Ethical issues for large-scale hearing aid donation programmes to the Pacific Islands: a Samoan perspective

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.