Table of Contents Table of Contents
Previous Page  14 / 156 Next Page
Information
Show Menu
Previous Page 14 / 156 Next Page
Page Background

Creating sustainable services: Minority world SLPs in majority world contexts

116

JCPSLP

Volume 18, Number 3 2016

Journal of Clinical Practice in Speech-Language Pathology

KEYWORDS

COMMUNICA-

TION DISABILITY

DEVELOPING

COUNTRIES

MAJORITY

WORLD

PARTNERSHIPS

SPEECH-

LANGUAGE

PATHOLOGY

SUSTAINABILITY

THIS ARTICLE

HAS BEEN

PEER-

REVIEWED

Karen Wylie (top)

and Clement

Amponsah

Sustainable partnerships for

communication disability

rehabilitation in majority world

countries

A message from the inside

Karen Wylie, Clement Amponsah, Josephine Ohenewa Bampoe, and Nana Akua Owusu

to provide a road map of how such relationships should

operate; however, it provides a perspective of some of the

complexities in developing and sustaining relationships

to support development of sustainable services for

communication disability.

Reflexivity statement

The authors of this paper are four speech-language

pathologists (SLPs) living and working in Ghana, West Africa.

Three are Ghanaian nationals, who trained in the United

Kingdom (UK). One is a long-term expatriate in the region,

who has lived in Ghana for four years and in the region for

thirteen years. Together we work at a government hospital

offering clinical speech-language pathology services. We

also work together at a university to establish a training

program for speech-language pathology. One of our group

also runs an NGO focusing on early intervention and support

for children with communication difficulties. Our regular and

varied contact with SLPs who wish to come to Ghana to

assist in the development of communication disability

services prompted the writing of this paper. We recognise

that our perceptions of the insider–outsider relationships

may differ from the perceptions of those who visit.

While Ghana is rich in history and culture, it is not yet

endowed with well-established rehabilitation systems for

people with disabilities. Furthermore, although our country

is foresighted and has an inclusive education policy

(Ministry of Education, 2013), awareness of disability rights

is still developing and services to support people with

communication disability (PWCD) are severely stretched,

with few speech-language pathology or communication

disability services available in the country. Building services/

systems for the future and improving awareness of

communication disabilities is the focus of our work.

Our context

Ghana is well recognised as a leading nation of West Africa

in areas including governance and economic development.

Ghana is a lower middle income country and is ranked at

140 on the United Nations Development Programme

(UNDP) Human Development Index (UNDP, 2015). It has a

population of 26.4 million (UNDP, 2015) and is a multiparty

democracy. In 1957, Ghana was the first sub-Saharan

African country to achieve independence from its former

colonial ruler Britain. While English is the official language of

Ghana, Ghana has a large number of languages and

dialects in use, with an estimated 25 to 43 main languages

(National Commission on Culture, 2006). Currently, the

Rehabilitation services for people with

communication disabilities (PWCD) in many

majority-world countries are extremely

limited, with speech-language pathology little

known. Collaborations between clinicians

and services in majority- and minority-world

countries provide important contributions to

developing rehabilitation services in the

majority world for PWCD. The effectiveness

of such partnerships may be influenced by a

number of elements within the relationship.

This paper presents insights from a group of

majority-world speech-language pathologists

(SLPs) in Ghana on establishing and

maintaining links between majority- and

minority-world services and clinicians. The

framework of three sustainability dimensions

(service environment, socio-cultural-political

environment, and economic environment) is

used to consider how SLP relationships across

majority–minority worlds can be meaningful

and lasting. Readers are encouraged to adopt

the perspective of SLPs from within the country

to consider the impact and sustainability of

majority–minority world partnerships.

G

lobalisation and technological innovation has made

linking with people from different geographical

regions more possible than at any other time in

history (Friedman, 2006). For service providers and people

with communication disabilities (PWCD) in countries of the

majority world, where services for communication disability

are often extremely limited, it frequently means establishing

relationships beyond their borders to assist with service

provision, service development and improvement in

quality. This article presents an insiders’ perspective and

discussion on relationships between clinicians and services

across minority- and majority-world countries based on

personal experiences of working in Ghana. The aims are

twofold: (a) to encourage readers to view majority–minority

world relationships through the lens of clinicians in the

majority world and (b) to offer a range of observations from

the authors’ perspectives as “insiders” on relationship

development and sustainability. This paper is not intended