NTSP Specials (S2) Prof Wallace meets Latin American SLTs in Mexico: Pia and Benito

The NTSP's Prof Sarah Wallace was recently speaking in Cancun, Mexico at the Sociedad Latinoamericano de Disfagia (SLAD, the Latin American Dysphagia Conference). 

Sarah bumped into Pia Astoroga and Benito Parra who work as SLPs in Mexico, one of 17 countries represented at the Conference. Pia and Benito took the time to tell us all about their work in Mexico, including their patient mix, the infrastructure they work in, common problems they encounter, and how they manage their caseloads. 

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Transcript

SPEAKER_02 0:37

Hola. So I am Professor Sarah Wallace and I'm in Cancun at the Universidad de Anahuac. And I'm joined by my lovely friends Pia and Benito who are from Mexico. We are at the conference of the Latin American Dysphagia Society, where we have representatives of 17 countries, and we really want to learn about tracheostomy care in different parts of Latin America. So Pia and Benito, thank you. And they're going to share some of their thoughts about tracheostomy in Mexico. So please would you introduce yourselves?

SPEAKER_03 1:23

Yes, yes. My name is Pia Gallardo. I am a speech language pathologist and I'm from Chile but living in Mexico and Argentina.

SPEAKER_01 1:36

My name is Benito Parra, I'm from Mexico, and I'm physical therapist and with the specialty of the intensive care unit. So I'm yeah, we are very happy to be here with you, Sarah.

SPEAKER_02 1:49

So I know you've done some amazing work in Mexico, but first let's talk about what sort of patients you see with tracheostomies and what other things that are quite difficult that you want to improve.

SPEAKER_03 2:04

Yes. People know different professionals derivations in the trachostomy. So they don't understand the dream team. No, no, no. It's difficult speak with the doctor. It's necessary physiotherapies, speech language pathologies, is the derbation in the trachostomy. But it's necessary education constant. For the explain, is necessary speech language pathologies for the speaker, for swallowing, is necessary respiratory therapies for the cough, is necessary all time speak. So it's the team working. Yes, the team working is the first problem. Yes.

SPEAKER_01 3:25

And but also we have a lot of things, positive things. For example, little by little, the person or the professionals who are in the intensive care unit, like intensivists and other important professionals, they say, well, it's important to start the rehabilitation, but also the evaluation since the intensive care unit, and they take a look with other professionals and but also we have a lot of another another barrier. For example, if that if those professionals say it's important to the evaluation uh of the rehabilitation of the dysphagia or the lungs or the respiratory therapy, there is not a lot of professional or speciality of professional here in Mexico.

SPEAKER_02 4:21

You're lacking enough staff, enough workforce. Yes. There's few people with the skills.

SPEAKER_01 4:27

Yeah, and and with the education about the for for getting into the intensive per unit.

SPEAKER_02 4:33

Alright, yeah. So then uh it's difficult, people don't understand the role, but you don't have enough people with the skills to help change that. Does that mean that patients go out of ICU still with the tube?

SPEAKER_03 4:47

Yes. It's very common. It's very common patient exit to the hospital, yeah. Oh go home with the yes, go home with trachostomy. Um but the medical um the medical specialist no no think the cannulation inside the ICU. Okay. Is it's very common. We go to patient the home with trachostomy. And in the home then what happens why?

SPEAKER_02 5:20

Why? So what happens to them at home?

SPEAKER_03 5:22

Yes. And in home the the family is difficult uh learning or learning to the aspiration, care, trachostomy is difficult. In the hospital is difficult, but the home is very difficult.

SPEAKER_01 5:43

Even in the in the in the with the families, in the in the home, start rehabilitation, not in the hospital.

unknown 5:52

Okay, yes.

SPEAKER_01 5:53

So that's uh a big opportunity to start working to make so things are having happening too late.

SPEAKER_02 6:01

Yes. Um so um what do you think you could do or what are you doing to change that situation? I know you guys are doing an awful lot of really amazing work um to change this. Yes. Can you tell us about that?

SPEAKER_03 6:15

I I am with many with Benito. Um I the illusion and Discagia Mexico is the company, the education all-time, professionals and non professionals, swallowing, but the care trachostomy is necessary, dream team in the ICU, training, training, training the professionals for the ICU. It's important to see this. I see this problem. I see this problem for the take uh different um to detect the problems early.

SPEAKER_02 6:56

Yeah, to start the remote early. Yes, yes. I know I know the training you do is is amazing and I I support you with that, don't I? I do some teaching for you and and I also I think you involve all members of the team in the teaching. Yes.

SPEAKER_03 7:12

Yes, yes, it's important uh nurses, uh physical therapies, uh speech language pathologists, and doctors, and pharmaceuticals, and uh authoringologies, it is different. It's important that all uh all team uh see uh the trachostomy and care the trachostomy in ICU and outside the CO.

SPEAKER_02 7:38

So how how about equipment um availability of different types of tubes and uh is that a problem um-way valves and things like that?

SPEAKER_01 7:50

Yeah, yes, the tracheostomy in we have to take a look in the hospital in the public hospital and the private hospital because it's it's going to be different in the in the public hospital uh it has or they it it has a tracheostomy, yes they have, but uh not not the necessary for for their rehabilitation, for example. They they don't have uh with uh spirit as uh aspiration superotic coat. Yes, yeah, yeah. It's difficult, no, it's difficult, but in the private hospital we can easily if we need you can say I can get it.

SPEAKER_02 8:36

On my mouse?

SPEAKER_01 8:37

It's difficult for the mechanical ventilation. We don't have uh speaking bar, but it's possible to get uh when the the patient is is out of mechanical ventilation, it's possible to get it in the public hospital and in the private in the public because we say we tell we we speak with the family, they need about that and they buy it, they buy it, not the hospital.

SPEAKER_02 9:07

Okay, so if they can't afford it, they don't get it.

unknown 9:12

Okay.

SPEAKER_02 9:13

So tell me some more about um the good the good things that you're doing. I know you do podcasts, you do films, you're doing a lot of things outside of Mexico as well, not just in Mexico. Yeah.

SPEAKER_01 9:26

Well, with with Pia and all the not not only me and Pia, but also uh other professionals here in Mexico are working, uh hard working for visible dysphagia, the all the things that we are working, we are talking about. Um so I think this that is the most important of that in Mexico all the professionals that work with the person with dysphagia try to get together, try to work in team, um to for only one objective that is the patient. And I think that is the most important.

SPEAKER_02 10:06

The other things little by little is going to get and we should name check Carlos Gonzalez. Yeah, and Melissa. So um, and obviously here we're having the conference in Mexico, uh, we have people from all over Central and South America, Latin America. Um what do you think you have learned about trocheistomy at this conference? Have you learned some new things?

SPEAKER_01 10:35

Yeah, but uh when when when you start learning about the trochistomy, it's not easy, obviously. And then you practice what you learn, but when you practice you start to get more questions and and more questions and more questions. I I think that it's important. So for me to come and to know the professional that works with tracheostomy and the intensive care unit, and for example, here in the in the slab in the Congress, um I'm I'm going to my practice, clinical practice with more questions than answer, and I think that's the the most important when I go to the Congress.

SPEAKER_02 11:25

Yeah, I agree. And think yeah, yes.

SPEAKER_03 11:29

The one situation in Mexico is the speak all the time. But the go to the other countries here, and it's important different situations. In Central America is one situation, Mexico is one situation, Argentina is one situation, Latino American is big. But different situation in the country. It's necessary here these possibilities and it's important different situation, it's important different outcome. I think the more important is speaking with different countries and uh learning different professionals when with the situation inside your country.

SPEAKER_02 12:25

So you take your uh you take examples uh that people share from their country and you can do country. Claro, and also you share your experience.

SPEAKER_03 12:37

Yes, yes. In USA is one situation, it's more different different in Mexico, but in Mexico it's possible the cannulation in ICU. In Guatemala it's possible the cannulation in ICU, but different situations, but it's possible. It's necessary um necessary adaptations to be the different country, but the message is it's possible.

SPEAKER_02 13:05

It's possible. You have different patients here than some the same, but different patients here than may maybe I see in UK because I know you have patients with gunshot wounds, and you know you probably see more of that than I do, but yes, at the end of the day, it's about teamwork and sharing the I think this is more important.

SPEAKER_03 13:30

Dream work, dream dream work, dream work, like but real work is different, but real work is possible.

SPEAKER_02 13:39

It's possible, different conditions is possible. Um and I think on that note it's very hot. Yeah, I uh just like to say thank you.

SPEAKER_03 13:54

Thank you so much for you. It's it's a pleasure to stay here with you.

SPEAKER_01 13:59

It's a pleasure thanks for the opportunity, Sarah. I want to conclude that. And uh I think where we do the the two things and because I because I heard for you, I heard for another person that a lot of people in the past since the past they are working a lot and that it's super comfortable for all the work that we are doing, but uh but I think that we have to start working in the uh in in Mexico, principally in Mexico, with the more investigation. I think it's going to be important, so I hope that in the future there's always more we can do.

SPEAKER_02 14:47

Um it's hard work we have put together.

SPEAKER_03 14:50

Yes. I think we can do it. So it's it's necessary investigation in Latin America, but it is more it's more different the patient with here uh the patient in the other countries. But it's important. Thank you so much.

SPEAKER_02 15:04

Thank you, Sarah. All right, ciao, ciao.

SPEAKER_00 15:08

This was our last episode in our studies from Latin America. So thanks so much to Sarah for asking the questions and to all our contributors, including Peter and Bonito in this episode. You can find out a lot more about our work on our website, which is please subscribe if you want to direct Latin America. Please check out the left check up the hot craft and thank you for eight people like eight.