Carol Natukunda
29 July 2008
Kampala — HIS blank stare tells it all. The anger... the pain... the fear that he might never be able to speak straight.
Lazarus Baseke tips his head back, before leaning forward to try and mutter the word "drum," one more time. Still, his "tied" tongue lets him down. "Um um " he says with a creased expression.
"D d d d repeat after me, okay?" his trainer edges forward to cheer on the little boy. "D d d " The passionate teacher goes on, gently tapping a small drum on the desk.
Five minutes later, the 12-year-old finally manages to pronounce the letter outrightly. He smiles broadly. His next battle is 'r." It could take months or even years to master his speech, but at the end of the day Beseke will speak properly.
This is the scenario during a practical session of the Speech and Language Therapy students at the Makerere University, Mulago-based medical school. A total of 13 students, including a Tanzanian, have been enrolled on the course, since its inception in February this year.
The programme aims at restoring hope to people who are born with speech problems or those who have lost their speech in the event of a severe illness or an accident. Such communication problems might include stuttering, voice hitches and slowness in developing language, among others.
However, having Ugandan therapists seems to be an uphill task. The sh1.5m tuition fees per semester is way too high and even the few students who have enrolled are not sure whether they will be able to continue.
Take for instance, Clemense Aryanyijuka. She has been working as a senior clinical officer for close to eight years. But as a mother, her meager salary is not enough to pay her tuition as well as look after her family.
"My children also need school fees," she says, "I have pushed through the last semester, but the next, God knows."
And yet, Aryanyijuka is incredibly drawn to the plight of people with speech problems. It is estimated that since 2004, Mulago Hospital treats about 200 children and about 100 adults every year with communication and feeding disorders.
The Speech and Language Therapy course is the first of its kind in East Africa. This implies that Uganda will have to wait for at least five years before it can have its own specialised speech therapist.
The Mulago clinic only has three full-time therapists, all of whom are expatriates from Volunteer Service Oversees (VSO). The fourth one is a part-time volunteer. "Our pioneer students will complete in three years. They have to proceed for training and then pursue graduate or specialised studies," explains Marise Fernandes, one of the therapists.
About 10% of the population has communication disorders, according to the 2006 Demographic and Health Survey.
Fernandes, however, is also worried about the fate of her students.
"We are not receiving Government funding until August 2009. Some embassies that would come in handy don't sponsor students who are above 30 years of age, yet this batch comprises mainly diploma holders, who had to leave their jobs to partake the course," she laments.
Yet, in a country with more than 50 languages, the course can only have impact if more students representing most regions secure funding for it.
Already, it is a lot harder for the expatriate therapists to attend to the patients who do not know English. In most cases, students like Aryanyijuka have to come in handy to translate.
Fernandes further observes: "A person from Lira shouldn't be coming all the way to Kampala, if there were specialists on their health centers. That is perhaps why some people end up not completing their treatment sessions, because the distance is long."
"Some people lose their speech when there is brain damage; some due to hearing impairments, or even when they have suffered from malaria or have been involved in a motor accident. Some children are slow to develop language," Fernandes explains.
"But the majority could be corrected. Treatment takes weeks, months or sometimes years, depending on the problem," she says.
Aryanyijuka remembers the first time she met a child whose tongue was tied. "His saliva was flowing endlessly. I felt I could do something for him; I developed a passion for such people," she says, "The need is huge, and if I could complete the course, I would train others."
But the course has proved a turning point. Two decades ago, speech and language therapy was a little known speciality, under the Ear, Nose and Throat (ENT) department. Since 1986, VSO was sending therapists to the department, but it had not proved sustainable due to the language barrier. By 2000, an idea was fronted to begin the course, targeting local personnel.
"It is satisfying to see the course develop at this level," says Sarah Bagnall, another specialist.
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