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Interplast Surgical Outreach Program with Smile Train has been providing free surgical care to the cleft population in Nepal. The activities have been able to reach 46 different districts of Nepal over the last five years. More than 700 of these patients also had cleft palate deformity repaired by the program. Since most of these cleft palate patients were operated in an age older than the ideal one (12-18 months) for various reasons, almost all of them require vigorous speech therapy. At present, speech therapy is being provided in both central (Kathmandu Model Hospital) and peripheral sites in a week long camp situation where the parents/guardians of the post operative cleft palate patients are invited and provided free food and lodging. The whole day is spent with the speech pathologists undergoing individual and group speech therapy. The parents are also taught how they can reinforce what the kids have learnt during the camp for the time in between the camps which are organized usually every 2-3 months. At a time, we have about 15-50 children in the camp.
Because of the small number of speech pathologists in the country (8 in total), it has been difficult for us to organize these camps as often as is necessary especially in the peripheral sites. Majority of the patients' speech problem is so severe that one week long speech camp organized every two to three months is not adequate. To make the speech therapy available to these poor people in the peripheral sites on a more regular basis, we need paramedics (CMAs, ANMs, AHWs, etc) trained in speech therapy for cleft patients who can travel and stay in these peripheral sites close to the homes of our patients' for longer time than just one week.
The training will have both didactic and practical components and both components of training will be conducted in Kathmandu (based at Kathmandu Model Hospital) where all speech pathologists are stationed and in periphery where almost all the patients live.
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