It sounds like you have done a lot to treat the symptoms of your Otitis Media but I think it will be important for you to find an ENT Specialist who will try and investigate the cause. Sometimes the cause can be sinus related, allergies, germs, bacteria, but it can also be hereditary -in which case one can only treat the symptoms.
If you do not manage your infections adequately you do risk another 'burst' eardrum which apart from being painful can affect your hearing. Eardrums do heal slowly over time in most cases and can be surgically repaired (tympanoplasty) but most surgeons will not repair it if there is risk of further infections.
The reason you probably suffer more in Johannesburg is due to atmospheric pressure changes
•The eustachian tube (linking nasal/oral cavities to the ear) keeps the air pressure normal in your inner ear. Pressure inside the ear increases when the eustachian tube gets blocked with fluid (due to Otitis Media). This pressure can cause the eardrum in the middle ear to burst. You may have fluid draining from your ear because the fluid cannot drain through the eustachian tube. This is usually not a serious problem because with time the eardrum repairs itself, but it can be painful.
It is possible there is a permanent cure for you if a cause can be identified. See an ENT Specialist and look into the viability of ventilation tubes (grommets) to allow air into your middle ear.
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