In December 2019, a deadly measles outbreak on the Pacific island of Samoa spread rapidly, mainly affecting babies and young children. British doctors, nurses and physiotherapists from the UK Emergency Medical Team (UKEMT), trained by UK-Med and Humanity & Inclusion (HI), travelled to Samoa to work with the Australian Medical Assistance Team (AUSMAT) to support the response.
It became apparent very rapidly that many children with oral, pharyngeal and oesophageal lesions caused by the virus were experiencing difficulties with eating and drinking. After children were stabilised and their emergency non-oral feeding methods removed, many were averse to returning to oral feeding, and babies struggled to return to breastfeeding, due to pain and scarring on their lips and in their mouths. Maintaining an oral hygiene routine with children was also challenging, putting them at further risk of infection.
In response to these challenges, HI sought the advice of SLTs to offer support to the medical team on the ground. Through networks including the RCSLT CEN Communication Therapy International, two therapists with international dysphagia expertise were identified by HI to offer voluntary remote support: Louise Edwards, who provided pre-deployment training; and Helen Barrett who coordinated an advisory group to respond to the challenges on the ground in Samoa. The advisory group consisted of six experts with experience working internationally (including in Samoa) and in humanitarian contexts, and they together produced guidance for the team in Samoa, in response to their priority challenges.
583 patients were cared for by the combined medical teams during the UK deployment and the remote SLT support was very well received. The value of SLT support in outbreak responses such as this has been recognised and the teams are currently reflecting upon the Samoa experience to ensure maximum preparedness for any future outbreak responses resulting in feeding difficulties.
With thanks to Pete Skelton at HI and the dysphagia advisory group: Helen Barrett (Coordinator: UK/Malaysia); Louise Edwards (UK); Mershen Pillay (South Africa); Georgina Feint (UK); Emma Shah (UK); Hannah Poynter (UK) and for the support of Julie Marshall (Chair, CTI).
This article was first published in RCSLT Bulletin in April 2020 and has been reproduced with the kind permission of RCSLT.