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Ethical issues for large-scale hearing aid donation programmes to the Pacific Islands: a Samoan perspective
  1. Annette Kaspar1,2,
  2. Sione Pifeleti1,
  3. Penaia A Faumuina1,3,
  4. Obiga Newton1,4,
  5. Carlie Driscoll2
  1. 1 ENT Clinic, Tupua Tamasese Meaole Hospital, Apia, Tuamasaga, Samoa
  2. 2 Audiology Division, Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
  3. 3 ENT Consultant, Wanganui Hospital, Wanganui, New Zealand
  4. 4 ENT Clinic, National Referral Hospital, Honiara, Solomon Islands
  1. Correspondence to Dr Annette Kaspar, Tupua Tamasese Meaole Hospital, Apia, Tuamasaga, Samoa; annette.kaspar{at}


The Pacific Islands are estimated to have among the highest global burdens of hearing loss, however, hearing health services are limited throughout this region. The provision of hearing aid is desirable, but should be delivered in accordance with WHO recommendations of appropriate and locally sustainable services. Large-scale hearing aid donation programmes to the Pacific Islands raise ethical questions that challenge these recommendations.

The aim of this paper is to consider the ethical implications of large-scale hearing aid donation programmes to Samoa, a nation of the Pacific Islands. Evaluation of both ‘Western’ and ‘Pacific Island’ perspectives reveals important cross-cultural differences regarding attitudes to donation programmes. We attempt to offer possible solutions that satisfy both ethical frameworks, and which should enable us to deliver an effective hearing health service for Samoa. These solutions may be translational and benefit other Pacific Island nations in a similar context.

  • quality of health care
  • applied and professional ethics
  • disability

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  • Contributors The first draft of the manuscript was written by AK. All coauthors read the manuscript and provided feedback to AK. Revisions were made by AK, and sent to all coauthors for approval prior to submission. Revisions based on reviewer comments were made by AK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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