Sri Lanka has a population of 21.7 million (2018), with 1.6 million people regarded as disabled (2012). In this, 180,833 people are said to have communication difficulties. Like most people with disabilities, people here also face a lot of significant stigma and discrimination. The main causes include poor hygiene, lack of medical care, the prevalence of a 30-year-old Civil war (which ended in 2009) and the after effects of a tsunami in 2004.
Speech and language therapy as a profession began in 1991, and there were diploma courses for people to get trained to become therapists. Since 2008, speech and language therapy is a four-year degree at The University of Kelaniya (Ragama) called the Bachelor of Speech and Hearing Sciences where one can specialise to become either a speech and language therapist or an audiologist.
Speech and language therapy is still a growing field in most majority world countries, including Sri Lanka. Most people are not even aware of the term ‘speech therapist/ pathologist’. Around 75 per cent of the population speak Sinhalese and the rest speak Tamil. There are only about 300 speech and language therapists across the country, with most of them coming from the Sinhalese speaking population. This is a huge disadvantage in Tamil speaking areas, which were most affected during the civil war. Speech and language therapy services are being offered by hospitals and schools run by the government and also by private clinics in important cities.
Most people do not understand the importance of speech and language therapy and the concept of time, effort and patience needed to battle a communication or a swallowing problem.
Lack of awareness and ignorance are two significant problems that we, as speech and language therapists here, are trying to overcome. Most people do not understand the importance of speech and language therapy and the concept of time, effort and patience needed to battle a communication or a swallowing problem. The parents of children with communication difficulties do not recognise their potential and limit them in all possible ways.
Communication is not recognised as a basic right but as a privilege and the parents take it upon them to communicate on their behalf. It is clearly frustrating to the child and to the parent. Most children are not given any sort of intervention or education. To even convince them to bring them to therapy is a huge feat that we are trying to advocate for. To add to this, as a consequence of the war, poverty is an issue. Most families do not even have the transportation funds to bring their child in for therapy.
Sri Lanka’s speech therapists, teachers and parents could benefit from hands-on training from experts specialising in different communication and swallowing difficulties and disorders. New ideas and approaches to creating awareness and advocacy are always welcome. Here is to hoping for a better future with better communication for you, me and everyone!
Speech and Language Therapist & Audiologist
District General Hospital