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The gift of a voice

Speech therapy is largely unheard of in Cambodia. Currently there are no speech therapists in the country who were trained at a Cambodian university. For the last 18 months, I have worked as Program Manager in a locally-run organisation working to grow speech therapy in Cambodia. We have a vision for a Cambodian university-qualified speech therapy profession that is able to provide high quality, culturally-relevant services to the estimated 600,000 Cambodians with communication or swallowing difficulties.

Establishing a new profession is a pretty daunting task! Curriculum writing, development strategy, clinical research and advocacy work all require connections and expertise beyond our little team of seven Cambodian staff and three foreign therapists. For a university course to be relevant to this context we need to document research and experience of using speech therapy strategies here. The purpose of this is to evaluate what approaches to speech therapy work in Cambodian culture and in the Khmer language, rather than simply transplanting models of practice from Western countries.

Cambodia has a long history of foreign therapists working in isolation for a few months or years, each investing in their small area but with little connection to government systems and no overall coordination. One of the first tasks for our organisation was to partner with others to establish the Cambodian Speech Therapy Network, with an aim to share resources and learning, and to be an orientation point for future speech therapists coming into the country.

Another early task was to establish a speech therapy clinic as a social enterprise. Two years in, our private clinic is booked out and needs more staff than we can find. This clinic brings opportunities to document therapy in Cambodia. Furthermore, also critical to ongoing success, the clinic helps to raise awareness and builds advocacy platforms with influential Cambodians whose families have benefited from therapy.

Currently, many children with disabilities are not in school even though by law and by government policy children with special needs are allowed to attend. Last year we designed and implemented a pilot project to coach rural primary and preschool teachers in their inclusion of children with communication difficulties within government schools. Beginning with disability-accessible schools from the government’s special education department, our staff worked to train the teachers in skills and knowledge that assists them in using teaching methods that helps all children learn. Presenting our results to the government was a tangible example of how speech therapy could help Cambodians. We ended the year with a formal partnership agreement with the Ministry of Education and had some very pleasing discussions with the University of Health Sciences as they plan a bachelor course in speech therapy to start in 2020.

Building on our national staff’s connections in the national disability and health sector, I’ve been able to bring my experience from 12 years of living and working in Cambodian poor communities along with my grassroots involvement in community-based disability rehabilitation work and establishment of community preschools and homework clubs. As a cross-cultural worker with longer-term experience, I’ve helped our local and foreign team members to understand each other better. In addition to my professional expertise in speech therapy, I’ve also drawn on Interserve’s values of partnership, servant leadership and valuing local expertise as together we grow our organisational culture and strategy.

While it’s not part of the employment criteria, it has been a surprise and encouragement to see how many staff members in the speech therapy project share the Christian faith. For the Christians within our staff it’s been easy to see God’s hand guiding our planning and his provision of resources and partnerships. It is such a joy to together celebrate God’s blessing, lament the injustice we encounter and advocate for systems that allow access to services for the poorest and most marginalised.

Ruth lives with her family in Cambodia. She works with a local NGO working to grow a Cambodian speech therapy profession.