Day 98 - 6th June 2019
This afternoon was a particularly hot one on the lake. The fan beside me blew sweet relief onto my skin. Small geckos scurried along the metal beams ahead. Once in a while a fly would unknowingly tickle my arms in it’s search for moisture. I didn’t like them but couldn’t blame them. And there were still more people waiting outside. I could hear the laughing screams of babies. Toddlers running around with their heavy footed stomping the wooden floor of the clinic. I called for the next patient. A young girl of fourteen sat on the blue plastic chair beside me.
She looked scared and gazed at the ground. If I was a fourteen-year-old child visiting a foreign doctor, I would have felt the same way I thought. I asked how she was. She looked up and began to speak but struggled to form sound. With much effort and inner tension, she spat out one word. The women around her gestured her to speak up and more clearly. I looked at them and said it was okay, and asked the girl to continue speaking. She struggled again. Sary told me that her grandmother said that the girl has had difficulty speaking since she had been a baby.
When times like this occurred and communication was difficult, I relied on my other senses more. I looked at her arms, legs and shoulder to see any signs of abuse – there were none. I asked her grandmother is she was doing well at school and she stated that the girl was a high achiever. She also said her speech was worse when nervous and around strangers. I didn’t like talking to the grandmother much to find out the history but also knew that I would induce more anxiety in the child if I asked her questions and made her struggle in front of the watchful crowd. So I asked the grandmother questions and used body language and smiling to communicate to the girl.
I examined her, including an examination or her ears and throat -which were all normal. She seemed to have a form of expressive dysphasia but the origins of her speech problems might have come from her vocal chords and structures around it too. What she needed was a speech and language therapist and I urged her grandmother to take her to the hospital. They agreed to go.
Not being able to speak must be debilitating and morale-damaging. Without speech you struggle to communicate and therefore you cannot tell others how you feel and share thoughts and memories. Without speech great stories would not have been told. Our civilisation is built on speech. Those with speech issues are more likely to suffer with social anxiety and this in turn feeds into itself making the speech worse.
As the young girl stood up and left, I realised how brave she must have been to have sat down to talk to me. Her grandmother and her must have taken hours to get to the clinic. This young girl independently sat on a chair and began speaking to a person she had never seen before, an alien of some sorts. Not only only that, it was to a person with authority. She openly tried to communicate her issues to a foreign doctor. All in all, she let herself become vulnerable by sharing her story in front of many other people.
She might have been the bravest fourteen-year-old I had ever met.