The warning sirens alerting Sderot residents of incoming Qassam rockets and the accompanying barrages are taking a heavy toll on the residents' ability to hear.

Rina Mor Yosef used to complain about the volume of the alarm system for Qassam rockets. Now, four years after it was installed, she can hear it only when her hearing aid is turned on.

Mor Yosef, whose hearing was damaged by the proximity of the loudspeakers to her home, says the problem is not hers alone. A few months ago, a neighbor with a newborn baby became frustrated and disconnected the speakers near their homes. The Home Front Command moved it to the roof of a synagogue on the same street.

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There have not been reports of other Sderot residents whose hearing was damaged by the warning system, but severe hearing loss and the accompanying need for hearing aids is quite common in the city because of the Qassams themselves. Attempts by Haaretz to obtain figures on hearing loss in Sderot from Clalit Health Services, the Health Ministry and the National Insurance Institute proved fruitless, because the statistics are not broken down by city, but a local business was able to provide some illuminating figures.

The Bon Ton speech and hearing clinic, which was established three years ago in the center of Sderot, receives patient referrals from the city's health maintenance organizations. Clinic director Orna Horovitch says that dozens of people have suffered hearing loss as a consequence of the Qassam barrages on the city but cannot afford a hearing aid. The bureaucratic hoops of the National Insurance Institute are too difficult for them to manage.

When Horovitch first inquired about opening the clinic, the district director of Clalit told her she would never turn a profit because the residents were too poor. Horovitch, however, saw that there was a need. In the past three years about 70 people between the ages of 20 and 60 have come to her after their hearing was damaged by Qassams falling nearby.

"There are different types of hearing damage," Horovitch explains. Anxiety can cause tinnitus - ringing in the ears - which hearing aids cannot help. Damage can also result from blast shockwaves, or from falling.

Mor Yosef suffers from anxiety, from hearing loss and also from tinnitus. At night she sleeps with a special device for people with anxiety that costs NIS 800. She also needs two hearing aids, one in each ear, but at NIS 4,000 apiece she has only been able to afford one.

"I knew something was happening to me, but in the past year it's gotten impossible: I've sat with people and had entire sentences disappear. The doctor immediately set me straight. At first I refused to accept it. Why should a 45-year-old woman have a hearing aid?" Mor Yosef says.

"It would be impossible for [Mor Yosef] to deal with the NII bureaucracy," Horovitch says. NII Spokesman Haim Fitusi describes the procedure for qualifying for aid as a victim of enemy acts. The claimant must submit a detailed claim to the NII, which passes it on to the Defense Ministry for its approval. The claimant then returns to the NII to argue his or her case, and is sent to a physician. "In the case of hearing, the doctor checks whether the loss was the result of exposure to noise and not from an existing condition," Fitusi said.

"That's hard to prove," Horovitch explains, because the likelihood of a healthy person having a hearing examination before noticing hearing loss is low.