Building Something That Would Last
Adam and Jerusha Shulberg reflect on a defining chapter of service in Western Nepal.
“The goal was to build something that would be lasting.”
For Adam and Jerusha Shulberg, being of service is not something separate from their work in hearing care. It is part of the reason they chose the work in the first place.
In 2001, Adam travelled to Western Nepal to help establish an audiology service in a remote, severely underserved region of around one million people.
He describes it as a journey into the unknown, but also as a time when it became profoundly clear that his skills had found their proper place.
The invitation came from Adam’s friend and colleague, the ENT surgeon Mr Neil Weir FRCS, founder of BRINOS, the Britain Nepal Otology Service.
For many years, Mr Weir and BRINOS surgical teams had been travelling to Nepal to run specialist ear camps. Working in difficult conditions and with limited resources, they treated people who had little or no access to specialist ear care.
The work was frequently life-changing and, in some cases, life-saving.
But the surgical teams also identified a significant gap.
What happened after surgery?
Many people continued to live with hearing loss after their surgery. Others had hearing conditions that could not be treated surgically at all.
For these patients, there was no permanent audiology programme providing hearing assessments, hearing technology, fitting, rehabilitation and ongoing care.
A surgical visit could achieve an enormous amount. But it could not, by itself, meet every hearing need within a community of this size.
What was needed was a service that remained after the visiting teams had left.
Adam travelled to Nepal to help build it.
A clinic rooted in its community
From the beginning, the intention was not to create a clinic that would remain dependent indefinitely on visiting clinicians from the UK.
It needed to become locally run.
This meant considering more than equipment and clinical procedures. It meant consideration given to developing skills, knowledge and systems that could be carried forward by people living and working within the community.
It also meant approaching the project with humility.
Lasting healthcare cannot simply be handed out from outside. It has to become part of the place it serves, supported by local commitment, local understanding and the confidence to continue independently.
A few years after Adam’s first journey, Jerusha, his wife and fellow audiologist, joined him in the work.
Together with BRINOS and the people working on the ground, they helped develop an audiology service designed not only to meet an immediate need, but to grow into something sustainable.
By 2011, the clinic had become self-funding and locally administered.
It was the outcome they had hoped for from the outset: not a permanent reliance on charity, but a functioning local service with the capacity to continue its own work.
When your skills find their purpose
Adam remembers his years in Nepal as one of the most rewarding and significant periods of his life.
The experience brought together clinical knowledge, collaboration and a deeply felt desire to make a contribution. It also reinforced something that continues to shape the philosophy of The Well Being BY CUBEX today: good hearing care is not simply about supplying technology.
It is about understanding what a person and a community genuinely need. It is about creating access to knowledge, continuity and support. And it is about building care that can endure.
Adam was later made a Fellow of the Royal Society of Medicine in recognition of this chapter of his work.
He remains profoundly grateful for the honour, but speaks with equal admiration for Mr Neil Weir, the BRINOS teams and the dedicated local people whose knowledge and commitment enabled the clinic to become independent.
BRINOS continues its remarkable work in Nepal today.
In this film, Adam recalls his first journey to Western Nepal, why he wanted to contribute and the need he encountered within the community.
He reflects on the work involved in establishing a permanent audiology programme, Jerusha’s later involvement and what it meant to see the clinic become self-funding and locally administered.
Nepal in our hearts
We had already planned to share this film as part of the story of Adam and Jerusha’s long-standing relationship with Nepal.
The devastating floods that struck northern Nepal on 26 August have now brought those memories into much sharper focus.
Although the disaster has affected a different region from the Western Nepal community in which Adam and Jerusha worked, the news has been deeply felt. Nepal and its people have held a special place in their hearts for more than 25 years.
Their thoughts are with everyone who has lost loved ones, homes and livelihoods, and with those working to provide rescue, medical care, shelter and emergency support.
To learn more about BRINOS and the work it continues to do in Nepal, visit:
