A Gift of Speech03 Feb 2014
Singapore International Foundation (SIF) and Caritas Centre for Children and Adolescent Mental Health (CCAMH) in Cambodia worked on a five-year partnership to enable a team of seven Singapore specialist volunteers to train 48 Cambodian trainees, enhancing the professional practice of the treatment and care of children with feeding and communication problems. The partnership recently concluded in November 2013. These trainees will now apply their new knowledge and skills to teach their professional counterparts and treat an estimated 2,800 children in Cambodia.
SIV and Volunteer Team Leader Michelle Tham demonstrating some of the foods that children with feeding problems can handle better.
Speech therapy SIV team training their Cambodian counterparts in feeding and communication strategies for children.
Cambodian trainees proactively leading the class during speech therapy training.
1. First off, can you tell us a bit about yourself and why you decided on speech therapy as a career?
I’m the Founder and Clinical Director at Leap Frogs, a private speech therapy clinic, and am in my 12th year of being a professional speech therapist, working with children aged from 18 months to 18 years of age. Speech therapy involves a lot of play and the creative use of tools and materials to stimulate the child’s communication part of the brain. How I got started in this field is a funny story – when I was 14, my paediatrician asked me what I wanted to be when I grew up and when I told him I wanted to be a psychologist, he didn’t sound too encouraging and instead suggested speech therapy, because his son was seeing a speech therapist who was both expensive and inundated with appointments all the time. When I heard that, I thought it was something worth exploring. I researched more, latched onto it and am now lucky to be doing something so fun that I enjoy!
2. How did you get involved in the SIF’s speech therapy project and what challenges do you face as a volunteer?
Before SIF, I did volunteer occasionally when I found the time. However, this project was my first time volunteering overseas, and on a professional and sustained basis. An occupational therapist and SIF in-field volunteer who was posted in Cambodia gave me the heads-up to SIF’s call for speech therapist volunteers.
Initially, I thought people would be happy to receive as long as we were willing to give. I expected the part about giving up my time, energy and knowledge. What I didn’t expect was the complexity of the nature of giving. In order to impart knowledge, you have to respect and be mindful of cultural differences, institutional hierarchies, political agendas and so on. I realised that if I want to share what I have, I need to think of how to give effectively. It was a big wake-up call for me.
An example of this was when we were excited to bring different tools and materials, and SIF was willing to support our proposal and budget, but we didn’t anticipate that not only did the locals not know how to use the tools we brought, they used them incorrectly and worsened the situation. Since they needed to be taught to use these new tools, it also made them feel helpless. So the simple act of giving can in fact open up other issues and complications.
3. How does speech therapy help children with feeding and communication problems in Cambodia?
The Cambodia Speech Therapy – Feeding and Communication Project (2008 – 2013) had two objectives. The first was to educate Cambodian individuals who work with special needs children in feeding and communication strategies, and the second was to train the team of individuals up to a level where they become trainers of other trainers. They then imparted that knowledge to other professionals, resulting in a model of impact which was self-sustained and propagated.
There is limited support in this area in Cambodia. We see kids with multiple disabilities, suffering from malnutrition and sanitation issues, complex deformities and even remnant effects from toxic poison from Agent Orange. Feeding is a big priority because these kids don’t have the ability to eat safely, and come to us malnourished in the first place. As for communication, we encounter children with cognitive and complex learning disabilities, and whom society views as having no future. They are usually wheelchair-bound, confined at home or abandoned. Communication is something that is overlooked, when it is quite easy to establish. For instance, a child can ask to go to the toilet instead of wetting himself. These are knowledge and skills that can be implemented once learnt.
4. Have you noticed any challenges while conducting speech therapy in Cambodia and how do you overcome them?
Firstly, the challenge of logistics. For a child to come in for therapy, parents have to travel a day to get to the therapy centre and one day back! Secondly, parents’ education is another issue. They don’t understand what needs to be done or that what they are already doing can cause more problems. Thirdly, the family’s socioeconomic situation – they miss out on a day of working in the field and wages they can’t afford to lose. Adopting different habits is another one – when we suggest playing with food to make feeding fun, they can’t fathom it! Food is something that is precious and should not be wasted.
Overcoming challenges takes perseverance, creativity and being strong in communication – really trying to understand their situation and mindset.
5. What is it about children that you love?
Kids are very resilient. Despite the challenges they face, they often find a way to have fun, enjoy and progress. There is an eagerness and readiness about them that is very moving to see, for example – kids trying to feed themselves, dropping the food and laughing about it.
6. What has your experience been, training and working with the Cambodian speech therapists?
We’ve built the relationships over seven years, and our friendships have moved beyond cultural and language barriers now. Every time they see us, they run out to give us hugs and ask after the trainers who are absent! We fostered a very close learning and personal relationship, because we made it a point to learn their individual learning styles.
The friendships that were formed, despite differences in language and culture, really emphasised the similarities between us. Trainers and trainees both want to make a difference – there’s a lot of commonality and compassion. And at the end of the day, SIF’s objective of building a better world is really why they’re there! We are all there for the same cause.
As for the project on the whole, we are a volunteer team working with a number of different parties, including the individual trainees and corporate entities like SIF and CCAMH. Over time, I’ve realised that we all rely on the foundation of volunteering which is compassion and the real desire to give. So we band together on that front, and work through the challenges with motivation that comes from this goodwill.
7. What was the single most significant impact outcome to you?
The changes I saw in the Cambodian participants. When they first started, they were very passive with learning and were not engaged with us proactively. But within the first workshop, I could already see their ability to initiate and be independent . They started to relate their own experiences and read up in their own time – small changes that contributed to a community change. They were so empowered that they eventually ended up taking the whiteboard marker from us, debating among themselves and taking over the class! That level of interaction was rare and not part of a culture that is usually quite passive. Now, they’re so inspired and empowered that they run their own workshops and develop their own training materials. To me, that was the single most significant change that occurred.
8. Finally, any future plans to continue volunteering overseas/in Cambodia? And what are your feelings now that the five-year project has ended?
Not at the moment. Because the Cambodia project was so successful and recognised, we were approached by several other organisations to do something similar. But we would rather work with SIF as we appreciate SIF’s rigorous and structured approach, and they have set the bar for us on what we expect in an organisation that we work with. The effort is scattered and dissipates quickly with other organisations, but what the SIF has in mind is to build sustainability, accountability and empowerment – an approach that I personally prefer too. Of course, I am open to future opportunities of working together.
The volunteer team is still very much in touch with our trainees and every time we part, I’ll shed tears. But then I think to myself that one should be so lucky to have something that is so hard to say goodbye to. I consider it fortunate more than anything else, even though it’s always sad to say goodbye.
Practising techniques to train others to help children with feeding and communication problems.
Several trainees graduated from the SIF's speech therapy training project on 27 Oct, 2013. Singapore Ambassador to Cambodia Mr Kevin Cheok (middle, back row) presented the graduate certificates, with Ms Anita Fam, SIF Governor (second from right, back row) and Dr Bhoomikumar Jegannathan, CCAMH Programme Director (far right, front row) attending the ceremony.
This Q&A interview with SIV Michelle Tham was conducted by SIF staffer Charlene Poon.
Siem Reap, CambodiaWater for Life Project (Siem Reap, Cambodia)