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Hearing loss treatment leads to first words for young refugee

Original article published at The Almanac by Kate Daly

Ahmad Popal waits with his son, Bilal, during a visit to the audiologist in Menlo Park.

"Papa" was the first word to come out of Bilal's mouth on that momentous day in August. Few thought the 11- year-old Afghan refugee would ever speak, but with a team of audiologists at Pacific Hearing Service in Menlo Park advocating for him, he started uttering sounds.

His father cried, and the audiologists got emotional too, knowing what a confluence of unusual circumstances led to this miraculous moment for a boy who has suffered from severe hearing loss since he was a baby.

Due to his lack of hearing, Bilal never went to school in Afghanistan, and communicated with his parents and three younger sisters by making up his own sign language.

The family resettled in Sacramento last September. When Menlo Park audiologist Dr. Jane Baxter learned about Bilal's case this summer, she offered to help, optimistic that "Bilal will now have the opportunity to participate in school, communicate with his family, and we hope, realize his potential to lead a full life."

In July her team spent several hours testing him to see if hearing aids would be a suitable solution, and helped him get fitted for them. He returned in August wearing his new hearing aids, and after two more hours of free followup testing, evaluating, and coaxing, Bilal also said "mama," "up," and "bye."

His father, Ahmad Popal, expressed thanks to everyone in the Menlo Park office for the breakthrough, and willingly shared his family's complicated back-story with The Almanac because the newspaper played a part in making all this possible.

Aghan refugee Bilal Popal, 11, in the center, is surrounded by his family. At far left is Katie Sluis, who played a key role in connecting the family with the Menlo Park audiologist and her team who worked to help Bilal hear.

A long journey

Popal considers himself one of the lucky ones. After receiving death threats from the Taliban, he went to the U.S. Embassy in Kabul and was able to get his wife and children out of the country on a special immigrant visa. The visa provides a green card and pathway to U.S. citizenship for people who serve as interpreters, translators or "perform sensitive and trusted activities for the U.S. government" for at least two years, according to the U.S. Department of State website.

Popal worked as a supervisor at a water and wastewater treatment laboratory for the U.S. Army Corps of Engineers for several years. He said he started receiving threatening letters and phone calls accusing him of being an American spy, and then his brother-in-law, who had worked as a technician, disappeared on his way to the market.

Popal said the Taliban sent him a video showing his relative being shot after being forced to say he was a spy. Popal described his brother-in-law's body "hanging in a tree for a few days.

After that, Popal recalled his office compound being attacked by a suicide bomber in a truck, and the shock of being a witness when "lots of people died." That happened in 2013, and Popal still suffers from sleeping problems related to the trauma.

He is now studying to be a medical assistant, and said he is especially grateful for the many helping hands that have come forward to treat Bilal since being scammed by "fake doctors" in Afghanistan. In that 2009 incident, Popal saw an advertisement that promised "to help the deaf." He collected $8,000 from family members to pay for corrective surgery. After 45 minutes in the waiting room, the family went to check on Bilal and found him sitting alone. The "German doctors" had taken off with the money through the back door.

These days, Popal's daughter's teacher, Katie Sluis, is at the top of his long thank-you list. In June the teacher attended a traveling art exhibit of pictures made by Syrian children living in the Zaatari refugee camp in Jordan.

The person who pulled together the collection is Maggie Conroy, an art therapist who volunteered alongside Baxter, the Menlo Park audiologist, on a humanitarian mission trip to Jordan in 2017. Conroy entertained families while they waited for audiologists to treat them.

On that same trip, Conroy met the art instructor who works with the Syrian refugees. Conroy brought over a set of their paintings and hung them on the walls at Pacific Hearing Service. (The Almanac published a cover story about this last year, and many members of the community came to see the art.)

Audiologist and Pacific Hearing Service co-owner Dr. Debbie Clark said that "because of the story (The Almanac) did, the art exhibit was such a success that Maggie was able to take it on the road."

Ahmad Popal watches as audiologists Debbie Clark and Jody Winzelberg test his son, Bilal.

The first stop was Sacramento, where Sluis met Conroy, and they talked about Bilal. Conroy then called her audiologist friends on the Peninsula to see if his case could fall under the nonprofit branch of their business, Pacific Hearing Connection, which usually recycles donated equipment and treats patients on a sliding scale.

In July the teacher drove Bilal and his father to Menlo Park so Bilal could be tested by a medical team that included Baxter and pediatric audiologist Dr. Jody Winzelberg, who was at Stanford University at the time and is now associated with San Jose State University.

Over several hours their assessment showed that Bilal has some hearing in both ears; they then contacted California Children's Services to speed up the process for him to obtain hearing aids from Sutter Health. Conroy then brought Bilal and Popal back to Menlo Park in August so the audiologists could run more free tests to see how well Bilal is processing sound with hearing aids. They determined he can hear up to 45 percent in the left ear and up to 22 percent in the right ear if the sound is at the level of a shout.

The next step is for him to get an MRI to understand what might have caused his hearing loss and complete his diagnosis. Winzelberg said he could be a candidate for one or two cochlear implants, but a surgeon has already warned her that Bilal is older than the average cochlear implant patient.

She also said Bilal might not hear well enough with hearing aids to learn how to speak clearly, but her conclusion after two sessions is, "he's so stimulable."

Audiologists Winzelberg and Clark placed their hands and his hands on moving lips and vibrating voice boxes to demonstrate to Bilal how air and parts of the body change when different sounds are made. They found him to be a fast and eager learner, and suggested that he aim beyond the special education program where he is currently enrolled and learning American Sign Language.

"Now we have definite goals for him, he needs auditory training, speech and language training," Winzelberg said.

As for Conroy, her goal is to take the show, Hearing the Call Art Initiative, to Indiana, Arizona and New York. She is also hoping to visit orphanages in Iraq this fall, and to bring back more artwork from Jordan so she can sell it to help support the artists and their families.


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