Speech therapy changes lives in Malawi: A Q&A with Morgan Silungwe
In this Q&A we chat to medical volunteer Morgan. He tells us what inspired him to choose a career in speech therapy and why it’s such a vital part of comprehensive cleft care.
Volunteer speech therapist Morgan Silungwe has been working with Operation Smile since 2012. In this Q&A we find out more about what inspired him to become a volunteer as well as his work with Operation Smile Malawi and recent further training in Speech and Language Therapy here in the UK.
Q: What inspired you to volunteer for Operation Smile?
A: So, I’ve a background in speech therapy and a postgraduate diploma. Operation Smile was coming here to Malawi, in 2012 and there was need for volunteers. I volunteered partly to gain knowledge and skill in the area of cleft palate, because despite learning it in school in Canada I had no hands-on experience. So I’ve gained a lot and my skills have been improved through coaching and mentoring from the speech therapists I met during surgical programmes.
Q: How important is the role of speech therapy for patients with cleft palate?
A: Speech therapy is very important when it comes to cleft care. Within Operation Smile or in any other setting, speech therapists are key practitioners. We know that surgery does not train or teach our children how to speak. It only fixes the palate or the lip and then we still need to go back in order to train them how to speak. By the time they are receiving surgery, they have already developed a habit of not talking well. Parents are often surprised that after surgery their child’s speech is the same, so speech therapy is vital to correct their speech production.
Q: How long does it take after a child has their cleft palate repaired before they see an improvement in their speech?
A: We don’t have a clear-cut bracket in terms of timeframe because there are a lot of factors that you need to consider in that. In the Operation Smile Malawi patient database we have lots of patients who have previously never accessed speech therapy because it has been so scarce in the past. The quality of speech therapy is also important. Ideally, we would meet a patient once a week and then the parents or caregivers have to continue facilitating the training at home. Quality speech therapy, good frequency, and proper training of the caregivers at home are the best way to help a patient improve their speech. It’s different for every patient, but it takes a long time.
Q: Do you have a favourite patient story that stands out in your memory?
A: There are a lot. But there are two patients that really stand out for me. Every month there is a clinic that happens that our central hospital, so this first patient has the advantage of coming to see me or other speech therapists regularly. Month after month, we could notice a clear difference in terms of his speech production. As I said, it’s a long journey still, because it takes time.
Number two, there was a second lady around 22 years old with a cleft palate. She wasn’t able to have surgery because of other medical conditions, but we fitted her with an obturator to help improve her speech and help her to eat as well. It also helped improve her self-esteem. These two stories stick out for me because of the impact we had on both patients and how their lives changed so much for them.
Q: Why did you choose a career as a speech therapist?
A: I was working as a rehabilitation technician in one of the children’s rehabilitation clinics within our city. The clinic had volunteer physiotherapists, occupational therapists and speech therapists. So while I was working there as a rehabilitation technician, it happened that that was attached to one speech therapist, and I was more or less like an assistant to her. When the contract expired, there was no one to continue the speech therapy so the organisation sent me to Canada to do a speech course. I did that one for one year and when I came back, I developed more interest in the area of speech therapy. So, from my postgraduate diploma I’ve been practicing since 2006.
Q: What would you say to our supporters whose donations are making our programmes possible?
A: I have a huge expression of thanks to our sponsors. I will not talk about me, but about Operation Smile Malawi. When we started in 2012, the numbers of patients with cleft conditions that we saw were vast. After surgery, if it was not for Operation Smile, what could have happened to those patients? They had no hope of any smiles at all. That means what they were going through, could have been a lifelong storm. Because cleft conditions come with a stigma and discrimination, there is a social attitude that is not good towards them. So the patient will have ongoing psychological issues. But, with Operation Smile and the people that are supporting us, they are changing stories, they are changing lives. And if you were to bring the patients to say thank you to them, they would cry. They’ll cry, because if it was not for them, their life could have been so difficult. We thank our donors that are supporting us. We hope they will continue to support us as we still have a long way to go.
A: You’ve been furthering your training in the UK for two years, when you go back to Malawi, what are the key activities you’ll be doing there for Operation Smile?
Since I came to the UK to study Speech and Language Therapy at the University of Essex, I have not been fully involved in the surgical programmes. However, until 2022 I was involved in a speech mentorship programme. There were about six rehabilitation technicians that have been mentored for speech. Operation Smile Malawi is training rehabilitation technicians to help us with providing speech therapy so we can reach more patients in our districts and in our regions. My mentor was Erika Bostock, she’s a speech therapist from South Africa, but also an Operation Smile volunteer.
Q: Apart from the academic lessons that you have learned, what are the other lessons you’d like to implement once you return to Malawi?
A: There are a lot of aspects that have really changed the way I view or the way I would approach patients, or how I would approach programmes. The first one is about putting the patient first. How patients need to be evaluated. Plus, also you must quickly understand what they are going through and what their condition is. They deserve respect at every aspect when you meet them. Also, the importance of the involvement of caregivers in service provision. We’ve learned that most cases need teamwork. So, it may not just be a speech therapist but there’s always a team that is dependent on each other. There are a lot of skills that have learned through my studies plus also the placement time. I am eager to take these learning and apply them when I go home after graduating next year.
Thanks to Morgan for taking the time to talk to us. We’re certain he’ll continue to change more lives in Malawi and also raise the profile of speech therapy and its important role in comprehensive care.