Week 6 – Beginning 10th October
Children’s Surgical Centre
We saw two patients at the cleft clinic on Tuesday. One patient was attending a follow-up after a repair of the soft palate. As she had hypernasal speech, Samnang provided early speech advice and we gave the family ideas of games to play at home to help the child distinguish between oral (mouth) sounds and nasal (nose) sounds. We then saw one of the twin boys that we met last week. We carried out the Khmer assessment of speech sounds (KASS) which revealed hypernasality and difficulties with a number of speech sounds. We’ve scheduled a therapy session next week to help address his speech difficulties.
National Paediatric Hospital
We spent Wednesday and Friday morning at NPH with Dr Alin. On Wedne sday we did some informal speech assessments, provided advice to parents and scheduled follow-up/therapy sessions. Friday was another busy cleft clinic at NPH. Astonishingly, we managed to see 20 patients in 3 hours!
Khmer Soviet Friendship Hospital (KSFH)
On Thursday we were joined by our visiting professor Tim Pring and Speech and Language Therapist Himali de Silva. Together we liaised with Dr Mok Theavy, a plastic reconstructive surgeon, from Smile Cambodia at the Khmer Soviet Friendship Hospital. KSFH do not currently have a speech advisor but are keen for us to train a member of their staff to provide speech and language therapy services. We were faced with a daunting list of over 1000 patients who had previously been seen for cleft surgery at KSFH. We began to create a list of patients to call who may require SLT input but this was a lengthy process. Dr Theavy then informed us that a patient was waiting to see us, which was a surprise as we had not scheduled any appointments. We carried out a case history with the family via an interpreter which revealed that the 6 year old girl was non-verbal and had recently had a diagnosis of Autism. The family had travelled 6 hours from Siem Reap as they were desperate to help their daughter. We were able to provide them with advice to help develop their daughter’s communication skills and we are now in contact with a school in Siem Reap, which has a specialist unit for children with additional needs. We hope that the school will help the family as we saw such communicative potential in the little girl after only spending a brief period of time with her.
With some help from Himali we were also able to provide some feeding advice to a family with a new born baby who was having difficulties feeding due to a soft palate cleft. The family were very anxious and thus very grateful to receive some hands on feeding advice. For example, we advised to massage the breast when breast feeding to help increase the flow of milk and if necessary to use a squeeze bottle as infants with cleft often struggle to create the right amount of pressure needed to suckle milk.
Our first training session at one-2-one was a success! We did an introductory session and revisited some topics covered by the 2015 cleft team. We were able to liaise with Dr. Annie who is keen for us to continue our training over the next 8 weeks. We are also keen to shadow the One-2-One team on their outreach working in the slums of Phnom Penh. Such collaborative work will help us understand how the team works and also enable us to tailor our training to the teams needs and for us to have an appreciation of what knowledge and advice will be most useful.
Overall, we’ve had a busy and productive week and we’re feeling positive after an initial slow start to work.