HOMEWARD BOUND

On Jan 13th, we woke up around 5am to start our 6 hour journey back to Accra to work with the cleft palate team in the Korle Bu Hospital. Once we arrived, we were split into small groups. Each group consisted of at least 2 clinicians who assessed the speech and language of 2-3 clients with cleft lip and/or palate. Afterward, we broke for lunch and reviewed each of our cases to practice our presentations to the cleft palate team. This review helped many of us relax and feel more prepared to present in front of the many members of the cleft palate team (e.g. Maxillofacial surgeon, orthodontist, nutritionist, dentist, pediatrician, otolaryngologist, dental nurse, speech pathologist). The meeting was conducted by the craniofacial surgeons: Dr. Laing, Dr. Ampomah and Dr. Paintsil. As each of the patients was called into the meeting, one graduate clinician reviewed the presenting issues related to speech and language, which included the current structural status and level of function. We also provided recommendations regarding speech and language therapy. As graduate clinicians, we felt fortunate to have this unique opportunity to be involved in this meeting as members of the cleft palate team were very supportive and appreciative of our participation.

After our long days at the placements, we would find time to get together for class and reflect on the day. Our Program Director, Cate Crowley, would lead the discussion which focused on our required readings along with several analytic questions. She posed this loaded question that had many of us students thinking:

"What did you not know before you came to Ghana that you learned on this trip?"

One student replied, "I learned a lot of information from other graduate clinicians which included looking at cases in ways I never would have before." She elaborated by saying that everyone brings new perspectives, experiences and knowledge from their own personal and diverse backgrounds. Another student stated that it is an interesting time to be in Ghana as the educational system is beginning to recognize the need to support those with disabilities. She added, "It would be interesting to see how this movement will evolve."

This past week, we spent a lot of time at the Effiduase Unit School with the Head Teacher, Belinda Bukari. Despite the movement towards supporting those with disabilities, Belinda feels a lot of opposition as a teacher of children with special needs. Every child in her classroom is allotted 4.50 cedi annually, which is equivalent to around 3 dollars in American currency. Yet, the school should get four times that amount for each child with a disability. It is clear that she is up against both cultural and financial obstacles, which has been a battle fought alone. Over time, she has gained support from the community and even receives free air-time on the radio to discuss the importance of educating children with disabilities. Another student stated, "Teachers in Ghana like Belinda do so much with so little when some schools in the USA do so little with so much." Another student also reflected on her experiences in Belinda's classroom and stated, "No words can describe how influential Belinda is." She added, "When you walk into her classroom, you instantly feel loved." Belinda teaches over 30 children at a time who vary in age and abilities. She has taken on a job which many would see as impossible. We all felt privileged to watch this extraordinary woman skillfully foster a learning environment that positively impacts all her students while making it look so easy.

Another student discussed how she learned more from the people of Ghana over the two weeks than she could have ever learned in a classroom. She stated, "We took so much more away from this experience than we could have ever possibly given." Someone else added that she felt that most of the parents of children with disabilities and the adult clients we saw throughout the trip generally appreciated our suggestions and recommendations despite preexisting beliefs about individuals who are disabled. Our interpreters (whom we referred to as our "cultural brokers") joined the discussion and stated that they also learned a lot during the clinical experiences. One interpreter stated that prior to working with us, he believed that a disability was caused by a curse. Now, he has learned that rehabilitation is a possibility and plans to share this experience with many people in his community.

Additionally, a student discussed her thoughts about sustainability. She compared her past experiences of international work to this trip. She stated how disappointing it can be when you invest a strong effort into facilitating projects abroad, but the program does not continue when you leave. Yet, our professional collaborators, like Belinda Bukari and Clement Ntim (Head Teacher at the Unit School in Nkawkaw), continue to use language stimulation activities and materials that were implemented in previous trips to Ghana. They greatly appreciate our input and plan to implement our speech and language recommendations from this year. Although there are only a handful of speech language pathologists in Ghana, there is a general understanding and respect for our profession. For this reason, The Komko Anokye Teaching Hospital in Kumasi plans to begin their first masters level program in speech and language pathology in the fall.

On Jan. 14th, we were fortunate to have a meeting with Hon. Alex Nathan Tettey-Enyo, Minister of Education and Member of Parliament Ada Constituency. Other representatives in attendance at this meeting were Mr. Stephen Adu, Director of the Basic Education Division, and Mr. Patrick Otaah, Acting Deputy to the Director of Special Education. Together with Cate Crowley, they discussed the educational infrastructure and how more financial support is necessary to provide quality education to children with special needs, especially in the Unit Schools. Hon. Tettey-Enyo discussed their plans to provide an effective educational system for all children. He elaborated by stating, "It is our constitutional duty to stop social injustice in Ghana." We knew that this meeting was important because an agreement was made to increase the financial allocation to each child with a disability in the Unit Schools. When we were leaving, Mr. Otaah thanked us for our participation and stated, "This meeting was a dream come true."

Afterward, we went to the TV 3 Television Station where we picked up our Clinical Director for the Ghana Program, Miriam Baigorri, and a graduate clinician, Christina Lam. They were interviewed by the news team about our work in Ghana. Then, we had our last Ghanaian meal with our tour guide, interpreters, bus driver and bus mate--George, Frank George, Nicholas, Richard, Steven and Francis. Graduate clinicians stood up and gave speeches to thank each of them for all their help and support throughout our service trip. This was followed by a lot of dancing and singing to live music at the restaurant.

Before heading to the airport, we stopped at the infamous Holiday Inn in Ghana—where President Barack Obama stayed during a recent visit—for a meeting with Hon. Naa Prof. John Nabila who is the Chief of the Northern Region, President of the National House of Chiefs, and Member of the Council of State. Chief Nabila is an old and dear friend to my uncle, Emmanuel Noggoh. For this reason, he graciously sat with our team and discussed his position as Chief in Ghana and his responsibilities as the President of the National House of Chiefs. Specifically, he informed us that a Chief has an important duty of being the liaison between the people and the government. Conveniently, a meeting amongst top Ghanaian officials was being held at the Holiday Inn so Chief Nabila introduced us to Dr. Kenneth L. Brown, who was the former US Ambassador to Ghana and currently the President of the Association for Diplomatic Studies and Training. After having the honor of introducing ourselves to these prominent political figures, they all commended us on our work in Ghana and strongly promoted our return to help more individuals with communication disorders.