The City Cambodia Project is a collaboration between City, University of London and organisations in Phnom Penh, to share Speech and Language therapy approaches and improve the standard of care of speech and language therapy in Cambodia.
This year marks the project’s 11th instalment.
CLAPA are lucky enough to be able to share the experiences and insights of this year’s UK participants, Louisa and Megan over the next 14 weeks.
Susaday from Cambodia!
We are Louisa and Megan, two Speech and Language Therapists from the UK.
We are volunteering in Phnom Penh for 3 months as part of the 11th team to visit Cambodia from City, University of London. We will be working in various hospitals and clinics, hoping to raise awareness of Speech and Language Therapy in the area, and empower the locals to continue the work when we leave.
We arrived one week before we starting working, to give us time to find somewhere to live and acclimatise to our new surroundings. Phnom Penh is a sensory overload compared to London! The vast amount of noise, smells, colours and sounds is amazing…although the sensations aren’t always pleasant. Due to serious cases of jet lag and the 33-degree heat, we cheated at flat hunting and secured the same accommodation as last year’s team. Easy-peasy! We spent a few essential days nesting, resting and getting ourselves ready for our first week of work. We did find some time for exploring and socialising too.
Our first location was Children’s Surgical Centre (CSC) and we arrived at the hospital bright and early for the 8am meeting. It was interesting to develop our understanding of the services the hospital provides by observing the MDT meeting and hearing case histories from patients waiting for treatment. We were introduced to the founder of the hospital, Dr Jim and Samnang, a Speech Advisor who has been working with the cleft team in recent years. Samnang informed us that now he is a doctor and spends less time doing speech therapy, so most of our time will be spent with Vin, who last year’s team began training with too. We also met Christine the admin officer, who gave us some much-needed free coffee!
We thought the best way of getting to know Vin and the setting was to observe her at work and do some joint sessions. We asked her to teach us the pronunciation of all the words in the KASS (Khmer Assessment of Speech Sounds devised by previous City Cambodia teams) so that they would be familiar when we complete the assessment with clients ourselves. Vin found our attempts incredibly amusing and this was a nice way to break the ice.
Our second day at CSC began with each us of presenting a 3 minute ‘all about me’ presentation to the entire MDT. A question raised by one member of staff was how we were able to teach language in Cambodia when we do not speak the native tongue. This is a common misconception experienced by the both of us in the UK as well, as we are often mistaken for elocution or language teachers when we tell people our job title. This was an important learning experience and highlighted the importance of explicitly explaining our role when we meet new people, that we are not here to teach language but focus on the development of communication and specific speech sounds.
We were curious to find out Vin’s long-term plans with speech therapy, so we had an open discussion about her current job and her hopes for the future. We also found out Louisa and Vin have lots in common (like their love of Taylor Swift)! After our first 2 days together, we’re looking forward to developing both our working relationship and friendship with Vin.
On our third morning of work we attended the National Rehabilitation Conference, held at National Paediatric Hospital, a setting we are hoping to work in more in the weeks to come. The focus of the conference was on an MDT approach to rehabilitation, and it was interesting to hear about efforts to further MDT working in Cambodia. There were also speeches and personal anecdotes from NPH staff and we learnt an inspiring message about not giving up on something you believe in from Raphael, an Occupational Therapist. Raphael initially came to Cambodia on a temporary volunteering basis and has ended up staying for years, playing an instrumental role in the development of a new rehabilitation centre at the hospital. We were lucky to have tour around the centre and meet speech therapists, physiotherapists and occupational therapists working for other non-profit organisations.
In the afternoon, we had an initial meeting with the Director of ‘All Ears Cambodia’, a charity providing treatment to adults and children with hearing impairment. This is a new setting for the cleft team, decided because of the clinical overlap between cleft palate and hearing impairment. We were shown around the very meticulously tidy and well-equipped office, and discussed exciting opportunities for collaboration with the charity, including provision of training in clinical skills such as assessment and basic therapy.
Thursday was spent preparing for the smile mission we were to leave for the following day. Smile missions involve a group of volunteers (surgeons, nurses, anaesthesiologists, biomedical engineers etc) visiting hospitals in different provinces to complete as many cleft lip and palate repairs as possible. We looked over the incredible supplies of resources developed by past teams and set off to make hundreds of copies, anxiously debating how much it was going to cost. The family who owned the shop were lovely, although very bemused by the two slightly stressed English girls making hundreds of copies of Khmer leaflets. We needn’t have worried either, as the bill came to a very inexpensive $7.
Week 3 is technically a continuation of Week 2, as we left for the mission on Friday morning and are working through until Thursday. Despite us both being incredibly tired when our alarms went for our 7am departure, the warm welcome from the Smile Cambodia team made it so worth it.
In the morning, the team was briefed by the lead surgeon and the various stations set up. When families arrived, the client was screened by nurses, paediatricians, surgeons, dentists and us, before having their photographs taken and being scheduled for surgery. We saw a total of twelve patients, between the ages of 3 months and 22 years. Unfortunately, due to torrential rain and flooding in some parts of the country, this mission was much quieter than expected and had to be called off a couple of days earlier.
Our sessions began by taking a case history from the client or their parent. This covered their general health and development, before exploring more cleft specific questions about speech and feeding in babies. If clients were old enough, we used the KASS to assess their speech sounds, in order to give some specific therapy techniques for after their surgery. This included training front sounds and using visual or sensory feedback to develop oral, rather than nasal, airflow. This was very fun to do with younger children, who particularly enjoyed our demonstrations using bubbles! We worked with a wonderful medical student called Chhora, who translated our sessions for us. She was very interested in SLT and we used the down time between patients to develop a training session, in Khmer to deliver to her and some of the other volunteers. We wanted to give them some more information about our role, both in general and on Smile Missions. Also, as there is not always an SLT on these missions, we wanted to provide Chhora with as much information as possible, so that she may be able to provide families with basic advice on future missions.
This was a wonderful experience, in which we learned a lot. It was a shame that it was cut short and we are thoroughly looking forward to joining them for their next one.