WEBVTT
00:00:08.560 --> 00:00:12.880
Hello and welcome to this special episode of Tracky Talk.
00:00:13.039 --> 00:00:26.480
We're here in Bengaluru in the south part of India and I'm joined by Professor Sarah Wallace, OBE, who's a legendary speech and language pathologist that I'm sure many of you know.
00:00:26.800 --> 00:00:34.240
We're currently in the Holiday Inn near the race course in Bengaluru and we're very grateful to the staff for finding us this nice quiet space.
00:00:34.399 --> 00:00:48.719
We've got a bit of time to kill before we have to head home, so we thought it'd be a really good idea to spend a bit of time just reflecting on uh what we have uh observed and learnt, uh, and some of the people that we've met and some of the things that we've seen in India.
00:00:48.880 --> 00:00:51.039
So I hope you find that useful.
00:00:56.000 --> 00:00:58.799
This is outreach from uh CMC, wasn't it?
00:00:58.880 --> 00:00:59.039
Yeah.
00:00:59.840 --> 00:01:01.119
So tell us a bit about that, Sarah.
00:01:01.359 --> 00:01:09.840
Well, so what was really interesting was that at CMC College, where there is a big hospital, very big hospital, I mean 3,000 beds.
00:01:09.920 --> 00:01:33.280
Yes, hospital is the new bit, and then they have all these other old bits, older buildings as well, and and and a training college, and they have made it sort of mandatory that nurses who teach in the degree programmes and postgraduate courses all still have responsibility for wards and for community outreach, and everybody has to do uh community outreach as well.
00:01:33.439 --> 00:01:58.400
So they've got this network of um village clinics where which are uh nurse-led, and um the nurses will go to you and use you know, either to visit patients in their houses or use um a very small kind of community space um and set up sort of clinics for children for the elderly, and they'll do a bit of exercise.
00:01:58.640 --> 00:02:11.280
We joined in with the exercise class, and all of the um elderly women this was for were were just absolutely killing themselves laughing at my attempts to um do a little bit of uh you know physio.
00:02:11.599 --> 00:02:15.280
And if I can persuade Sarah to put our pictures on social media, I will.
00:02:15.520 --> 00:02:16.319
Oh, why not?
00:02:16.639 --> 00:02:20.000
Uh it it it did kind of I think we bonded over it.
00:02:20.240 --> 00:02:22.560
Um, but they also get health checks.
00:02:22.639 --> 00:02:33.759
Um, there's a lot of diabetes in India, and that's something that they are managing people with you know long-term conditions in the community, and it can and it it's it's just fantastic.
00:02:34.319 --> 00:03:04.319
So, you know, no one has to pay unless they can pay, they get their prescriptions for free, um, they give them a you know a bit of food and and and drink as well, and it's a social aspect as well, because somebody told us how um the elderly in India in the urban areas now, because of the way that people work such long hours in their jobs and and move away from families, they've got the same problem we have in the West, which is the elderly people are isolated.
00:03:04.639 --> 00:03:13.759
So having these sort of centres where they can socialise as well, they they're really placing a um a great uh sort of service there.
00:03:14.240 --> 00:03:21.120
Um, in the villages, it's it's still a lot more sort of you stay with the family, and the family then have to do all of the care.
00:03:21.599 --> 00:03:24.319
So the family have to learn how to look after a tracheostomy.
00:03:24.560 --> 00:03:26.080
Yeah, which is quite a big deal, isn't it?
00:03:26.240 --> 00:03:48.319
I mean, we just literally met one of the managers at the Holdy Inn as we were just coming up here, and they were finding us this lovely space, and she said, Oh, tracheostomy is my father had a tracheostomy, and she was describing how exactly as we've said, you know, there was an inpatient period, and then her father was discharged to the family, and there was a little bit of education, but uh not a lot.
00:03:48.479 --> 00:03:58.639
And she said she remembers sitting with her family looking at YouTube videos, trying to work out how to do the suctioning, and you know, she's describing all the things that that we do on a daily basis.
00:03:58.800 --> 00:04:05.919
Uh and then yeah, really scary, and that was something that really came across from our visit here.
00:04:06.000 --> 00:04:36.079
That that you know, we've got a lot of resources that are very specific to the UK and to sort of our setup, but it was very clear that that we can develop resources in partnership with our colleagues here in India that that that may well be relevant to exactly that situation because of that sort of really strong sort of family unit that that they have in India that that are essentially tasked with doing pretty complex care that in our country we'd be having sort of community district nurses going out to to deliver.
00:04:36.240 --> 00:04:41.199
So it was quite spectacular, really, that that that families can can take that word load on.
00:04:41.439 --> 00:04:43.439
And I think I mean she actually said, didn't she?
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Well, what was I supposed to do?
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I had no choice.
00:04:45.759 --> 00:04:53.439
Of course I'm gonna look after my father, and that you know that's the strength of I think in India what we've been the hospitality has been incredible, hasn't it?
00:04:53.600 --> 00:04:58.720
And that and that um sort of obviously family is incredibly important, isn't it?
00:04:58.959 --> 00:05:08.959
And the family networks are obviously really strong, but yeah, I think we've already had some people offer to translate NTSP resources into Hindi, haven't we?
00:05:09.120 --> 00:05:16.240
So we we've obviously uh when we ran the course at the weekend um on trackicare with uh Dr.
00:05:16.399 --> 00:05:19.040
Bincy Pandian and and my Dr.
00:05:19.120 --> 00:05:28.079
Michael Brenner from the States, we we did a lot of shared, you know, sharing of um you know discussions, didn't we?
00:05:28.240 --> 00:05:41.199
And um yeah, some we said, wouldn't it be great if someone could now follow on from our Portuguese and Spanish versions and and have something in Hindi and two people come up to you within five minutes saying?
00:05:42.079 --> 00:06:03.759
Yeah, so I mean it's it's fantastic, and and and that's what we're hoping to get is it's a collaboration and trying to work out how we can work together going forward to develop sort of India-specific resources, I guess, but then that would be more sort of relevant to this part of the world, sort of taking those principles of outstanding care that we've seen and adding in what we've learned.
00:06:04.160 --> 00:06:20.319
We had a lot of conversations with everyone we've met, haven't we, about just not reinventing the wheels and not doing things our way because that's not appropriate for India, the different different challenges, different healthcare uh setup organizations are set up differently.
00:06:20.879 --> 00:06:42.079
But don't reinvent the wheel here, use this as a template, and and we talked a lot about collecting data, and people are really you know, how they find time to do that is another thing, but everybody's incredibly keen on producing more um research in India on the in on the um subject of tracheostomy management.
00:06:42.160 --> 00:07:04.800
I spoke to lots of speech therapists about you know how do you how do you um still primarily work as a clinician but do clin do clinical research as well, and you know that's what I did most of my career until I got protected time, so I don't have their case over sizes, but I think they are they're so passionate and key.
00:07:05.199 --> 00:07:15.439
Everyone we met, yeah, I mean it's all I suppose the the it it's all about goodwill and compassion and and dedication, isn't it?
00:07:15.519 --> 00:07:16.639
I've been so impressed.
00:07:16.720 --> 00:07:22.079
Yeah, and then at um St John's that was a different experience again, wasn't it?
00:07:22.319 --> 00:07:47.759
Yeah, very much so, and and it's again a slightly different funding model again, but the uh you know we were lucky enough to be taken around to the wards, we went to the very impressive intensive care unit, and then we got taken to a brand new sort of purpose-built geriatric unit, which again builds on those sort of Indian values, you know, there's lots of space, space for families to come, uh opportunities for sort of respite care.
00:07:47.920 --> 00:07:48.639
They had patients.
00:07:49.040 --> 00:07:50.720
Oh, yeah, yeah, yeah, yeah.
00:07:51.279 --> 00:08:08.079
Yeah, and they'd had a few patients through with tracheostomies, and on that sort of transition from acute hospital care, you know, obviously, the older you are, the more likely it is you're going to take a bit more time to either come to terms with the tracheostomy and learn how to look after it, or to even potentially be decannulated.
00:08:08.319 --> 00:08:16.959
We were talking about you know getting speech and language therapy involved in in some of those patients because it's likely not all will need a tracheostomy long term.
00:08:17.519 --> 00:08:29.360
Yeah, but I think there's I mean it's such a massive unmet need here because like at St John's Hospital, I think they had four speech therapists for a thousand three thousand beds.
00:08:29.439 --> 00:08:42.559
Yeah, um, and so they they'd sort of had to one just did sphage and one just did stroke, one just did communication, and you know, of course they haven't got the capacity to get involved early enough.
00:08:42.879 --> 00:09:00.799
Um but I think that you know there's a and I think there's still they're still at the point where uh there's a bit of a lack of awareness of what we can do for patients and why why we should be seeing them early with tracheostomies not not waiting until they've got you know almost discharged.
00:09:00.960 --> 00:09:06.159
So there's I think um some really interesting discussions around that, weren't there?
00:09:06.720 --> 00:09:10.879
It probably reflects probably the journey that we've been on the last 10-15 years, isn't it?
00:09:11.840 --> 00:09:12.720
It is indeed, yeah.
00:09:12.879 --> 00:09:24.480
And you know, what we'll be trying to do is is share stuff that we're up to now and and and say, look, you know, we've had exactly these problems, and this is what we've been able to do to get speeches and other people.
00:09:26.080 --> 00:09:37.519
What would be great is if um Indian clinicians can collect their data and and their evidence because you know there are different problems, yeah, different clinical problems here.
00:09:37.840 --> 00:09:38.240
Fantastic.
00:09:38.399 --> 00:09:40.720
Alright, well, Sarah, always a pleasure to talk to you.
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Thank you so much for your insights.
00:09:43.279 --> 00:09:44.080
Yeah, cool.
00:09:44.320 --> 00:09:46.399
So uh that's it for this episode.
00:09:46.480 --> 00:09:54.960
Uh, as ever, the opinion you just heard are our own opinions, they don't necessarily reflect the opinions of the organisations uh which pay our wages.
00:09:55.039 --> 00:10:00.159
Uh, you can find out lots more on our website, uh, you can follow us on our social media channels.
00:10:00.320 --> 00:10:02.720
Um, thanks for listening and see you next time.
00:10:02.960 --> 00:10:03.279
Thank you.
00:00:08.560 --> 00:00:12.880
Hello and welcome to this special episode of Tracky Talk.
00:00:13.039 --> 00:00:26.480
We're here in Bengaluru in the south part of India and I'm joined by Professor Sarah Wallace, OBE, who's a legendary speech and language pathologist that I'm sure many of you know.
00:00:26.800 --> 00:00:34.240
We're currently in the Holiday Inn near the race course in Bengaluru and we're very grateful to the staff for finding us this nice quiet space.
00:00:34.399 --> 00:00:48.719
We've got a bit of time to kill before we have to head home, so we thought it'd be a really good idea to spend a bit of time just reflecting on uh what we have uh observed and learnt, uh, and some of the people that we've met and some of the things that we've seen in India.
00:00:48.880 --> 00:00:51.039
So I hope you find that useful.
00:00:56.000 --> 00:00:58.799
This is outreach from uh CMC, wasn't it?
00:00:58.880 --> 00:00:59.039
Yeah.
00:00:59.840 --> 00:01:01.119
So tell us a bit about that, Sarah.
00:01:01.359 --> 00:01:09.840
Well, so what was really interesting was that at CMC College, where there is a big hospital, very big hospital, I mean 3,000 beds.
00:01:09.920 --> 00:01:33.280
Yes, hospital is the new bit, and then they have all these other old bits, older buildings as well, and and and a training college, and they have made it sort of mandatory that nurses who teach in the degree programmes and postgraduate courses all still have responsibility for wards and for community outreach, and everybody has to do uh community outreach as well.
00:01:33.439 --> 00:01:58.400
So they've got this network of um village clinics where which are uh nurse-led, and um the nurses will go to you and use you know, either to visit patients in their houses or use um a very small kind of community space um and set up sort of clinics for children for the elderly, and they'll do a bit of exercise.
00:01:58.640 --> 00:02:11.280
We joined in with the exercise class, and all of the um elderly women this was for were were just absolutely killing themselves laughing at my attempts to um do a little bit of uh you know physio.
00:02:11.599 --> 00:02:15.280
And if I can persuade Sarah to put our pictures on social media, I will.
00:02:15.520 --> 00:02:16.319
Oh, why not?
00:02:16.639 --> 00:02:20.000
Uh it it it did kind of I think we bonded over it.
00:02:20.240 --> 00:02:22.560
Um, but they also get health checks.
00:02:22.639 --> 00:02:33.759
Um, there's a lot of diabetes in India, and that's something that they are managing people with you know long-term conditions in the community, and it can and it it's it's just fantastic.
00:02:34.319 --> 00:03:04.319
So, you know, no one has to pay unless they can pay, they get their prescriptions for free, um, they give them a you know a bit of food and and and drink as well, and it's a social aspect as well, because somebody told us how um the elderly in India in the urban areas now, because of the way that people work such long hours in their jobs and and move away from families, they've got the same problem we have in the West, which is the elderly people are isolated.
00:03:04.639 --> 00:03:13.759
So having these sort of centres where they can socialise as well, they they're really placing a um a great uh sort of service there.
00:03:14.240 --> 00:03:21.120
Um, in the villages, it's it's still a lot more sort of you stay with the family, and the family then have to do all of the care.
00:03:21.599 --> 00:03:24.319
So the family have to learn how to look after a tracheostomy.
00:03:24.560 --> 00:03:26.080
Yeah, which is quite a big deal, isn't it?
00:03:26.240 --> 00:03:48.319
I mean, we just literally met one of the managers at the Holdy Inn as we were just coming up here, and they were finding us this lovely space, and she said, Oh, tracheostomy is my father had a tracheostomy, and she was describing how exactly as we've said, you know, there was an inpatient period, and then her father was discharged to the family, and there was a little bit of education, but uh not a lot.
00:03:48.479 --> 00:03:58.639
And she said she remembers sitting with her family looking at YouTube videos, trying to work out how to do the suctioning, and you know, she's describing all the things that that we do on a daily basis.
00:03:58.800 --> 00:04:05.919
Uh and then yeah, really scary, and that was something that really came across from our visit here.
00:04:06.000 --> 00:04:36.079
That that you know, we've got a lot of resources that are very specific to the UK and to sort of our setup, but it was very clear that that we can develop resources in partnership with our colleagues here in India that that that may well be relevant to exactly that situation because of that sort of really strong sort of family unit that that they have in India that that are essentially tasked with doing pretty complex care that in our country we'd be having sort of community district nurses going out to to deliver.
00:04:36.240 --> 00:04:41.199
So it was quite spectacular, really, that that that families can can take that word load on.
00:04:41.439 --> 00:04:43.439
And I think I mean she actually said, didn't she?
00:04:43.600 --> 00:04:44.639
Well, what was I supposed to do?
00:04:45.040 --> 00:04:45.600
I had no choice.
00:04:45.759 --> 00:04:53.439
Of course I'm gonna look after my father, and that you know that's the strength of I think in India what we've been the hospitality has been incredible, hasn't it?
00:04:53.600 --> 00:04:58.720
And that and that um sort of obviously family is incredibly important, isn't it?
00:04:58.959 --> 00:05:08.959
And the family networks are obviously really strong, but yeah, I think we've already had some people offer to translate NTSP resources into Hindi, haven't we?
00:05:09.120 --> 00:05:16.240
So we we've obviously uh when we ran the course at the weekend um on trackicare with uh Dr.
00:05:16.399 --> 00:05:19.040
Bincy Pandian and and my Dr.
00:05:19.120 --> 00:05:28.079
Michael Brenner from the States, we we did a lot of shared, you know, sharing of um you know discussions, didn't we?
00:05:28.240 --> 00:05:41.199
And um yeah, some we said, wouldn't it be great if someone could now follow on from our Portuguese and Spanish versions and and have something in Hindi and two people come up to you within five minutes saying?
00:05:42.079 --> 00:06:03.759
Yeah, so I mean it's it's fantastic, and and and that's what we're hoping to get is it's a collaboration and trying to work out how we can work together going forward to develop sort of India-specific resources, I guess, but then that would be more sort of relevant to this part of the world, sort of taking those principles of outstanding care that we've seen and adding in what we've learned.
00:06:04.160 --> 00:06:20.319
We had a lot of conversations with everyone we've met, haven't we, about just not reinventing the wheels and not doing things our way because that's not appropriate for India, the different different challenges, different healthcare uh setup organizations are set up differently.
00:06:20.879 --> 00:06:42.079
But don't reinvent the wheel here, use this as a template, and and we talked a lot about collecting data, and people are really you know, how they find time to do that is another thing, but everybody's incredibly keen on producing more um research in India on the in on the um subject of tracheostomy management.
00:06:42.160 --> 00:07:04.800
I spoke to lots of speech therapists about you know how do you how do you um still primarily work as a clinician but do clin do clinical research as well, and you know that's what I did most of my career until I got protected time, so I don't have their case over sizes, but I think they are they're so passionate and key.
00:07:05.199 --> 00:07:15.439
Everyone we met, yeah, I mean it's all I suppose the the it it's all about goodwill and compassion and and dedication, isn't it?
00:07:15.519 --> 00:07:16.639
I've been so impressed.
00:07:16.720 --> 00:07:22.079
Yeah, and then at um St John's that was a different experience again, wasn't it?
00:07:22.319 --> 00:07:47.759
Yeah, very much so, and and it's again a slightly different funding model again, but the uh you know we were lucky enough to be taken around to the wards, we went to the very impressive intensive care unit, and then we got taken to a brand new sort of purpose-built geriatric unit, which again builds on those sort of Indian values, you know, there's lots of space, space for families to come, uh opportunities for sort of respite care.
00:07:47.920 --> 00:07:48.639
They had patients.
00:07:49.040 --> 00:07:50.720
Oh, yeah, yeah, yeah, yeah.
00:07:51.279 --> 00:08:08.079
Yeah, and they'd had a few patients through with tracheostomies, and on that sort of transition from acute hospital care, you know, obviously, the older you are, the more likely it is you're going to take a bit more time to either come to terms with the tracheostomy and learn how to look after it, or to even potentially be decannulated.
00:08:08.319 --> 00:08:16.959
We were talking about you know getting speech and language therapy involved in in some of those patients because it's likely not all will need a tracheostomy long term.
00:08:17.519 --> 00:08:29.360
Yeah, but I think there's I mean it's such a massive unmet need here because like at St John's Hospital, I think they had four speech therapists for a thousand three thousand beds.
00:08:29.439 --> 00:08:42.559
Yeah, um, and so they they'd sort of had to one just did sphage and one just did stroke, one just did communication, and you know, of course they haven't got the capacity to get involved early enough.
00:08:42.879 --> 00:09:00.799
Um but I think that you know there's a and I think there's still they're still at the point where uh there's a bit of a lack of awareness of what we can do for patients and why why we should be seeing them early with tracheostomies not not waiting until they've got you know almost discharged.
00:09:00.960 --> 00:09:06.159
So there's I think um some really interesting discussions around that, weren't there?
00:09:06.720 --> 00:09:10.879
It probably reflects probably the journey that we've been on the last 10-15 years, isn't it?
00:09:11.840 --> 00:09:12.720
It is indeed, yeah.
00:09:12.879 --> 00:09:24.480
And you know, what we'll be trying to do is is share stuff that we're up to now and and and say, look, you know, we've had exactly these problems, and this is what we've been able to do to get speeches and other people.
00:09:26.080 --> 00:09:37.519
What would be great is if um Indian clinicians can collect their data and and their evidence because you know there are different problems, yeah, different clinical problems here.
00:09:37.840 --> 00:09:38.240
Fantastic.
00:09:38.399 --> 00:09:40.720
Alright, well, Sarah, always a pleasure to talk to you.
00:09:40.879 --> 00:09:42.879
Thank you so much for your insights.
00:09:43.279 --> 00:09:44.080
Yeah, cool.
00:09:44.320 --> 00:09:46.399
So uh that's it for this episode.
00:09:46.480 --> 00:09:54.960
Uh, as ever, the opinion you just heard are our own opinions, they don't necessarily reflect the opinions of the organisations uh which pay our wages.
00:09:55.039 --> 00:10:00.159
Uh, you can find out lots more on our website, uh, you can follow us on our social media channels.
00:10:00.320 --> 00:10:02.720
Um, thanks for listening and see you next time.
00:10:02.960 --> 00:10:03.279
Thank you.
