“While I sit in the hallway of the Tamale teaching hospital in Northern Ghana, the noise from the busy street below forces me to lean closer to hear one of more than 240 children gathered to be assessed by international speech-language therapists. Through interpreters, we desperately try to ascertain articulation and nasality, and ultimately understand communication here in Ghana, where there are more than 250 different languages and dialects.”
Louise Edwards, Advanced Specialist Speech & Language Therapist
Cambridge University Hospitals NHS Trust, UK
Operation Smile Volunteer
Sitting in an external hallway of Tamale teaching hospital in Northern Ghana, the humidity is sending trickles of sweat down my back. The noise from the busy street below forces me to lean closer because before me is one of more than 240 children gathered to be assessed over the next two days by international speech language therapists/pathologists, including myself. Through interpreters, we desperately try to ascertain articulation and nasality, and ultimately understand communication here in Ghana, where there are more than 250 different languages and dialects. Listening really is one of the greatest skills and gifts a speech therapist can have.
From the moment I land in the country I am listening, getting a sense of the resonance and articulation. Ghana is somewhat easier than some of the more challenging countries I have volunteered in. The resonance in Ghana is not dissimilar to English—when compared with countries like Cambodia that have a majority nasal resonance.
My Time in Ghana
Whilst our focus during a project is from a cleft lip and palate perspective, the reality is actually much more. This is an opportunity to teach, share, and change the perception of communication and feeding and swallowing.
During my time in Ghana I was one of three speech and language therapists/pathologists (Liisi Raud Westberg from Sweden and Salmah Kola from South Africa) working together to ensure change and learning. Our professional title was one of the many subjects we debated that ultimately enabled us to learn and share our experiences, not only professionally, but also culturally. I gained so much understanding from the other therapists—working with Liisi in a busy Cleft and Craniofacial Centre, and with Salmah in a similar acute paediatric setting as the one I was working in.
One of the most humbling experiences in Tamale was entering a school of welcoming and enthusiastic students. We took the opportunity to discuss speech and language development with teachers. Classes with at least 70 pupils squeezed together on benches, children singing nursery rhymes and the alphabet in return for stickers. The walls were bare—no toys lay discarded in the ‘playground’—but the smiles were infectious and the eagerness to practice English clear.
Joining a ‘Pioneering’ Class of ‘Forgotten’ Children
We were asked to join a reportedly ‘pioneering’ class of ‘forgotten’ children. The head teacher informed us there are around 14 children from the area that attend this class. She was proud of the class and the teacher that clearly understood his pupil’s needs. This was the only special needs class in the area. Their lessons included activities of daily living and art therapy.
Five children were in attendance—each with different needs. The teacher explained that not all pupils come to class each day. We were requested to support in any way possible—simple things like encouraging a ‘dab and roll’ technique for a drooling teenage student, and discussing the importance of pictures and gesture to augment communication for all the pupils (but specifically for two children with Trisomy 21). Mixed emotions filled me as I left that classroom, eager to stay and do more, but incredibly moved that change was happening.
The Future of Speech & Language Therapy in Ghana
I am excited about the future of speech and language therapy in Ghana, with the initiation of the first MSc Speech and Language Therapy at the University of Ghana in Accra—one of five qualified SLTs in Ghana—by Josephine Ohenewa Bampoe and her colleagues. I believe that non-governmental organisations, such as Operation Smile, also contribute to this important change—not only ensuring that repaired smiles are left behind, but also skills and knowledge.
I recognise that we are not all in a position to volunteer abroad and use our skills, but I am proud to represent the Speech & Language profession, particularly in a country that is only just starting on its journey to developing and ensuring a future of communication, and feeding and swallowing support. I believe it is not a selfless act of giving up my free time, but as you can see I do truly gain from this experience—skills I believe to be applicable to my ever changing diverse and multi cultural clinical caseload in the UK and hopefully with future voluntary projects with Operation Smile.