We arrived at the very modest ENT (ear, nose, and throat) “wing” of the Korle Bu Teaching Hospital early this morning to meet Albert, who is one of the two speech-language pathologists in all of Ghana. He is an elderly man in his 70s, with eyes that smile through is rimmed spectacles, and although he retired ten years previously, he has been working through his retirement because there is such a shortage of SLP services in Ghana. Albert travels weekly between Accra and Kumasi, a five-to-six hour drive, so that he is able to provide services at both hospitals, Korle Bu and Komfo Anokye. His dedication to the people of Ghana is so inspiring, and it’s truly an honor to collaborate with him.
After walking through formalities and snapping a group photo, our team was divided into small groups, ours supervised by Dorothy. We assessed and provided recommendations for a number of clients, mostly children whose parents’ concern ranged from lack of spoken words to disturbing behaviors to illiteracy. We also evaluated several adults with various disorders. It really took us a half an hour or so to get our feet on solid ground, working out the kinks of assigning roles, covering assessment bases, and working with translators when necessary. Each evaluation began with an interview to assess main concerns of the parents or the patient himself, which was followed by clinician interaction with the patient to determine age-appropriate skills that were or were not present. As clinicians, we discussed sustainable strategies and treatment, then shared our recommendations with the parent, modeling the various activities and techniques with the child.
Our first client of the day was 4 year-old Kalib, who presented with speech characterized by jargon, rote language, and decreased social intent. Though his creche (preschool) teacher expressed no concerns, Kalib’s mother described him as “always wandering, never interacting with other children, and always placing items in his mouth.” Kalib regularly followed simple directions such as “close the door” and “get the big cup”, but did not respond to “who” or “where” questions, make eye contact with people speaking to him, or use language to request objects or actions -- all skills that should be well established in typically developing children; also all typical characteristics of children with autism.
We came up with various therapy techniques to stimulate and encourage language, all simple and low-tech so that they could be carried out by Kalib’s family members at home and in their everyday environment. Kalib’s mother was incredibly receptive and grateful for our suggestions, and expressed that she believed these approaches would be motivating and fruitful for Kalib. Additionally, we provided her with flashcards (easily replicated in case of loss, as we had created them during the session with markers and cardstock) so that she could use AAC (augmentative alternative communication) to facilitate Kalib’s language development.
After a rewarding first day of seeing patients, we were taken by George to a local fabric market where we could select fabrics, and have tailor-made outfits customized for us. What was most exciting was browsing the selection with Miriam, one of our clinical supervisors, who is choosing a fabric for her wedding gown!
As for myself, I selected a gorgeous mustard-yellow and white floral swirl print, what I’d like to call “Anthropologie-meets-Africa”, for a flowy skirt. It was a quite a bit more than I’d hope to spend on fabric, but the purchase was justified by the fact that I’ll probably never again have the chance to have a custom-made skirt from Ghana, right?
The seamstress is here taking our orders and measurements, while we watch ourselves on national television. Unreal. This is a huge thing for speech/language pathology in Ghana! As for us, we’re quite a silly bunch, with our cameras in hand, snapping photos of the screen. :)
11:34 pm
So as I showered tonight, one hand holding the spout above my head and the other hand lathering shampoo into my hair (normal), the water pressure gradually decreased until there was only a trickle slowly dripping from the spout (not normal). I finished off my “shower” with bottled water, and joined my team to find that our entire hotel is waterless. Quite the predicament. Cate has made the executive decision – we’re switching hotels in the morning. Farewell, Yegoala!
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