Tackling Cambodia’s desperate need for speech therapy

Tackling Cambodia’s desperate need for speech therapy

Cambodia does not have a single qualified speech therapist, despite a pressing need to treat symptoms that affect more than half a million people in the country.

PHNOM PENH: When her daughter was born with Down syndrome, Yu Kanha was left in despair.

Life can be a constant challenge for many poor families in Cambodia as it is. She knew that nothing would come easy for little Serey.

“When I talk about this story, I always cry. We have many difficulties,” she said, sitting on a plastic seat in a classroom in Phnom Penh.

Serey is now 14 years old. As she cut, glued and drew with colourful pieces of paper, surrounded by other children with extra needs at Phoum Russey Primary School, she smiled and laughed. In this environment, she was happy.

“She likes to study. She learns how to read and sing. The teacher also teaches her how to greet people, like saying hello. So when we go home, she practices it,” Kanha said.

But experience had proved that this was just a brief escape from the realities of living with a disability. As she forewarned, tears came easily when Kanha spoke about Serey’s future.

“There is no hope. If my child doesn’t have me or her father, she won’t have anyone to depend on. I just want my child to have a good life.”

Central to Serey’s ability to cope, as a child or adult, is her ability to communicate. It is a struggle for her, and many of the other dozen or so children in the class. And they are just a fraction of the individuals in need across the country.

Yet, Cambodia does not have a single qualified speech therapist.

Weh Yeoh is trying to change that through a programme launched in mid-2013 - OIC Cambodia - specifically targeting communication. The Australian estimates, based on general global statistics, that about 600,000 Cambodians are in need of speech therapy - an issue that often goes hand-in-hand with disabilities like Down syndrome and autism.

“It’s not the number of people that’s unusual in this country, it’s the response to that percentage of people, where there really isn’t anything for them,” he said.

“If you can’t communicate, you can’t really do anything. It’s difficult to get into school if you’re a child, it’s very difficult to find friends, it’s difficult to get a job and become a productive member of society.”

Dedicated classrooms for children with a disability are rare in Cambodia, despite the need.

Speech therapy can also assist people suffering from the more severe condition known as dysphagia, where swallowing becomes difficult and food and liquids can end up in the lungs, potentially leading to pneumonia and death.

Official statistics for the number of Cambodians suffering from swallowing problems have not yet been gathered, but Yeoh admits that dysphagia could be a common silent killer among the population.

In response, the centrepiece of the programme is to create a university course that will eventually roll out a wave of locally-trained experts - specifically, 100 of them by 2030 when OIC plans to exit the country.

Funding and support for disability has historically been haphazard in Cambodia, often relying on inconsistent foreign non-governmental organisations (NGOs) and favouring more visible physical disabilities - an issue OIC wants to address by partnering with the government.

“We have a Cambodian-owned solution. Everything is integrated into government from day one, we don’t want to be flying in and flying out,” Yeoh said. “We try and take a holistic view of the entire profession and help the government to create these basic pieces of infrastructure so the profession can survive.”

The government is supportive of the plan to boost its ability to respond to a pressing health need and has forecast including speech therapy under the umbrella of the Ministry of the Health.

“We do understand about the condition and the difficulty for people who have the difficulty of speaking in Cambodia,” said Em Chan Makara, the secretary general of the Disability Action Council.

“We encourage students who want to start considering the specific skill of speech therapy. If we do have a training school for speech therapy, it will be the best way.”

Training has already begun in pilot programmes across half a dozen provinces in Cambodia, through OIC and other partner organisations like the Centre for Child and Adolescent Mental Health and Komar Pikar Foundation (KPF). The teachers at Phoum Russey, including Heng Sophorn, have received basic speech therapy skills to help children like Serey.

Heng Sophorn has received basic speech therapy training to assist children's learning.

“I studied how to teach special children a lot, for example, how they should speak, eat and behave. I also studied how to educate them and, most importantly, how to protect them,” Sophorn said.

As the 30-year-old moves through the classroom, the demands of her role are clear. She is patient as children shout and run, supportive when they show frustration and encouraging when they do well.

“People help other kids a lot but not kids with special needs,” she said. These children have rights just like other children.

Her dedication and expertise are still rare in a country that carries rampant prejudices and slim opportunities for those with a disability. Stigmas are hard to overcome though, even among the parents of children receiving assistance, said KPF project supervisor Ham Sophal, himself someone who identifies as a person with a disability.

“If they're at home, they're alone. Some families try to block them or tie them up so they don't go out. They're scared. They think no one will want to play with them,” he said.

“Here they can communicate and play. They can also make good relations with the other kids outside. They have friends.”

As Serey walks through the school playground holding hands with her mother, she strikes as a young woman growing with confidence - part of a future generation for whom life, possibly, might be a little easier.

Source: CNA/jb