Abstract: For the roundtable, we welcome anyone who has interest in public health and education in underdeveloped countries for the discussion of concrete implementation strategies of a powerful combination of a 3x3-tier (geographical x educational) approach of using E-learning as a tool to build onsite- and tele-healthcare in audiology. In our approach, the three geographical tiers consist of an academic audiology program in the USA, a hub in Paramaribo, Suriname, and communities in the Amazon inland of Suriname. Three educational tiers, supporting trainees for a certificate of Health Facilitator, an Associate’s degree as Audiology Technician and a Bachelor’s degree in Audiology, are offered by the International Institute of Education for Development (IIED) at Paramaribo under the academic and clinical supervision of audiology experts in the USA. Advances in technology and online teaching and learning help to integrate E-learning and telehealth, thereby scaffolding students in Suriname from lower to higher educational tiers.