Speak Out June 2018

Creating swallowing awareness in Cambodia An Australian volunteer’s perspective

A ustralian speech pathologist Geraldine (Gerri) Harris was inspired by the people of Cambodia on a family holiday; a trip that saw her return almost a year later to share her skills and expertise in dysphagia management. Gerri successfully applied for a Speech Pathology Adviser position through the Australian government’s Australian Volunteers program. The 12-month assignment was based at The Calmette Hospital, an adult tertiary hospital located in Cambodia’s capital, Phnom Penh. Gerri’s assignment objective was to strengthen the capacity of hospital staff and develop and implement a new speech therapy service that included FEES competency. Gerri’s assignment was created by Speech and Swallowing Therapy Cambodia (SSTC) on behalf of the hospital administration. Having recently returned to Australia, Gerri shares some of the challenges, rewards and achievements from her time volunteering in Cambodia. Following a review of records for the 60-bed neurology unit, it quickly became apparent to me that few screenings for swallowing difficulties were being performed. In a hospital with over 1,100 stroke admissions per year, the need for a consistent service for dysphagia management was evident. I was also amazed to learn that patients’ families were often responsible for providing all physical care, meals, fluids and even bedding. With my objectives clearly defined, I developed training for hospital staff and produced resources to ensure Calmette was equipped to provide services for the long-term. Some key developments included: • creation of culturally sensitive translated materials for staff, patient and caregiver education, including handouts on therapeutic exercises and compensatory techniques, • establishment of a very simple process for record-keeping and tracking patient outcomes that was embedded into the hospital’s operations,

• leading the collaboration between Camlette and SSTC on a dysphagia short course for doctors, nurses and physical therapists, including revision and translation of a complete set of lectures, creation of recipes for modified fluids and three videos on safe swallow strategies. This also included coordination of a clinical component supervised by six international volunteers. Despite challenges, we achieved significant progress together. Eighteen trainees in the Bachelor Bridging Program for Physical Therapists at the Technical School for Medical Care have now learned how to complete dysphagia screenings and two thirds of them are likely to complete further training in dysphagia management. When recalling the highlights of life in Cambodia, the obvious comes to mind. It was the glorious weather, the bustling streetscape and relaxed pace of life, to name just a few. However, my favourite thing was the genuine nature of the Cambodian people, who are always willing to share a smile and spend time with other people. Family and relationships are valued above all else, remaining steadfast through the devastating Khmer Rouge regime. I want to acknowledge the support of family and friends who helped make the project successful, including the Speech Pathology Department at Sir Charles Gairdner Hospital, and volunteers at SSTC: Stacey Arthur; Katherine Watson-Short; Paula Espinosa; and Elizabeth Chafouloff. Special thanks also go to other international volunteers Alannah McCague, Rosalind Burgess, Kendall Stone, Clare Park, Erin Maruzzella, Nicole Lorenz and Alice Smith–all who gave up their holidays and self- funded their flights to help make the program a success.

Geraldine (Gerri) Harris Speech Pathologist

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June 2018 www.speechpathologyaustralia.org.au

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