My first time – and first day on the mission. Where should I start? What should I do? I felt a little lost in all the activity and preparations even though I had prepared a kind of protocol and brought some equipment from home. I was assigned a corner of the screening room where all the children came with their parents and were screened by surgeons, ENT-doctor, dentist, nurses, photographer and speech therapist. There was a lot of noise and not perfect conditions for speech evaluations. But I listened to them all and made the children repeat sound and explained to parents about cleft and speech.
The children had different speech problems due to the unrepaired clefts. All had some kind of nasalized speech, with or without audible nasal airflow and week pressure consonants. Others had nasal realizations of fricatives some again had glottal sounds and a few with cleft type characteristics like backing to velar. The most heartbreaking thing was some of the older children with unrepaired palates did not go to school. Their speech was almost unintelligible. All the children I met this first day I will meet again in the ward after surgery on Monday or Tuesday. My priority will be the children that undergo cleft repair. I will work with the parents and demonstrate oral airflow and correct placement of consonants. I have brought games and activities the parents can play with their children. As there are only 2 speech therapists on the whole island the goal is to help the parents help their children achieve better speech.