He can’t walk, nor can he speak or eat normally. Mai is one of an estimated 600,000 Cambodians with a speech and swallowing disorder which puts him at risk of dying from pneumonia. It also means he can’t go to school or get a job.
Thanks to an enterprising Australian though, Mai’s life is on the up. A pilot program in speech pathology run by 32-year-old Sydneysider Weh Yeoh is helping him learn how to swallow.
Sydneysider Weh Yeoh who has set up a pilot program in speech pathology in Cambodia.
‘‘Where once he could only communicate through his enormous smile, he has now started to communicate like his peers,’’ says Yeoh.
Yeoh has worked in Asia for the best part of a decade, for much of the time as a volunteer, most recently helping hundreds of kids in the poorest parts of Cambodia. Before this, he ran an adult shelter for people with disabilities in Vietnam, interned with refugees in India, and studied Mandarin in Beijing, China.
What he has been able to achieve in the past couple of years in speech pathology with just $45,000 scraped together from crowd sourcing, a contribution from the Red Cross and the help of some generous Australians has been astounding. It is a story which revives faith in foreign aid but it is heartbreaking too.
Weh Yeoh works as a volunteer with CABDICO, a local Cambodian non-profit organisation
‘‘Imagine if every time you opened your mouth to talk to somebody, your words came out scrambled and you were met with blank or puzzled faces,’’ says Yeoh. ‘‘Imagine if every time someone spoke to you, their words were unintelligible, like a foreign language for which there is no translation.’’
‘‘What about if every time you reached for a glass of water, you were unable to swallow it properly? Think about how it would feel running down your windpipe and into your lungs, but even worse than that, knowing that because of this problem with swallowing, you were 13 times more likely to die before your time was up.’’
Speech Pathology Australia, the peak body for speech pathologists in this country, estimates there are more than 1.1 million Australians who have trouble being understood, and more than 1 million who find it hard to swallow safely.
There are about 5500 speech pathologists in Australia. In Cambodia, there are no speech pathologists. Until now there has been no awareness by government, or at community level; there have been no policies to tackle the problem, yet the number of people with speech and swallowing disorders is estimated at 600,000, or 4 per cent of the population.
Yeoh is not a speech pathologist. He trained in physiotherapy at the University of Sydney and did a masters degree in international development at the University of NSW.
But he identified speech pathology as an area of particular need. Now he works as a volunteer with CABDICO, a local Cambodian non-profit organisation. CABDICO has a staff of just 11 people, and an annual budget smaller than many individual United Nations salaries.
‘‘With a small grant from the Australian Red Cross, I began to research the extent of the problem within Cambodia,’’ says Yeoh. ‘‘I found the number of people afflicted by communication and swallowing disorders to be enormous, with tens of thousands of people dying every year, because swallowing disorders can lead to pneumonia, when food or liquid enters the lungs instead of the stomach.’’
The economic cost of ignoring the problem is vast, he says. UK research has shown that for every £1 spent in speech pathology services for people with swallowing problems, there is £2.3 saved in health care costs, mostly by avoiding pneumonias.
According to US research, if you evaluate loss of income and productivity as a result of these disorders and compare it to the cost of treatment, communication disorders may cause the loss of up to 3 per cent of gross national product (GNP) each year.
Yeoh says the equivalent loss to Cambodia may be almost $400 million in lost GNP annually. The good thing is that a dollar in aid to Cambodia stretches a very long way.
‘‘After close to a year of searching, I helped them access a fund that was then known as AusAID,’’ says Yeoh. ‘‘We also crowd-funded online over $15,000, given by 70 generous individuals, most of whom are Australians. With a total of less than $45,000, we set out to address the enormous gap for over 600,000 people in Cambodia.
He started up a pilot program, training CABDICO staff in basic speech pathology skills. The trick was to show that speech pathology can work in a Cambodian context, using Cambodian language and Cambodian people.
‘‘The idea is that we would then demonstrate these gains to relevant people working in the Cambodian government, and help with starting a university course training Cambodian speech pathologists. The overarching aim is to decrease their reliance on outside expertise and aid.’’
In less than six months, Yeoh and his team have been able to achieve the following
- Seven CABDICO staff and 30 local teachers have learnt strategies to improve the communication and swallowing of children with disabilities;
- Over 100 children have already benefited from this increased knowledge;
- Members of the Cambodian government, such as those from the Ministry of Health and Education, have gathered together to discuss and plan the future of speech pathology in Cambodia;
- The University of Health Sciences in Phnom Penh, Cambodia, has agreed in principle to start a speech pathology course;
- Speech pathology is to be explicitly mentioned in the National Disability Strategic Plan, adopted by government for the next five years.
All this for a total spend of less than $45,000 – a budget more than a thousand times smaller than the annual aid budget spent on HIV in Cambodia.
Small amounts of money can be effective in countries like Cambodia, says Weh, especially if handled by small, local organisations. But there is no funding for disability in Cambodia so the staff of CABDICO has voluntarily taken pay cuts to keep their organisation running on the funds that Yeoh managed to raise.
‘‘Staff who earn as little as $350 a month are sacrificing their own financial security because of their belief in their work,’’ he says.
But crunch time has arrived. ‘‘By the end of June 2014, we will have to walk away from this project if we cannot find further funds to continue. We have before us a project that ticks all the boxes: enormous under-serviced population, small and local organisation highly motivated but with little finances,” he says.
‘‘Given small amounts of money, anything is truly possible. Collectively, are we able to recognise when we are onto something good?’’