Cambodia Project Week 9: 9th -13th November

So it has been another busy week! We can’t quite believe it is Week 9 already.

On Monday we had a meeting with our Khmer friend Thyda, who works in an International school, to discuss raising awareness of Speech and Language Therapy in her school. We will be preparing a presentation for parents and teachers in English and then Thyda will hopefully be our interpreter on the day. This is an exciting prospect as we are always looking to get the word out about Speech and Language Therapy and how it can help children and adults, not just those with cleft. We also had another meeting with a representative from Smile Train who are an organisation helping to fund cleft surgeries in countries all over the world, including Cambodia. We wanted to try and get funding for a Speech Adviser in some of our other cleft settings so we chatted to him over dinner, along with Dr Nous Sarom, a surgeon from Military Hospital. We are finding it difficult to work at Military Hospital at the moment due to the lack of a consistent Speech Adviser. We hope to get someone to train in the next few weeks so that they feel confident working independently when we leave. This is still up in the air at the moment so we will keep you updated. They did however say that they are happy to get the Smile Train feeding video we found translated into Khmer, so this is small step forward! We hope to get one of our Speech Advisers to provide the voiceover.

On Tuesday morning we visited All Ears Cambodia, an NGO which provides free hearing tests and ear care to people in Phnom Penh. As children with Cleft Lip and Palate very often have associated hearing difficulties, this was a great chance to see where we are referring our patients. We met with Ned, a British audiologist who is head of the training at All Ears. Every two years they take on 10 new Khmer trainee audiologists and help them gain a new profession. We were very impressed by the set-up and we hope to the see the same sort of training for Speech and Language Therapists in Cambodia one day. The afternoon brought us CSC and time with our Speech Adviser Samnang. Unfortunately there were no patients for us to see and this is happening quite regularly so we had a chat with him about how we could organise the way he sees patients. Tim Pring, who started the City-Cambodia Project, came out with us to CSC and wanted to speak to Dr Jim, the founder of the hospital. We had a meeting with them all and we gave Samnang a target of finding at least 10 cleft patients for us to see in our last two weeks at the hospital! (Samnang is at a cleft conference next week and it is Water Festival the week afterwards, so time is running out!)

Wednesday morning was the first Non-Cleft clinic at NPH with Dr Alin. She is growing more and more confident in her skills and is already calling herself a Speech Therapist after her 3 months training in Taiwan. Although she is brilliant at providing speech and feeding advice for cleft clients, she hasn’t had much experience in providing language advice or therapy for children without cleft. The normal protocol would be to refer these on but now she wants expand her skills which is great. We saw about 5 children and informally trained Dr Alin on some basic language assessment. We think it is a great idea to separate the cleft and non-cleft but it is just a matter of making this clear to the patients, who seem to turn up whenever they like!

On Thursday afternoon we went to see Samnang again but unfortunately he was ill. We saw the twins again and gave advice for a little girl who had just had her palate operation. The twins have obviously been practicing a lot, as despite not coming to therapy for the last two weeks, they have improved a lot. This was great news as often parents come to us for a quick fix for their child’s speech, but this Mum seems very motivated and makes sure her children do their homework! Ramaniya, an eye doctor came to help us when giving advice and therapy, as we needed someone to translate for us. We still haven’t learnt much Khmer apart from numbers one to five, ‘mouth’ and ‘nose’! Although it was helpful to have a translator, it is even better when Samnang is here because he can improve his skills as a speech adviser and translate for us at the same time.

A little girl from the NPH Cleft Clinic playing with our new assessment toys!

A little girl from the NPH Cleft Clinic playing with our new assessment toys!

Friday was a busy day like always and we saw about 20 patients between us at the National Paediatric Hospital. It was great to work with Dr. Alin again because we don’t have much time left with her. We also saw the patient’s quicker than usual because we could split up and give advice; one of us working with Chanthy and one working with Dr Alin. Maybe Dr Alin could use her skills to train Chanthy in the future but we will see how this goes. NPH is so busy and it would be great to see the other hospitals having a clinic like this – an aim for future City-Cambodia Cleft teams I think! In the afternoon we saw Chanthy, Dr Alin and all the staff at One-to-One again to give training. This time it was about assessing children’s speech and language and we tested everyone’s discrimination of speech sounds, with mixed results! We have one more training session to do next week and then it is Water Festival and everyone in Phnom Penh has a week off.

We’re 9 weeks in with 4 more to go! To learn more about cleft lip and palate, check out the web site of the Cleft Lip and Palate Association (CLAPA) 

Your cleft team,

Lauren and Kristin

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