NTSP Special Interview (India 2026) Mumbai SLT team

The team were in India in February 2026 and had the privelege to meet patients, families and staff who were working to improve tracheostomy care. This special interview is with the Speech & Language Head & Neck Fellows from the Tata Memorial Hospital Mumbai. The team were reflecting on their successful National Tracheostomy Conference.

The UK National Tracheostomy Safety Project (NTSP) is committed to providing education, information and resources to improve patient safety and the patient experience for those with tracheostomies and laryngectomies. All of our resources are housed on our website www.tracheostomy.org.uk, accessed by over 30,000 visitors each month from around the world.

This is the only podcast to bring you literature reviews, hot topic discussions and interviews with healthcare staff, patients and families.

Our goal is to improve the safety and quality of care for patients with tracheostomies and laryngectomies through education. We work closely with patients, families and healthcare professionals to develop new resources to improve care. We’ve collaborated with key stakeholders in tracheostomy care since 2009, and developed freely accessible resources, supported by online learning developed with the UK Department of Health. We’ve worked with the Global Tracheostomy Collaborative since 2012 to improve care for patients and their families everywhere.

We are funded by grants, donations and in partnership with medical device companies through unrestricted awards. This podcast series is supported by unrestricted education funding from the Atos Learning Institute. The funding supports the professional production of the podcasts and videos, and the medical device companies that support us do not have any creative influence over the content that we record. All of our work is undertaken by volunteer healthcare staff, patients and their families. 

Most of our content is supported by videos. You can access our training videos and resources for Basic Care, Emergency Care and Vocalisation & Swallowing. Download and print bedhead signs and emergency algorithms from our resources. 

You can support our work by watching or clicking any of the advertising links that appear via the NTSP YouTube Channel. You can also donate directly to the NTSP through the NTSP website, or by clicking the Buzzsprout podcast hosting "support" links. You can support our work by watching or clicking any of the advertising links that appear via the NTSP YouTube Channel.

Transcript

SPEAKER_01 0:07

Hi, it's Ben Ralph and TSP. This is a series of special interviews that we've collected from our 2026 trip to India. We attended a two-day trip yesterday course hosted by the Tata Memorial Centre and National Transport in Mumbai. This is organized mostly by the head of ecosurgical department and the speech and language therapy team at the Tata Memorial Hospital. We're so impressed by the skills and dedication of the speech and language therapy team led by Dr. Arim Balaji that we just had to record a conversation with the fellows in the department. So hope you find this interesting.

SPEAKER_02 0:49

So here we are in Mumbai with the speech and language therapy team at Tata Memorial Hospital. I'm going to start off by getting them to introduce themselves. So fire away.

SPEAKER_05 0:57

Hello, I'm Panare Ulgar. And I'm a fellow in speech language and Soloth Ehiripi here in Tata Memorial Hospital.

SPEAKER_03 1:05

Hello, I am Brenchatov, and I am also the fellow in speech language pathology in Tata Memorial Hospital.

SPEAKER_06 1:12

Hi, my name is Anushka Kulkarni, and I'm a fellow here at Tata Memorial Hospital in Speech Language. So it's speech and swallowing pathology.

SPEAKER_00 1:19

Hello, my name is Midul Lali, and hello in Tatam Moral Hospital.

SPEAKER_03 1:25

Hi, my name is Dad again. And I'm a speech language therapist in Tatam Moral.

SPEAKER_04 1:32

Hello, I am Nikita and I am a current fellow in a speech and language pathologist in Tatam Memorial Hospital.

SPEAKER_02 1:40

Fantastic. So we've been here for a couple of days learning from you guys and talking a lot about tracheostasy. So it's really useful to hear about your jobs because they're very different jobs in my country. So why don't we start by telling me what your typical day looks like if you have a typical day?

SPEAKER_05 1:56

So our typical day it starts around at 9am in OPD. So we start our OPD around 9 am and we see around 60 to 70 patients a day, and we also have award rounds where we go around, and plus we also have an endoscopic clinic as well, which which we all fellows we go by turns and we do fees and we do FOLs. So yeah, that is how our day looks like when it ends, it depends upon there is no fixed time every day when it ends, so yeah.

SPEAKER_06 2:28

We also have a period of fluoroscopic swallowing study clinic, which is mostly on these Saturdays, so it's once a week, and uh we have like quite about 15 to 20 patients per day, uh like per week, whom we schedule for barium swallow as well. And uh, other than that, our caseload it's a high-volume center. We have a lot of patients coming to us, uh, but we are predominantly dealing with patients, uh heronic cancer patients, and to be more specific, uh, you can say oral cancer patients or laryngectomy cancer, uh laryngectomy patients.

SPEAKER_03 3:02

To add up with that, we also uh see acute patients and we go to wardrounds, we uh see patients coming from the surgery post-operative day, like four, five, six days of the surgery. So that's and also we do have postings uh in the Actric by Tata Memorial Hospital, two days in a week. There also we have to see the patients there, same similar case load, and we do have uh VFS schedules. So every Monday and every Thursday, we do two of us have to go there, and there also we have to see the patients around 35 to 40. Uh there.

SPEAKER_00 3:40

And other than head and we are uh also dealing with the thoracic cases, lung cancers, and LR in the speech rehabilitation, and also we have a bridge between the thoracicity, head and OPD. We get a reference from this. We get a reference from Olive.

SPEAKER_04 3:58

So, you know, uh if we are dealing with uh head and neck cancer patients, so uh as it is a multidisciplinary team, if we are having any doubts and if we are having anything which uh we should uh uh we should have to take a call, so we'll uh take a uh take our consensus head and active department also, so that we'll get uh uh a decision from them and we'll act accordingly.

SPEAKER_02 4:24

Okay, fantastic. And we've had the privilege of being here for a few days now and seeing what you guys do. I mean specifically, what what is the speech and language therapy input uh into the caseload if we just focus, say, on a head and neck cancer patient? What specifically do you guys do?

SPEAKER_06 4:39

So predominantly we work with swallowing for these patients. So, like from the speech, language, swallowing, and voice aspect of our field per se, we do uh exist like extensively work with swallowing. Uh, in that we do assessments, we do evaluations, we plan the rehabilitation for such patients. We see those patients uh previous to like any kind of adjuvant uh radiation therapy or any surgery that has been planned for them, and post-op and then post-rediation or post-chemoradiation, whatever adjuvant therapy the patient might undergo. Uh, in that, uh, our role is to ensure that the swallowing function of those patients, which is definitely compromised post these treatments, that we try and get back uh to maybe not if not 100%, but at least close to what they used to have, so as to you know rehabilitate and let them go back to their normal lives.

SPEAKER_04 5:34

That's one of the major functions that we uh so adding to that we have uh specific skills we are using in academic cancer department. So where uh the those skills are helping uh us to uh uh us to uh uh elaborate about the aspiration risk and everything. So we are uh having such skills where we'll uh use those skills and we'll uh uh do accordingly.

SPEAKER_05 6:00

So apart from that, we also have our fees clinic as well, and plus we also have a rehab fees as well, which we provide. So when we teach any rehab strategy to the patient, so we want to make sure that he's using it appropriately frequently, so we show show it with the help of a biofeedback in our endoscopy clinic. So they also understand that what exactly is happening when I'm doing this technique, and and plus, how am I supposed to don't do it? So it is very helpful, and we also have a rehab piece, so that is something which we know.

SPEAKER_03 6:31

We have a voice restoration program also in which we have use stroke and also we have uh therapy in giving like for the voice patients, we give voice therapy programs, and uh it is very useful for them to you know get their voice in a back to getting back to normal. So that is also a very useful thing which we are doing.

SPEAKER_00 6:52

And every Tuesday and Thursday we have a Jana club where we will uh discuss about the reason's current uh evidence-based practice in dysphagia and challenging cases, and uh we further discuss a further evaluation and what to do and uh when how things also we will discuss only these days.

SPEAKER_03 7:15

An important aspect uh adding on to the practice which is there is uh in TMH, what we follow is more of a multidisciplinary approach. So here uh the head and neck team and the speech language pathologist team and the nutrition team as well as the physiotherapist team all together come to help the patients in uh one go. We do have an EMR system where every each and every report of the patient and uh information is being updated. So no professional, no uh like uh healthcare professional is uh like uh clueless about what is going on with the patients and what is the treatment plan further ahead for the patient. So we can go on with that, those things, and we can also have the like we do have the uh uh like uh uh we can directly talk to the people whoever are there in the team to plan for further like intervention.

SPEAKER_02 8:04

Okay, fantastic. So you got a whole wide range of different skills and interventions, it's a full portfolio, really, isn't it? So we're here at the end of this Tracheostomy conference, that's what all the noise is in the background that we're trying to keep our voices uh elevated over. Um this has been a really interesting couple of days for us. I mean, what have you guys learned from the from the conference, do you think?

SPEAKER_03 8:25

So before uh like attending this conference, so there have been so many myths, though there have been so many uh like uh myths which have been there in the minds of SLPs. So being an SLP in India, it's been like uh more of uh whatever we have learned. Whatever we have learned is uh more of uh like we haven't dealt much with the trachistomy things. There are so like different colleges, they have different different uh exposure to the patient. So most of the SLPs when it comes to dealing with the patients with trachistomies, it is a fearful experience. So seeing the patient intubated or seeing the patient with the trachistomy tube, it itself uh gives a uh feeling of fear to the SLP. So now understanding trachistomy and understanding aspiration is a whole new perspective from this conference which we have got. There have been so many mythbusters which were there, is exactly like before we had an ex uh like if there is an aspiration, we will think that the patient is going to fall into the aspiration emotions and eventually death. So these all things have been ruled out from our minds. So this will definitely uh go to uh going to help us in our future uh practices to the patients.

SPEAKER_04 9:36

So adding to that, so whenever we see a tracheostomy patient, we'll uh uh see in a way that how to decannulate it. So, what are the factors to decannulate the tracheostomy cube and how uh we are uh going to uh take that action of uh decannulating it. So, uh in order to rule out all these aspects, this uh tracheostomy uh course has uh played an impact uh important role uh in learning all those such things, and also the tracheostomy care and what we should have to say to the patients, caregiver, uh how to uh maintain tracheostomy uh tubes and how to uh maintain their stoma at home. Everything we have uh uh learned in the tracheostomy course.

SPEAKER_00 10:17

And one of the most important things which uh one of the most important things which uh I learned is the role of each provision in tracheostomy. Like uh now after this conference we got to know that uh in which all situation we need to seek different provisions to help. So that is one of the biggest things learned from this conference.

SPEAKER_06 10:39

I think I'll just add my greatest takeaway from here was the kind of research that's being done in terms of helping the patient get their voice back, whether it's speaking wells, whether it's above voice, above uh voicing. I mean, these are all very new things for us, and um it was quite enlightening to know that okay, this is something that's achievable for such patients. Like, I mean, imagine a patient is lying on his bed and it's POD3, and they're still wondering that I'm not able to speak, I'm not able to express myself. But oh, we have another um mechanism in which even in an acute setting the patient is able to voice. I mean, that's such a great thing. And I think like uh before this conference, I to whatever little reading that I had done, I genuinely thought that that was not possible for a patient to achieve that in an acute setting. So I think that was a great takeaway from this course, Risha, and all thanks to our activities here.

SPEAKER_03 11:36

So, first of all, I want to thank everyone. Uh, all of you have come a long way to teach us, and at the same time, we have got a very uh broad knowledge on how to like we have a lot of caseload, I understand, but then there is a on the opposite side, we have a structured way of doing it. So, that also we are understanding the protocols, the descriptions which you are following over there, and that has got us a very uh like enlightenment for us to proceed on, like, okay, what and all has to be some necessary steps to follow and protocols, and which is evidence-based. So, according like again, Anishka, what she said, it is a like a big study which is happening, so we are also now motivated that we should also be doing some kind of research here. Absolutely.

SPEAKER_05 12:23

So, that is a very important inspiration for all of this that that we have to generate more evidence-based. And since during the course of all our studies of six years, we have been not taught much about the trick use to mean pressure, even not dealing with them also. But this course was definitely going to help us to build more evidence and use evidence-based practices with our patients. So, yeah.

SPEAKER_04 12:48

With such a huge population over here, and which uh which with such a huge caseload over here, I think we as an young uh speech therapist we should also initiate and we should also uh do research and we should also uh make some evidence based uh managements over here, which uh in which we are uh we have learned from this course and also from you. Thank you.

SPEAKER_05 13:14

We are we are glad that we got opportunity to learn from you all this year.

SPEAKER_02 13:19

We've learned from you guys too. It's been a two-way experience. It's been a privilege to be here. Thank you for hosting us and thank you for taking the time out of your day to uh explain to everybody a bit about your roles and a bit about the work you do at TALS More itself. Thank you very much. Thank you. Thank you.

SPEAKER_01 13:43

That's it for this special episode in India. Hope you found that interesting. Please, if ever leave any comments on our social media platforms, and feel free to follow us, to get involved, and to check out our resources on the website. The opinions that you've heard are the opinions of the individuals and not necessarily those of the organizations in which we work. Hope you found that useful. Look forward to seeing you next time. Bye for now.