Whispers on the Web - October 2005 - WebWhispers Nu-Voice Club

<strong>Whispers</strong> on the Web - October 2005
3/30/08 8:22 PM
between the ?highlands? (the Andes Mountains) and the low lying ?coastal region? with the population divided
between these two. About half of the country?s population are Indian, one third are Mestizo (a person of mixed
Spanish and Amerindian blood), maybe a tenth are of European decent and the remaining are a combination of
African and Asian. The men that I saw came from indigenous groups of Indians living a fair distance from the
major cities in Peru. The larger cities in Peru are Lima (population of about 6.5 million), Trujillo (population of
about 600 thousand), and Chiclayo (population of nearly 300 thousand). In these larger cities, Lima in
particular, there are medical services available, although the indigenous folks do not routinely use these
services for a variety of reasons related to their culture, socio-economic status, distance away from the
population centers and the inability to travel. I am not tied in closely to the local medical folks as that is not
our primary mission, so there may be others (ENTs, speech therapists) right in Peru whom I could have tapped
for services, but I am not aware of who is there.
To be honest, I cannot relay much to you about where these Peruvians had their surgeries done or
other medical history. Part of my ?lack of knowledge? stems from language barriers. There are a large number
of languages spoken here, even though Spanish is the official language. While we have good interpreters, the
process of communication is often difficult, particularly for more technical topics for which the local language
might not have all the relevant vocabulary for describing their medical conditions/history. This language barrier
proved somewhat frustrating in working on alaryngeal speech options, but quite frankly, I have grown
accustomed to communicating with folks with whom I do not share a common language. In general it did not
get in the way. We laughed through our gesturing and mimicry as we tried to figure out what each was trying
to say.
I was shocked that these four gentlemen had a laryngectomy in the first place. While there is Western
medicine in Lima and the other larger population centers, even the indigenous folks who live within 50 or 100
miles of the centers tend not to access the healthcare system. Most groups have there own approaches and
beliefs about health and disease (and how to treat it) that are rooted in the history of their culture. From what I
could gather, however, there must have been some medical missionary work passing through some portions of
Peru about 5-10 years ago. Each of these four had had their surgeries done roughly within this time frame and
it sounded as if they had been screened by an itinerant doctor ?from the city? who had arranged for the
necessary surgery and so forth. I have not been able to gather whether there are others out there who may
have been caught up in this medical sweep. The vastness and the remoteness of much of the country will
likely keep me from ever knowing much more.
Two of them lived near one another and knew of each other. The other two lived quite some distance
away. None of the four men were using any verbal communication at the times that I first saw them although
they all appeared to be active within their families and communities. I?ve always found the indigenous people
to take great care of their family and to diligently look out for those who are sick or in need. The primary
communication mode for each was via gestures and facial expression. Mouthed speech was also being used
but it seemed to be secondary. One of the Indian men was ?fortunate? in that a fairly elaborate gestural
language was part of the culture anyway (this was easy to see after being in the village for little more than an
hour as I was reminded of the stereotype of Italians using excessive gestures while talking!). Writing was not
an option for any of the men as none of them could read or write. I suppose drawing could have been an
option, but none of them had naturally gravitated toward this as far as I could learn.
The first laryngectomee that I met went by the name Ical (that is my best guess at spelling his name
and I do not know how to translate it into English). I was forced to go through my line of thinking in dealing
with his communication and then met the other three over the next few months. The situations were fairly
comparable as was my thinking on best means of communication for all of them.
After my initial shock at seeing a laryngectomee in the Andes, I jumped into my usual, non-speech
pathology role, which involves talking with the local women to establish relationships that can then be built
upon and used for subsequent education programs related to healthcare, farming, and other issues. But I kept
watching Ical whenever I could. Being in the village for several weeks I was able to see him quite often and
watch how he got along. While he did quite well, and while he and those in the village had long ago figured
out how to communicate with each other, I couldn?t resist getting to know him. After taking a few more days
to ease into a relationship with him, I was able to pull him aside with a local translator and get more of his
story. His surgery had been done about 4 years prior, mainly because he was having trouble breathing during
exertion in the fields. He?d been taken to the city in a car with a doctor who stayed with him much of the time
while in the hospital (a stay that lasted for about 3 ? 4 weeks as best I could understand). He returned with this
same doctor and has been healthy ever since. I asked if he would be interested in having a voice. He was. I
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