These days, when Sudha Panchapakesan comes in to office, she has a session of speech therapy first, before dealing with the day’s work. Two years ago, Mrs. Panchapakesan suffered a stroke that affected that part of the brain associated with language. It left her with aphasia — a condition that can affect a person’s ability to speak, write and understand language.
Today, after intensive speech therapy both in the United States and in Chennai, she is on the road to recovery. For many others though, the outcome may not be as good — experts say there is a serious lack of speech language therapists to cater to the needs of patients here.
An estimated 4,500 people suffer from stroke in the country every day, said D.S. Halprashanth, consultant neurologist, Global Hospitals. Of these, at least 60% are strokes that damage the left side of the brain and therefore, affect speech and language. About half of these patients develop aphasia, he said.
According to the Aphasia and Stroke Association of India, a non-profit organisation, the condition affects an estimated 800,000 to 1,00,000 people annually in India. Strokes are not the only cause — infections, brain tumours and other conditions that damage the left portion of the brain can also cause it, doctors said.
There are various kinds of aphasia, said M. Balamurugan, consultant neurosurgeon, Apollo Hospital. One type affects the ability of the person to express themselves, while in another, persons may be able to speak but may use incorrect or unrecognisable words. There are other types as well. “In aphasia, recovery is a time-consuming process — it could take months. While most patients recover almost completely, a few may not. The problem is, there are not enough speech therapists available,” he said.
Multiple causes
Prakash Boominathan, professor, department of speech, language and hearing sciences at Sri Ramachandra University, agrees. “There are only about 6,000 speech language therapists registered in the country. In Chennai, there are about 100. With the incidence of stroke rising there is a need for more therapists. Even among the therapists we have, many do not specialise in aphasia,” he said. Recovery, he explained, involves a shift of function from the damaged part to the undamaged part of the brain.
Aphasia affects not just the person who has it, but also their families, said Prof. Boominathan. “It alters family dynamics, can disrupt work and day-to-day activities and can cause immense difficulties, especially as more men get it and often in their fifties. One of the biggest problems is that it is difficult for patients to come to hospitals regularly for months on end for the treatment they need. Not many therapists offer home serves,” he said.
Close to four years after her husband suffered from a stroke at the age of 50 and got aphasia, Girija* sometimes still struggles to understand what he is saying. “It is much better now and he can ask for what he wants. Reading and writing are coming back slowly and he goes to work. But it was very difficult for us,” said the home-maker, whose husband is in the police.
Awareness needed
R. Vilasini, audiologist and speech language pathologist at Global Hospitals, says there is also a need for more awareness among patients and caregivers. “More speech therapists are needed and more awareness about the time it takes to recover is also needed among patients and caregivers,” she said. Another issue, says V. Nagarajan, senior consultant neurologist at SIMS Hospital, is that speech therapists are concentrated in urban areas. There are only a few therapists in rural areas or even none.
“Losing speech can be a very traumatic event. But aphasia is not a loss of memory or intelligence — far from that. This should be understood,” said Mr. Panchapakesan, founder-trustee, Bhoomika Trust.
*Name changed
To increase awareness about aphasia and to make patients and caregivers aware about options and resources available as well as to help improve the quality of therapy, Bhoomika Trust along with Sri Ramachandra University and the Indian Council of Medical Research, is organising a conference from February 23 to 25 for speech therapists followed by a half-day session for doctors and caregivers on February 26. For more details, contact Murali on 9841076244 or email vmurali@bhoomikatrust.org
