance services (UNICEF, 2025; PNGO portal, 2025). Many children and adults who previously relied on these devices have experienced extended periods without functioning equipment, resulting in auditory deprivation, regression in communication skills, and reduced participation in daily life.

The impact extends beyond physiological hearing loss. Disrupted access to assistive devices and specialized care has significantly affected social interaction, emotional well-being, and access to education and psychosocial support, particularly for children with hearing disabilities. In both Gaza and the West Bank, intensified military incursions into refugee camps, villages, and urban neighborhoods—often involving sound grenades and live fire near civilian homes—have further increased the risk of noise-induced hearing damage.

The ongoing prohibition on the entry of cochlear implant equipment and advanced audiological technologies, combined with a critical shortage of trained audiology professionals and medical infrastructure, continues to delay or prevent timely interventions, resulting in progressive and largely preventable deterioration of hearing health among affected populations (Atfaluna Society for Deaf Children).

Audiology Charities

Several NGOs and international partners support cochlear implant programs, hearing aid distribution, and community outreach initiatives in both regions. Despite these efforts, service availability remains insufficient, and many individuals wait years for hearing aids or cochlear implants due to financial hardship.

• The Atfaluna Society for Deaf Children (ASDC) in Gaza provides comprehensive audiology and speech-language services, including screening, diagnostic evaluation, hearing aid fitting, earmold fabrication, device repair, and speech therapy.
• UNICEF has supplied hundreds of hearing aids to Gaza, particularly during crises, with priority given to children with severe hearing loss.
• The Red Crescent Society provides hearing services in selected governorates, primarily through screening programs, hearing aid provision, and referrals for further audiological or ENT evaluation.

References

Contributors to the original text

Layan Hamayel

Author

📘 RG

Nausheen Dawood

Contributor

🆔 ORCID