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Making a Difference in Botswana

Children in Botswana

“[Working in Botswana] I saw the significant difference that we can make in the lives of children as speech language therapists—simply by educating parents, caregivers, and educators, as well as providing them with strategies to connect and communicate.”

Niki Reid

“Welcome to a country that is very under resourced. We have to make do with what we have.” Those were the words spoken to me by Mma Mariri, a private speech language therapist in Gaborone, Botswana. Truer words could not have been spoken.

Last year, I embarked on a journey that would change my perspective of speech language therapy (SLT) and the very real impact it can have in children’s lives.

I finished my SLT degree and wasn’t sure of the career path I wanted to take—or if I wanted to even be a speech language therapist at all. I thought I’d take some time out and do volunteering in Botswana for six months. I didn’t intend to do SLT, but once I arrived, the need was so overwhelming I couldn’t help myself.

Discovering New Methods of Service Delivery
I volunteered with two private speech language therapist, Miracle and Mma Mariri, in the metropolitan city of Gaborone, where most people spoke some English. The biggest difference I found between New Zealand and Botswana was the method of service delivery. Both Miracle and Mma Mariri had set up their own preschools that only take children with special needs, including autism, Down syndrome, global developmental delay, and children with behaviour difficulties that no other preschool would accept. They offer intensive therapy, including occupational therapy and a neuropsychologist, as well as specialised teacher support. They believe this is the best way to target early intervention, and also provide service to lots of children who are missing out because of the demand on the Ministry of Education (MOE) speech language therapist.

There are three MOE speech language therapists to service the whole country of Botswana—that’s half the population of New Zealand, but double the land size. So after initial assessment, children are given a brief management plan with a plan to follow up in the next 12 months. Sadly, often this follow-up does not occur. Working with Miracle and Mma Mariri in private practice was a great learning experience, and very inspirational to see how speech language therapists are taking initiative to address the need for early intervention.

Working at a Vastly Under Resourced School
My life changing experience was working in a rural village at the Anne Stine Special School. I arrived to work with a teacher overflowing with questions about a new diagnosis that a lot of children had been given—autism. The school had been inundated with children with autism, as well as children with other disorders, but only had two teachers and one teacher’s aide. They managed their caseload by splitting the school into two—a class of 10 children with autism, aged eight to 13 years old; and a class of 22 children with Down syndrome, global developmental delay, cerebral palsy, and other syndromes, aged seven to 13 years old. “Under resourced” was an understatement.

After observing and talking to the teachers, it became clear that their biggest need was help with their class of children with autism, so I decided to focus on helping this group of students. First, by educating staff and parents about autism; and second, by brainstorming practical ways to support their child’s behaviour, language, and learning.

Step One: Educate
I was given the wonderful opportunity of presenting about autism at a parent and teacher workshop. A Motswana occupational therapist who was also presenting at the workshop acted as an interpreter for me, which was great because he could explain some of the medical and development terms in a way they could understand. This was actually more challenging than it sounds. I was fairly confident in my knowledge of autism spectrum disorder (ASD) and strategies to try, but relating these strategies to a rural African culture and lifestyle was really difficult.

Step Two: Practical Support
I visited the school weekly for a few months, helping the teachers and teacher’s aids implement strategies and incorporate language activities into their daily schedule. They were desperate for resources, so I left a USB with copies of simple resources I had collected over the years. Thankfully, they had access to a computer and printer.

Education is Key
My experience at Anne Stine changed my life. I saw the significant difference that we can make in the lives of children as speech language therapists—simply by educating parents, caregivers, and educators, as well as providing them with strategies to connect and communicate. This is certainly only the beginning of addressing the huge need for intervention in developing and third world countries, but at least it’s one step towards improving the quality of life for these precious, beautiful children.