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All aboard: speech and language therapy around the world

In August we are celebrating the 75th anniversary of the RCSLT with the theme of ‘Around the world’. While the COVID-19 pandemic has meant that international travel and working trips abroad are no longer the option they once were, collaborating and sharing with international colleagues is easier than ever thanks to the widespread use of technology across the profession. Now, more than ever, is a time for the global speech and language therapy community to come together and celebrate all that we share and all that we can learn from each other.

Speech and language therapy in Ghana

Bulletin caught up with Josephine Ohenewa Bampoe from @SLT_GH on Twitter who told us all about speech and language therapy in Ghana.

Ghana is in the huge, westward bulge of the continent of Africa. It lies just above the Equator and is neighbours with Ivory Coast, Togo and Burkina Faso. The present population is approximately 30 million people. Ghana is a multilingual society with about eighty languages (Wikipedia, 2020). The language for education is English.

Services for people with communication disability in Majority World Countries are limited, however they are gaining much attention in some Majority World Countries like Ghana. Speech and Language Therapy is a relatively new profession in Ghana. Currently there are about 18 registered Speech & Language Therapists (SLTs). The Universities of Ghana and Health & Allied Sciences in Accra and Ho are the two universities currently training SLTs in their MSc and BSc programmes respectively.

Most of the few SLTs in Ghana are found in public hospitals. Although Ghana has 16 regions, SLT services are currently found in only three regions. This means that many persons with communication disability (PWCD) in Ghana have to travel for long distance to access services. Almost all special schools and mainstream schools do not have resident SLTs due to the limited number in the country. There are however a couple of private SLT clinics. 

(pictured: Adelaide Emma Gyamera, Jamila Abdulai, Gladys Akosua Agbeko, Christiana Adede Totimeh, Gifty Ayoka, Ruby Constance Commodore, Bernice Brown, Leticia Afi Gomado, Godwin Tettevi, Getrude Abbey, Malaika Abigail Addai-Sundiata and Abena Asiedua Owusu Antwi)

At the Korle bu Teaching Hospital, Ghana’s premier healthcare facility, there are 6 full time and 2 part-time SLTs. Clients are seen by appointments. As in Minority World Countries, clients are seen initially for assessments following a referral from within or outside the hospital. Clients are booked for therapy where appropriate. After the assessment and where necessary, onward referrals are made. Unfortunately, SLT services in Ghana are not yet covered by the National Health Insurance Scheme, which is a national health insurance by the government of Ghana aimed at providing “equitable access and financial coverage for basic health care services to Ghanaian citizens” (Wikipedia 2020). Persons with communication disability (PWCD) therefore pay for each SLT session.

Often, therapy sessions are initially for an 8- week block. It has however been very difficult for most PWCD to consistently attend therapy due to distance and financial constraints. Although Ghana is a multilingual country, the language used in SLT sessions seems to have been limited to English at the moment.

It has been invaluable to receive support to develop the profession in Ghana from more experienced countries like the UK, Australia and USA. 

(pictured: Nana Akua Victoria Owusu, Clement Amponsah and Josephine Ohenewa Bampoe)

Josephine Ohenewa Bampoe
Speech and Language Therapist/Clinical Tutor
Korle bu Teaching Hospital/School of Biomedical & Allied Health Sciences, University of Ghana
 

Read more here

Jois Stansfield: around the world in 500 words

Speech and language therapy in the UK owes a lot to our international predecessors. 

Europe in particular produced people who formed the knowledge base upon which we built our practice. In the 19th century, these were predominantly men, reflecting the structure of society at the time. Paul Broca (1824-1880) from France, and Carl Wernicke (1848-1905) from Germany both identified areas of the brain vital for language. Manuel Garcia (1805-1906), a Spanish baritone and subsequently voice teacher and innovator, worked in France, inventing the laryngoscope in 1854 to observe the vocal cords directly. Theodor Billroth carried out the first laryngectomy in 1873, with Carl Gussenbauer creating artificial larynxes for his patients. Adolf Kussamaul published Die Storungen Die Sprache (Disorders of Speech) in 1877. Hermann Gutzmann (1865-1922) had a speech and language therapy service in Berlin by the beginning of the 1900s and published a number of books on ‘dysphemia’, or stuttering.

The final name of note in this small selection is Emil Froeschells (1884 -1972) from Austro-Hungary. Following his medical qualification in 1907 he worked with children with speech problems and his Viennese clinic became world famous, offering informal education to interested people from around the world until, as a Jew, he and many others found it necessary to escape from Europe in the 1930s.

In the 20th century the USA became increasingly influential, leading the way on children’s speech disorders through the work of Edward Scripture (1864-1945) and Sara Stinchfield (1885-1977), and in stammering therapy through Charles van Riper (1905-95, who also wrote fiction as Cully Gage). Judy Duchan hosts a website on US (and wider) speech and language therapy history for those interested (bit.ly/2Za5D4C).

The early British speech therapy registers indicate that a small number of therapists moved abroad, mainly (although not exclusively) to English-speaking countries, contributing to the development of the profession in Australia, New Zealand and Canada. Meanwhile the Bulletin and Journal indicated an interest in international developments over the years, with articles on Fiji, Ghana, India, Indonesia, Kenya, Nicaragua, Russia, Pakistan, Paraguay, St Lucia, Singapore, Sri Lanka, Tanzania and Uganda, as well as (other) English-speaking and European countries.

The profession formed national and international bodies to off er professional support. The International Association of Logopedics and Phoniatics (IALP), whose current President is Professor Pam Enderby, was formed in 1924, with early membership from Austria, Germany, the UK and the Netherlands. Today it represents national associations almost from A-to-Z: Australia to the USA (although disappointingly not Zambia or Zimbabwe) by way of Brazil, Egypt, the Philippines and Taiwan. More recently (1988), European colleagues formed the Comité Permanent de Liason des Orthophonists-Logopèdes de l’UE, more easily known by its acronym CPLOL. Both of these organisations run conferences bringing together a multitude of colleagues, languages and ideas.

Cultural competence is essential in any speech and language therapy service, and there is a growing body of literature from across the world on what works where. International communication, whether face-to-face or virtually (more necessary in recent times), can benefit our services by opening our eyes to different approaches and beliefs.

Jois Stansfield, emeritus professor, Manchester Metropolitan University

Illustrations 

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