Children born with Cerebral Palsy (CP) often struggle to swallow, while medication for multi-drug resistant tuberculosis makes some patients go deaf.

When hospital staff members find patients with these problems, they call in speech and language pathologists to help their patients to communicate.

For the past four months, speech and language pathologist Thaaniyah Gydien has been working mainly with paediatric patients at a large hospital in the Northern Cape (she was allowed to do the interview on condition that the hospital isn’t named).

“With CP patients, we have to teach them the safest way to eat. We also see a lot of children with severe acute malnourishment or SAM. Most of these children have developmental delays, with not speaking on time. The SAM kids have to stay in the hospital for a while and we have to make sure that they get stimulation.”

Parental ignorance

The Northern Cape is a vast and poor province and Gydien says much of the malnourishment is related to poverty, parental ignorance and alcoholism.

“There are a lot of social issues. Some of the moms drink a lot, and some are teenagers who don’t know how to raise a child.”

Trying to teach autistic children to communicate is a particular challenge, especially as most are outpatients who usually only get therapy a couple of times a month – and then for 30minutes.

“Sometimes it can take 15 minutes just to calm a child,” says Gydien.

“I was smacked hard by a seven-year-old autistic child two days ago. My face was red and swollen. Another autistic child punched me hard in the stomach. They don’t understand pragmatics. If you say no, they get angry. It takes month to make any progress.”

The one thing Gydien struggles with is the workload.

“The patient load is insanely high. We see 10 to 15 inpatients a day and four or five outpatients,” says 22-year-old Gydien, who graduated from the University of Cape Town last year.

Therapy is a slow process, so each patient needs at least 30 minutes of attention for the interaction to be meaningful.

Making an impact

“There are pages and pages of outpatients waiting to be seen. We haven’t even got to the ones from November yet.”

Although there are four speech therapists at the hospital, there is only one permanent one – the other three are doing community service. When people take leave, patients get left behind.

“Over one long weekend, I was the only one working. You get a pile of 50 patients, and it is impossible to see so many in the day, so you have to prioritise,” said Gydien.

Despite the workload, Gydien says that the speech therapists constantly remind doctors to refer patients to them and also screen the wards for patients.

“Doctors are usually very curative. We need to advocate for what we do to get them to think about therapy, and refer patients to us who are struggling to eat, for example.

“But I can really see the impact of my work. I really want to continue to work in a big hospital once my community service year is over.” – Health-e.

“I really feel I am making a difference