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Three years ago, Modesta Bene, aged 13, failed her school exams in rural Malawi. No one knew it yet, but Modesta was capable. She just couldn't hear.

In January 2020, a Malawian doctor diagnosed Modesta as having glue ear and perforated eardrums. He fitted a bone conduction headset invented by Tamsin Holland Brown, a paediatrician based in Cambridge, UK. The device became so important to Modesta that when it broke, she fixed it with layers of tape. It did the job.

Glue ear, where fluid fills the middle ear, often resolves if identified and treated but can cause lifelong deafness if missed. Middle ear disease affects half of Malawian young people with hearing loss, according to research published in PLOS One in 2017. 

Bene has passed every exam since using the headset, though her progress could also reflect natural development, better teaching, and changes in her hearing loss. She is now on track to become a midwife.

Holland Brown, founder of Hear Glue Ear, told BMJ Future Health that she had wanted to solve a problem she had observed in clinics: glue ear. She said she had managed a patient who was almost misdiagnosed as having a learning disability. The problem hit closer to home when her daughter Lilac developed the condition too.

Holland Brown, now co-clinical lead for the NHS Clinical Entrepreneur Programme (CEP), is adamant that publishing in BMJ Innovations in 2021 changed her company's trajectory and carried her work from the UK into African countries. At the time, she wanted global reach but knew little about writing an academic paper.  A call with Ashley McKimm and later iterations guided by Helen Surana, both co-editors-in-chief of BMJ Innovations, produced a paper that at least 30 news outlets covered, including the Independent and Daily Mail. The projects in Africa that supported young people like Bene followed, Holland Brown said.

Holland Brown said her experience is not the norm. The CEP receives thousands of applications yearly, yet a route from invention to academia barely exists, she said.

"Another pathway needs to be open to clinicians who are innovators first. They see the problem, and they want to solve it," Holland Brown said. "As a clinician, you want global reach. You want your colleagues to recognise the work."

Holland Brown said Bene told her she wants to become a midwife to give back to the community that supported her.

Competing interests: Tamsin Holland Brown is a member of the BMJ Future Health advisory committee, founder of Hear Glue Ear, co-clinical lead for the NHS Clinical Entrepreneur Programme, a member of the Royal College of Paediatrics and Child Health digital committee, and a member of the WHO World Hearing Forum.