Hello! 

Muli Bwanji?

As the past year has been filled with lots of contracts and adventures, it is time I come back to writing to share it all!

It has been long awaited…. but I am living in ZAMBIA!! (Or for at least 6 months). Currently, I am volunteering with Catholic Medical Mission Boards as a speech-language pathologist to provide speech therapy services. The project I am working on is specific to children with disabilities regarding feeding and swallowing difficulties, as well as advocating for speech therapy in Zambia. 

During the work weeks, I have the opportunity to visit three different hospitals and clinics to provide speech therapy services. These facilities include University Teaching Hospital (UTH), Kanyama Level 1 Hospital, and Chawama Level 1 Hospital.

At UTH, I am providing support and education to the healthcare worker providing services in the speech clinic, in addition to caregivers and parents of children with disabilities. Here, we see pediatrics ranging from ages 4-months to 11-year-olds with various disabilities, such as developmental delay, speech and language delay, expressive and receptive disorders, autism spectrum disorder, cerebral palsy, and down syndrome.  Typically, children are seen for group therapy at least once a week for speech therapy services.

At Kanyama Level 1 Hospital, I help with educating physiotherapists and providing speech therapy services during the paediatric clinic for children with disabilities once a week. These disabilities include (mostly) cerebral palsy and down syndrome with ages between 7-months and 8-years-old. Due to the number of children, limited therapy time, and lack of materials/toys, I have developed a home program for both feeding/swallowing strategies and communication strategies. These home programs have pictures and easy-to-follow recommendations for parents to use at home with their child. During the time of the clinic, I provide education and handouts to parents based on the parent-report evaluation with the recommendation to provide feedback the next time the child comes for physiotherapy.

Although the project aims to assist children with disabilities, Kanyama Level 1 Hospital has a large number of stroke patients with speech and language deficits. Currently, I have seen 5 stroke patients with weekly or bi-weekly check-ins and/or speech therapy sessions. Based on the assessment, I provide a home program for the adults and caregivers/families to complete at home. It is recommended these individuals come weekly or bi-weekly, depending on transport and availability.

Chawama Level 1 hospital is very similar to the Kanyama Level 1 Hospital, where I continue to educate and support the physiotherapists and provide speech therapy services during the paediatric clinic for children with disabilities once a week. The primary disability seen is cerebral palsy with ages ranging from 2-years to 11-year-olds.  After the parent-reported assessment is completed, I provide recommendations with a home program based on the needs of the child. It is recommended to provide feedback and questions either weekly, biweekly, or the next time the child participates in physiotherapy.

Throughout the years of the project, Access to Health Zambia has collaborated with SPOONs, an organization based out of Oregon (USA) that focuses on providing nutrition and speech therapy services to children with disabilities relating to malnourishment. This education and knowledge was also provided to Special Hope Network, a local NGO within the Lusaka area providing special education services to children with disabilities. Special Hope Network continues to use the SPOONs resources to provide cooking demonstrations for caregivers. I had the pleasure to attend a few demonstrations to assist with feeding and swallowing questions, including positioning, chewing, and any other feeding/swallowing challenges.

Lastly, I am working on advocating for speech therapy in Zambia. At this time, there are 3 certified speech-language pathologists in Zambia (all within the Lusaka area). Although this field is still a novelty in this country, it continues to slowly grow. Now, speech therapy is recognized by the Ministry of Health, Health Professions Council of Zambia, and Zambia ENT, Audiology, and Speech Therapy Society. Our goal is to improve the knowledge and raise awareness of the importance of speech therapy in Zambia!

Within the last three months, there have been several challenges and learning curves, such as understanding a new culture, learning the operations of hospitals/clinics, and adjusting ‘typical’ speech therapy sessions. However, with the support from CMMB and Access to Health Zambia, I feel we are making great strides to expand the education of speech therapy and provide services to those who need it.

I look forward to continuing the work we have started, learning from the Zambian people, and exploring this beautiful country!

Zikomo!

Abbey Pratt M.S., CCC-SLP