As per the estimates of the World Health Organization (WHO), there are approximately 63 million people in India suffering from significant auditory impairment. This places the prevalence at 6.3 percent of the nation's population.

According to the National Sample Survey Organisation 2001 survey, there are currently 291 persons per one lakh population suffering from severe to profound hearing loss.

Of them, a large percentage are children below the age of 14 years. Then there are the elders above 60 years of age and the lifestyle changes that the impairment forces on them. Self-esteem could be badly affected.

Cochlear implants offer a way out of hearing impairment. They are surgically implanted electronic devices, often referred to as a bionic ear.

The cochlea is the auditory portion of the inner ear.Contrary to hearing aids, cochlear implants do not amplify sound. Instead they use electrical impulses to directly stimulate any functioning auditory nerves within the cochlea. External components of the cochlear implant include a microphone, a speech processor and a transmitter.

Under appropriate conditions, an implant can give a deaf person a useful auditory understanding of the environment and/or hearing and help them to understand speech, although post-implantation therapy is usually required. According to researchers at the University of Michigan, approximately 100,000 people worldwide have received cochlear implants; roughly half of them being children.

At the moment the benefit of the implant does not reach many because of the prohibitive cost of the device, surgery and post-implantation therapy.

Predictably, India has a long way to go to effectively redress the problems faced by the hearing and speech impaired, who perhaps constitute between 1 to 2 percent of the population. (It is accepted that a larger percentage of the population suffer from milder degrees of hearing loss).

The initiative of India’s former president APJ Abdul Kalam, fondly known as a people’s president, is quite relevant in this context. He is seeking to develop a cheaper cochlear implant through the Defence Research and Development Organisation (DRDO), and that could transform the lives of millions worldwide.

In fact, the whole world is waiting to hear from India on this. Only three nations, Australia (Cochlear Ltd), Austria (Med-El) and the United States (Advanced Bionics), produce the implants. The costs range from Rs 5 to Rs 10 lakh per implant, apart from the operation and post-operative care. The Sydney based Cochlear Limited, that produces the cheapest version at a little over Rs 5 lakh, enjoys a Microsoft-like dominance in the market. In such a context, the Kalam initiative is expected to lower the cost by one fifth, at about Rs 1 lakh or even less than that.

But the Indian version could take many more years as the technology is sophisticated and highly advanced, say ENT specialists. At present, the country has very few public or government hospitals performing cochlear implants. The fact that the whole country must have performed only about 1000 to 2000 implants all these years tells its own story.

``The implant replaces the inner ear, not physically but functionally. It is only for patients with profound hearing loss. People who can't hear at all even with the most powerful hearing device,'' '' says Dr Lt Col A. Ravi Kumar, Professor and Head, Department of ENT, Head and Neck Surgery, Sri Ramachandra Medical College & Research Institute. The prestigious institution, situated in Chennai, capital of the southern Indian state of Tamil Nadu, is the only medical college in the state to perform cochlear implants.