Bea Staley
This article was published in S&L World (February 2013)
Rehana Pasta, Nuala Alibhai
and the organizing committee for the fifth East African Conference on
Communication Disorders to be held in Mombasa later this year recently put out
a call for papers. Mombasa -- is a city on the Kenyan coast, an urban hustle
and bustle of a town that is hot, diverse and swims with a brightness like few
other places. The heat pervades everything. The air swirls with a complex array
of smells and sounds. Conversation is everywhere. Language buzzes: Swahili,
English, Giriama. The days are bright; the sky is blue, but like clockwork each
night the light leaks out at six pm, leaving seven pm a mass of stars or clouds
against the dark of night. Twelve hours later, six am begins in darkness and
seven am arrives in day. The call to prayer announces it; the clamor of traffic
amplifies it; another day has begun. Bless the routine of equatorial light.
I first went to Kenya as a speech
language therapist (SLT) in 2006 and relocated there in 2007 with Voluntary
Services Overseas to work on a European Union funded project that supported the
training of special education professionals in the area of communication
disorders. As I plan for the upcoming conference later this year, it is
impossible not to ponder the regional developments of the profession in the
last seven years.
This article presents the new training
programs slated to start in the region in 2013, reflects on how the East
African conference has changed over the years, and touches on the more global
discussions about the SLT profession taking place at large national
conferences.
Introducing the New East
African SLT Training Programs
In early 2008, Makerere University in Kampala, Uganda, began
their SLT degree program, which has successfully graduated two cohorts of
therapists who now work in Uganda, Kenya, Rwanda and Tanzania. This year there
are plans underway to begin three more regional programs as a result of
collaborations between foreign organizations and East African universities.
Shannon Benton and CLASP International,
in conjunction with Kenyatta University in Nairobi, will be interviewing
candidates this April for enrollment in a Masters program planned to start in
September 2013. Based on a model developed in Zambia, CLASP conducts much of
its classroom-based learning with online real-time lectures taught by
professors at universities in the United States. Students participate in two
years of online learning, supplemented by a variety of clinical rotations
provided by visiting teams of clinicians. Students then complete a one-year
clinical fellowship and spend three years working in a government SLT position,
whilst also instructing the cohort that follows. This is a model that requires
government support and a commitment to fund positions for the graduates of the
program. Discussions with the ministry are still in negotiation, but government
support is an important part of the CLASP model and reportedly one of the
biggest stumbling blocks for fledgling programs in developing countries.
Another program that is anticipated to start in the next
Kenyan academic year will be a Masters program at Moi University in conjunction
with Sweden’s Linköping University. The curriculum has been submitted to Moi University
for approval and will be run by faculties of both institutions.
In addition, a third
program is being developed by a partnership between the SLT department at the University
of Hanover and the special education program at Sebastian Kolowa Memorial
University in Lushoto, Tanzania. This Masters level program focuses on SLT for children
with special needs and will be supported with visiting lecturers from Germany.
The East African Conference on
Communication Disability
As I revisit Dr. Jochmann’s (2006)
writings about her work as an SLT in Uganda, I reflect on how much and yet how
little has changed ‘on the ground’ over the years. Although I wasn’t present at
the first conference Jochmann’s (2005) report indicates that six (of the seven)
then practicing East African based SLT’s met for five days to discuss the
challenges of the providing SLT services in the region, and well as share
expertise. The second
conference took place at Nairobi Hospital in September 2008, organized by Elisabeth
Scheltema-Kruger and several other Nairobi based therapists, myself included.
By this time, there were eight to ten SLT’s practicing in the region. This
conference was attended by a small group of American professors who provided
professional development in their areas of expertise to a group of approximately
20 SLT clinicians and related
professionals (e.g. doctors, nurses, special educators, occupational and
physical therapists).
The third conference took place the
following year organized by Emma Shah and Laura Gomersall. It was hosted at Aga Khan Hospital in Nairobi
and included a different group of foreign therapists and professors who
provided continuing education opportunities to the audience of 20 to 30
participants.
A tension arose at both Nairobi
conferences between educating and informing local non SLT professionals about
the work of SLTs and providing professional development for practicing SLTs in
the region. This tension was managed by 1) covering different topics on
different days and 2) advertising different days to different audiences so that
the conference might better appeal to a wide variety of interested attendees.
Given the enormous amount of time and
energy required to organize the conference by the small pool of clinicians (there
are still only 13 SLT’s
practicing in Kenya) who were busy treating their own caseloads, a decision was
made following the third conference that it would be a bi-annual event.
By the time the fourth conference rolled
around in January 2012, the first cohort of SLTs had completed their program at
Makerere University and the Association of Speech and Language Therapy East
Africa (ASaLTEA) had been established in Uganda with the intention of being a
regional association. Eighty-two participants from 15 different countries gathered
in Kampala for the conference. Organized by Helen Barrett, Makerere’s course
coordinator, the program included research presentations by the Makerere
graduates as well as papers from international guests and related
professionals.
This conference had a different tone to
prior conferences in part due to the increase in size of the audience and the
increase in the number of SLTs in the region. Discussions included issues
related to the logistical future of the field and the ways SLTs might provide
appropriate service provision for local populations in local contexts.
Conversations acknowledged that SLT practices as taught in university programs
and implemented in clinical settings are typically based on foreign research,
resources and views of child development that might not be applicable universally.
The fifth conference plans to build on these discussions with a focus on
implementing culturally appropriate SLT practices in East African
contexts.
Contextualizing the Development of the
Profession
East African conversations and changes in the profession
have taken place within the context of notable growth in discussions about SLT
practices beyond Western borders, particularly in regards to the sprouting of
new programs in developing countries supported by American and European
universities. For example:
·
The
program committee of the 2011 American Speech and Hearing Association’s (AHSA)
Annual Convention sponsored a panel on “SLP University Programs in Developing
Countries: Culturally Sustainable Approaches” (McLeod et al. 2011), which
focused on the success and risk factors for new programs. For example, included
speakers shared their experiences about the programs at Pham Ngoc Thach
University of Medicine in Vietnam, and Universiti Kebangsaan Malaysia (National
University of Malaysia).
·
The Council of Academic Programs in Communication Science and
Disorders (CAPCSD) held a Global Summit on Higher Education
in Communication Sciences and Disorders preceding their annual conference in 2012 that
included presentations by professionals from a wide variety of countries.
·
The Asia Pacific Conference on Speech, Language and Hearing in
2013 will focus on “globalization and
localization of the discipline.”
·
The International Journal
of Speech-Language Pathology recently published a scientific forum with a
lead article on “Changing practice: Implications of the World Report on
Disability for responding to communication disability in under-served
populations” (Wylie, McAllister, Davidson & Marshall, 2013) and a series of
articles discussing the growth of the profession in various countries around
the world.
For the past twenty years Kenya has been
home to the majority of SLTs living and working in the region. With the new
program in Lushoto and Ugandan graduates now residing in Dar es Salaam,
Tanzania, and Kigali, Rwanda, we may be seeing the emergence of a trend by
which the distribution of the profession slowly changes. Hopefully this will
include clinicians moving beyond urban centers into rural settings where the
needs of individuals with communication disabilities are largely unmet. While
the number of clinicians still remains small compared to the relative needs of the
population, the developments outlined above reflect the results of many years
of hard work by SLT professionals both locally and internationally. We hope you
will join us in Mombasa this September to be part of the ongoing activities in
the region.
References:
Jochmann, A. (2005). Speech and language therapy in
East Africa:
The first East African speech
and language therapy conference in January 2005 in Nairobi. Retrieved from http://www.cplol.eu/files/East%20African%20SLT%20conference.pdf
Jochmann,
A. (2006, February 07). Speech and Language Treatment in East Africa. The ASHA
Leader.
McLeod, S.,
Staley, B., Wylie, K., McAllister, L.,
Bleile, K., Marshall, J., Atherton, M.,
Wickenden,
M., & Ahmad, K. . (2011). SLP University Programs in Developing
Countries: Culturally Sustainable Approaches. . Paper presented at the
American Speech Language Hearing Association Annual Convention. San Diego, CA.
Wylie, K.,
McAllister, L., Davidson B., & Marshall, J. (2013). Changing practice:
Implications
of the World Report on Disability for responding to communication disability in
under-served populations. International Journal of Speech-Language
Pathology, 15(1), 1-13.
Contacts for the Speech Language Therapy
training programs:
The
program at Kenyatta University, Nairobi, Kenya: Shannon Benton (shannonbenton@claspinternational.org)
or CLASP’s website at www.CLASPinternational.org
The program at
Moi University, Eldoret, Kenya: Hillary Sang (hillarysang@yahoo.com) or Anita
McAllister (anita.mcallister@liu.se)
The program in
Lushoto, Tanzania: Project supervisor Prof. Dr. Habil. Ulrike Luedtke (ulrike.luedtke@ifs.phil.uni-hannover.de) or project coordinator
Ulrike Schuette, (ulrike.schuette@ifs.phil.uni-hannover.de)
