JCPSLP November 2016

Ethical conversations

“I can’t believe you want to leave at lunch time” A reflection on how narrative ethics may inform ethical practice in cross-cultural and majority-world contexts Helen Smith

I n the mid 1990s for 2½ years I was a volunteer speech pathologist with Australian Volunteers International in a sub-Saharan African country. This story is based on my time working in country. This piece will use a narrative ethics framework (Speech Pathology Australia, 2014) to consider the story; the current story as I experienced it, a reflection on the background story from multiple perspectives and a reimagined future story. Finally, some considerations for ethical volunteering as speech pathologists in culturally and linguistically diverse majority- Sarah, 1 a hard- working and dedicated rehabilitation technician 2 returned one Monday from a rare funded professional development opportunity. She was the mother of two and the adoptive mother of three (her sister’s children, adopted after her sister’s death from HIV the year before), and it had taken a huge amount of organisation and personal commitment for Sarah to attend the course. (The course was based in a central location requiring 3–4 hours travel and several nights away from home.) The course was funded and run by a service organisation from North America which had recruited volunteer specialists from their own country, provided them with travel and living expenses but no salary, so they could provide a week-long specialist training program to local health workers. The service organisation had also funded the travel and living expenses for the local health workers to attend. A rare and generous gift with the goal of improving the provision of specialist services to people in the country. Sarah, a keen learner, was always motivated to improve her knowledge and skills. Therefore, I was surprised on the Monday morning following the course when my question asking how her course had been was met with a huge sigh and a look of despondency. Concerned, I asked Sarah what had happened. Sarah started by expressing her delight in the amazing opportunity to develop her understanding of the specialist area. She was delighted that what she was required to do for patients at our hospital made more sense as the course rolled out. Sarah, however, then expressed her frustrations. First, the “whole” course as outlined in the brochure had not been provided. Second, each day, regardless of the presenter, the content appeared very rushed, with no time to consolidate learning or to ask questions. Despite the speed of delivery, she commented the presenters were world contexts will be provided. The current story

constantly complaining at their frustration that they couldn’t fit in all the content they had planned. Over lunch one day Sarah asked one of the facilitators why everything was being covered so quickly. While English was the official language for education and business, English was a second (or third language) for most of the attendees. The majority of the participants had a TAFE-level qualification and were finding it challenging to keep up. The facilitator responded to Sarah’s question by saying: You all had to travel on Tuesday. We had expected you to travel on Monday as it was a public holiday but none of you could be bothered to do that. And none of you will stay all day on Friday. You all want to leave at lunch time. So our carefully planned 4-day course is being squashed into 2½ days. Sarah commented she felt like the facilitator was saying she and her fellow participants didn’t value the educational opportunity to improve the specialist services they would provide to their patients. Nothing could have been further from the truth. On reflection, Sarah wondered how she could have helped the facilitators change their perception of the participants. She was concerned about the facilitator’s misperception that the participants were not motivated or were lazy. She wondered how this valued and valuable training could have been less than optimal because of such a lack of understanding. She did not feel empowered to continue the conversation as the facilitator rushed off to prepare for the next session. Sarah certainly did not feel A narrative approach to ethical reasoning considers an individual’s or cultural group’s life story (Speech Pathology Australia, 2014). The values and experiences each participant brings to the story are considered. This allows both sets of voices in the story to be heard. Each person in the story arrives at the situation described from their own perspective. It is only through the consideration of these multifaceted perspectives that a new and deeper shared understanding can be reached. The volunteer presenters had dedicated valuable vacation time to come to Africa to deliver training. They had spent many hours preparing the training program prior to their departure from home. They came with slides and handouts and workbooks. The timing of the trip had been made to accommodate the volunteers’ usual summer holiday period to have the least impact on their own local valued or respected by the facilitator. The background story

KEYWORDS CULTURAL AND LINGUISTIC DIVERSITY MAJORITY- WORLD VOLUNTEERING NARRATIVE ETHICS

Helen Smith

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JCPSLP Volume 18, Number 3 2016

www.speechpathologyaustralia.org.au