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Ghana — Great Strides in Speech and Language Therapy

A group of Ghanaians take a selfie with the author.

A short lecture, ending the day at the British Association of Head and Neck Oncologists’ (BAHNO) Annual Scientific meeting in May 2015, has led me to become involved in inspiring and exciting work in Ghana — mainly with head and neck cancer patients, but also more widely with any patients needing speech and language therapy input at Korle Bu Teaching Hospital (KBTH) in Accra, Ghana’s capital.

Ghana, which lies on the coast of West Africa, has a population of around 27 million. Until 2018 there were just three qualified speech and language therapists (SLTs) for the entire country, plus occasional help from overseas SLTs working in National Government Organisations or private concerns. The three SLTs are all based at KBTH. This hospital is famous as a highly respected tertiary referral centre for West Africa and is the third largest in sub-Saharan Africa.

Several years’ work on the part of these three SLTs, plus an ex-patriot Australian, have culminated in the establishment of a two-year, post-graduate SLT training programme under the auspices of the University of Ghana at KBTH. This is a fantastic achievement, and with the first cohort of students graduating in August 2018, Ghana now has 15 therapists!

In March 2016, when I first arrived in Ghana, the aim of my visit was to see how to improve links between the Ear Nose and Throat and speech and language therapy departments, and also the surgical wards and SLT, involving nursing staff more in the rehabilitation care. Two of the overriding problems for patients are finance and transport, with the vast majority having to fund themselves. This means that while they may be able to bring together the cost of an intervention and all the diagnostics that goes with it, they may be unable to have as frequent follow-ups as we might wish for… so the more that can be instigated during their hospital stay, the better.

Two of the overriding problems for patients are finance and transport, with the vast majority having to fund themselves.

Realising that I was equipped with the right background skills, knowledge and clinical/ teaching experience, the SLT department invited me to be one of several specialist overseas lecturers for the new graduate programme. In February 2018, I delivered the head and neck cancer teaching, including laryngectomy (surgical removal of the larynx) to the first cohort of students. This was an honour and a privilege. It was also a challenge to devise my own course, pitch it at the right level and, above all, equip the students with the skills to tackle any patient coming into their clinic, post-qualifying. I also arranged to run dysphagia (swallowing difficulties) workshops for the surgical ward nurses. The uptake was incredible — and most encouraging. I am always struck by their keenness to learn.

Going forward now, there are even more exciting developments. BAHNO has, as one of their primary two to five year objectives, a programme to improve head and neck cancer outcomes in low to middle income countries (LMIC) as they are known. This programme is in the early stages; BAHNO hopes to secure a £7 million grant from the Global Health Research Institute and use this to establish low-cost, high-impact interventions. BAHNO’s priorities will be informed by asking professionals and patients in the countries concerned what would most help and then collating this information into five discrete categories. The plan is that Ghana becomes one of three exemplar countries.

My work was, to my total surprise, but great delight, acknowledged with a Giving Voice Award from the RCSLT in October 2018. This was completely unexpected and will be treasured. More importantly, it puts the work and needs of my colleagues and patients in Ghana on the radar.

Jane Dawson
Queen Victoria Hospital NHS Foundation Trust
United Kingdom