Alex Rymer

How did you develop an interest in Speech and Language and why did you choose to study at City St George's, University of London?

I have always been interested in the English language and writing, in fact I was originally going to study Creative Writing at university. Instead, I studied Psychology with a placement year, in which I worked as a Speech and Language Therapy Assistant in Birmingham, helping adults with learning disabilities.

Speech and Language Therapy spans psychology and language studies, looking at the person behind the communication and how this fits into their environment. I chose to study this at City St George's, University of London initially because of the central location of the university. After coming to look around I knew that the University was a good environment to study and the lecturers were all passionate about what they taught.

What have you enjoyed most about the course?

The wide array of communication disabilities that we learn about is extremely useful and is preparing us to work with many different client groups, which will be very helpful when we qualify. I have also enjoyed the more scientific aspects of the course: for example, learning all about the anatomy and physiology of the head and neck, and also how to transcribe phonetically.

What have you enjoyed most about your time at City St George's?

I have enjoyed the extra placement opportunities offered by the university (e.g. helping out on an intensive stammering course). I also enjoyed the placements themselves and the level of support that is available regarding this through tutorials with peers and clinical tutors.

How have you benefited from the facilities available at City St George's?

I have used the library and the rooms/labs assigned for lectures. I have enjoyed the use of the library’s rooms specifically for group work as this is a good private, quiet area to be productive in. I took part in an Intensive Stammering placement which was organised through the Roberta Williams Speech and Language Therapy Centre, although we actually used rooms outside of the teaching clinic because of the group sizes and activities involved.

Tell us about your work placements.

First, I was based within a Community NHS Trust. I had two practice educators working in two different areas of Speech Therapy, and I alternated my one-day-a-week with them. One week, I was in a specialist school, providing therapy for children with special educational needs from ages 6 to 18.

The other week I was based in a clinic, from here I did visits to mainstream primary schools/nurseries, and clinic based appointments including groups for parents and their children to aid with communication. For my summer block placement I was in these same placements, with each practise educator 2 days a week.

This year I have been placed in a language unit in a primary school. Here I have been doing lego therapy groups (involving children taking on different roles in collaborating/communicating to build a specific shape with lego bricks), and 1:1 therapy sessions with children. This term I will have a similar placement but this time in a nursery school’s language unit.

I have enjoyed running Lego Therapy groups the most, and being given opportunities to run and plan my own intervention sessions and therapy groups.

In my career, I want to work with children so these experiences have been extremely valuable. I have worked with a wide variety of children, of all different ages and diagnoses. It has been very helpful to be placed in an environment so similar to one I wish to work in when I am qualified.

What would be your advice to anyone considering studying Speech and Language Therapy?

Make sure it is what you want to do – Speech and Language Therapy is a very specialist degree. While you do gain a wide knowledge of linguistics, biology, phonetics, and psychology, the way you are taught to apply it is very specific to a Speech and Language Therapist’s job.

If you’re not sure if you want to be a Speech and Language Therapist, try and get some kind of shadowing experience. You also have to be interested in lots of different aspects of speech and language, and all different difficulties with communication someone can have. The course is hard work but also lots of fun!

Tell us about the Kyaninga Child Development Centre.

Kyaninga Child Development Centre provides specialist services to children with physical and/or learning difficulties in rural Uganda. They are based in Fort Portal which is in Western Uganda, about 5 hours from the capital city of Kampala. Healthcare services such as speech and language therapy are available in Kampala, but travelling to Kampala is a luxury few can afford.

Kyaninga was founded by Steve Williams, an English man who manages a hotel in Fort Portal. He originally employed an English Physiotherapist (Fiona) to work with his young son who has Cerebral Palsy. This inspired Steve and Fiona to help provide services such as this to other children in and around Fort Portal.

The team grew and today the centre offers Physiotherapy, Occupational Therapy, and Speech and Language Therapy, as well as orthopaedic splinting and casting, and supporting inclusive education in schools. They offer clinic based appointments where families have to get themselves and their child to appointments (which can be tricky, particularly when funds are low or in the rainy season).

For families who are further away or find it difficult to travel, the team do home visits (often hiking up a mountain to provide their therapy!). They also do an outreach most days a week, which is where several members of the team go to a health centre far away and families from that district come to be seen by some (or all) health professionals available.

A second centre has now opened up in a town a couple of hours away, where they provide physiotherapy services daily and an outreach of other therapies every 2 weeks.

Multidisciplinary teamwork is very important, because only some of the staff speak the language that is used by families in and around Fort Portal. Often one member of the team has to relay their recommendations and/or assessments through another member of staff who can speak the local language.

How did the opportunity to volunteer at the Kyaninga Child Development Centre come about?

The KCDC contacted Bernard Camilleri (Programme Director) as they were aware of LCS involvement in another international initiative – the City Cambodia Project. They were interested in involving Speech and Language Therapy students for volunteering at Kyaninga to share knowledge, skills and practice with the local health workers and community.

At that time, Kyaninga only had a speech and language therapy assistant, no therapist. Bernard delivered a short presentation at the end of a lecture about the opportunity, including Kyaninga’s email address to email for more information.

As this was the first time that the KCDC were offering volunteering opportunities for SLT students, I contacted the KCDC directly. Now students who are interested in getting involved can apply through the University’s volunteering website.

Please tell us about your time there.

I flew to Entebbe on the 22^nd August 2017, arriving at Kyaninga on the 23^rd and left Kyaninga on the 19^th September 2017, flying home very early morning on the 20^th. I stayed at the Kyaninga child development centre: it has two double bedrooms (with ensuites) for volunteers to stay. They have a living room type area (also used as an office) and a kitchen.

I lived on my own for the first 9 days, but then an English volunteer Physio arrived and was there for the remainder of my stay. The centre was open between 8.30am and 5pm, so there were always people there through the day. Sometimes people were around on a Saturday too as this is when staff took children to see the farm where they made goats cheese to help fund the centre.

My role was initially going to be to help train the speech and language therapy assistant, but when I arrived I found there was a new Speech and Language Therapist who had started two weeks before I arrived. Because he was so new, a lot of my role was collaborating and knowledge sharing, rather than him taking a more clinical supervisor role which may be expected in England.

I helped deliver therapy: often devising my own sessions once I had been briefed on the client and read over their notes. I attended many outreach activities and home visits and assessed new clients as well as continuing intervention sessions previously started by the speech therapy assistants. If there were no clients in for me to see at the time, I was able to sit in on Physiotherapists’ or Occupational Therapists’ sessions with other clients.

When clients did not come to appointments (it could have been raining for example) I busied myself making toys or games to use in therapy, from recycled food packaging, bottles, etc.

Outside of work hours, the English Physiotherapist and Occupational Therapist made sure I had lots of things to do, and invited me to different social events. There are many amazing things to do around Fort Portal, including Safari at Queen Elizabeth National Park, chimp trekking in Kibale Forest and many beautiful walks around the volcanic crater lakes. It is a beautiful part of the world and I felt at home within a few days of being there.

What did you enjoy most about this experience?

I most enjoyed working in an environment so different from my own, but still finding that the skills I learnt, although I am still very inexperienced, were so very useful to families who have had no training at all in how to help their child communicate. I enjoyed going on outreaches and home visits up into the mountains surrounding Fort Portal and seeing what amazing things families could do for their child with so little resources.

One family had made parallel bars out of tree trunks to help their son to walk! I also enjoyed sharing my knowledge with Ugandan speech and language therapists and comparing different approaches used. And of course, the Safari and Chimp Trekking experiences were also amazing!

Were there any aspects you found challenging, and how did you overcome them?

It was challenging to experience such an extreme level of poverty which I had never been exposed to before. It was difficult to see feeding advice being given (i.e. type and texture of food to give a child) and then to hear that the families simply could not afford any more food, or that type of food. This meant that some of the children were very small as they did not have the correct nutrition to help them grow.

I overcame this challenge by talking to the local team members and other English volunteers about the stark contrast between this and the developed countries I am used to. I learnt that I had to take a step back and there is only so much help we can offer.

What would be your advice to anyone considering taking part in this or similar volunteering opportunities?

Be prepared for a very different way of working! Something that shocked me most was how relaxed the schedules are: just because an appointment has been booked doesn’t mean that people follow it, or doesn’t stop other families travelling for 4 hours to come to the centre without an appointment! Your day will probably turn out very different from what you thought it was going to be!

I went for just under a month but it would have been better to go for longer – maybe 2 months. Some outreaches are monthly so it would have been good to see those children more than once to follow up on any advice given. Do lots of reading on working in low resource settings and be prepared for the locals to have very different views to what you have. For example, many people in rural Africa believe that learning disability is a curse, so often mothers and their child are ostracized.

Take enough money to explore Uganda! Look at any different areas you may want to visit while you are there, and take a few days at the end to go explore different areas that are too far away to go on a weekend (e.g. Gorilla trekking takes 3 days including travel time as it’s many hours away).