JCPSLP November 2016

Creating sustainable services: Minority world SLPs in majority world contexts

Practice innovations from the emerging speech-language pathology profession in Vietnam Vignettes illustrating indigenised and sustainable approaches Nguyen Thi Ngoc Dung, Le Khanh Dien, Christine Sheard, Le Thi Thanh Xuan, Trà Thanh Tâm, Hoàng V ă n Quyên, Le Thi Dao, and Lindy McAllister

This paper presents vignettes of innovations in speech-language pathology practice in Vietnam, and situates these in the larger context of global considerations impacting on speech-language pathology education and service delivery. The paper provides an introductory vignette setting the context for four more vignettes from speech-language pathologists in southern Vietnam. The graduates’ vignettes illustrate a range of innovative, sustainable, indigenised and culturally relevant developments in speech- language pathology practice and education. Two vignettes highlight the use of volunteers and the available health and education workforce to develop sustainable new services for children and adults with communication disorders. Two vignettes illustrate innovative and culturally appropriate ways of indigenising curricula and approaches to educating the Vietnamese public and the existing health workforce about communication and swallowing disorders and speech-language pathology services. The paper invites readers to reflect on what speech-language pathology globally might learn from our colleagues in majority- world countries. C ollaborations between clinicians and academics in minority-world (developed) and majority-world (developing) countries have been successful in establishing speech-language pathology (SLP) education and services in many majority-world countries (for examples from nine such countries, see the International Journal of Speech-Language Pathology , 2013, vol. 15, issue 1). However, there is a risk of post-colonialism (Nixon et al., 2015) when minority-world curricula or practices are transferred into new SLP courses in majority-world countries. That is, what comes from minority-world countries can be privileged over local knowledge and practices, in the assumption that “west is best”, even when it may not be culturally relevant or the knowledge applicable in new contexts. Therefore, it is important

that SLP students in these new courses can interrogate “transplanted” information for its relevance and develop culturally relevant knowledge and clinical practice skills; that is, “indigenise” their knowledge and practices (see for example Hauser, Howlett, & Matthews, 2009). Furthermore, it is important that majority-world practitioners are able to share with minority-world clinicians innovative “indigenised” approaches to the problems they face in practice, to enable two-way learning (Walsh, 2016). This paper presents vignettes highlighting innovation, indigenisation and plans for future development by graduates of two-year postgraduate courses in speech- language pathology, and where appropriate their Australian mentors. The first vignette in this paper comes from Vietnamese academic Dr Nguyen Thi Ngoc Dung, recognised as the champion for the development of speech-language pathology in southern Vietnam. Her leadership enabled the development of the two-year postgraduate course at University Pham Ngoc Thach. Four graduates of this course, known to be doing innovative work to develop SLP education and services, were approached to write four vignettes for the paper. Vignette 1. Background to speech- language pathology education in south Vietnam Prof Ngoc Dung, professor of ENT and former rector of the University Pham Ngoc Thach, Ho Chi Minh City As an ENT doctor and former director of the ENT Hospital of Ho Chi Minh City (HCMC) I know that speech therapy 1 is vital in the treatment and rehabilitation of people with communication and swallowing impairments. Speech therapy training in HCMC started in 2009 with a short course run by Trinh Foundation Australia at the ENT Hospital for doctors, nurses and audiologists on aspects of speech therapy. Becoming rector of University Pham Ngoc Thach in HCMC enabled the development and delivery of two 2-year postgraduate courses (2010–12 and 2012–14) run at University Pham Ngoc Thach with support from Trinh Foundation Australia and Australian Volunteers International (see McAllister et al., 2013). Thirty-three graduates from those two courses have established speech therapy clinics and services, mostly in public hospitals, in Ho Chi Minh City, Hue, Hanoi, Vung Tau, Bau Loc and other provinces. With the management of the speech therapy office at University Pham Ngoc Thach, the support of Trinh Foundation Australia and Australian Volunteers for International

KEYWORDS INDIGENISED PRACTICE INNOVATION MAJORITY- WORLD COUNTRIES SPEECH- LANGUAGE PATHOLOGY SUSTAINABLE PRACTICES VIETNAM

THIS ARTICLE HAS BEEN PEER- REVIEWED

Nguyen Thi Ngoc Dung (top) and Le Khanh Dien

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JCPSLP Volume 18, Number 3 2016

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