Language and culture in speech-language and hearing professions in South Africa: The dangers of a single story

Abstract

BackgroundSpeech-language and hearing (SLH) professions in South Africa are facing significant challenges in the provision of clinical services to patients with communication disorders from a context that is culturally and linguistically diverse because of historic exclusions of black and African language speaking candidates in higher education training programmes. Over 20 years post the democratic dispensation, minimal changes have been noted in terms of the training, research as well as clinical service provision in these professions, although the demographic profile of students is seen to be transforming gradually.ObjectivesWe offer this viewpoint publication as a challenge to the professions to interrogate their academic and clinical orientation in respect of African contextual relevance and responsiveness.MethodWe do this by identifying gaps within the higher education context, highlighting the influencing factors to the provision of linguistically and culturally appropriate SLH training and clinical services in South Africa, while asking questions about what SLH students and practitioners need to carefully consider.ResultsWe make recommendations about what needs to happen within the SLH professions in South Africa in order to stay safe from the dangers of a single story.ConclusionWe invite debate in order to allow for constructive engagement with this complex issue within the South African SLH professions.

Training for hearing care providers

“…For example this has occurred with the under-provision of speech and language therapists services to the black, economically disadvantaged population of South Africa. 48 While the guiding principles of speech and language therapy or deaf education are universal, the specific nature of the training will be determined by the local culture and language (whether spoken or signed). Such differences means that sharing of training resources or learning across linguistic regions or borders may be difficult or even inappropriate.…”

Special Issue: A Southern African Dialogue on the Professions and Professional Work

“…In South Africa, increasingly literature has begun to draw attention to the need for transformation of profession-from highlighting importance of linguistic and cultural background when working with individuals and the subsequent need for developing culturally-fair assessment tools (Mdlalo, Flack, & Joubert, 2019), the need for SLPs to consider their own positionality in relation to the racial, linguistic and cultural diverse populations served (Khoza-Shangase & Mophosho, 2018) to the need to think creatively when considering the needs of the South African context (Moonsamy, Mupawose, Seedat, Mophosho, & Pillay, 2017). Populations that benefit the most from SLP services are middle class, generally white populations who speak a dominant language such as English (Overett & Kathard, 2006;Pascoe et al, 2010;Pillay & Kathard, 2015).…”

Scarce Health Human Resource Wastage: No work for South African Audiologists? A descriptive Survey Study.

“…To date, audiology training as a singular, autonomous profession is available at some of the six higher education institutions offering the degree in South Africa with approximately 100-150 new graduates recorded annually [24][25][26] . It is worth noting that this is a low number of audiologists entering into healthcare system to meet the high need of hearing health services as influenced by the disease and disability burden, in South Africa [27] . Lower supplies of rehabilitation health professionals like audiologists is a common challenge in low-and middle-income countries, including many located in sub-Saharan Africa, where the need of rehabilitation professional skills tends to be greatest [28] .…”

“…Audiologists in South Africa are mostly employed and function in the public healthcare system [24,27] . The South African public healthcare system is unfortunately marred with several challenges including well-documented lack of skilled professionals, infrastructural constraints, limited wellfunctioning facilities, general lack of resources for the size of the population, risk versus benefit assessments predicaments as well as challenges with translating policies into practice [27,[29][30] .…”

“…These challenges affect mostly the already vulnerable parts of the population such as the poor with communication disabilities such as hearing loss [27,[30][31][32] .…”