Back to the Basics: SLPs Witness Emerging Profession in Vietnam, Cambodia Sometimes professional life can become complex. In speech-language pathology, work is much more than just doing a job; there’s also keeping up with the research, following policies that affect the profession, and (of course) maintaining the ever-lengthening paper trail. But what if you had to provide treatment with no resources? ... World Beat
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World Beat  |   March 01, 2010
Back to the Basics: SLPs Witness Emerging Profession in Vietnam, Cambodia
Author Notes
  • Kellie Rowden-Racette, print and online editor for The ASHA Leader, can be reached at krowden-racette@asha.org.
    Kellie Rowden-Racette, print and online editor for The ASHA Leader, can be reached at krowden-racette@asha.org.×
Article Information
Speech, Voice & Prosodic Disorders / Professional Issues & Training / International & Global / World Beat
World Beat   |   March 01, 2010
Back to the Basics: SLPs Witness Emerging Profession in Vietnam, Cambodia
The ASHA Leader, March 2010, Vol. 15, 22-23. doi:10.1044/leader.WB.15032010.22
The ASHA Leader, March 2010, Vol. 15, 22-23. doi:10.1044/leader.WB.15032010.22
Sometimes professional life can become complex. In speech-language pathology, work is much more than just doing a job; there’s also keeping up with the research, following policies that affect the profession, and (of course) maintaining the ever-lengthening paper trail.
But what if you had to provide treatment with no resources? No materials, no records—just an adult or a child in need. For most speech-language pathologists, the idea is an interesting mental exercise, but for the few SLPs in some non-industrialized countries, it’s reality. That’s what 35 SLPs discovered during a trip to Vietnam and Cambodia in September 2009. For 11 days the group met with education and health leaders who are trying to establish a speech-language profession in these countries. Among the group was Alex Johnson, provost and vice president of academic affairs for MGH Institute of Health Professions in Boston and 2006 ASHA president. Although Johnson has traveled on similar excursions to South Africa and Russia, he said this particular experience gave him a lot to think about.
“It was hard to see the lack of the resources available to help so many people who need it,” Johnson said. “I think everyone on this trip came to realize how fortunate we are. Over here we are arguing over sub-specialization and finding resources to do complicated and advanced treatment, but going over there was really like taking a trip back to the basics. It made us think: If there was nothing there, what would be the first thing you would do?”
The purpose of the trip, sponsored by the humanitarian organization People to People, wasn’t for participants to provide speech-language treatment, but rather to provide insight into starting a speech-language program from scratch. The challenges, participants discovered, are formidable. Vietnam is still recovering, physically and emotionally, from war; likewise, Cambodia still bears scars from the Khmer Rouge regime, which caused 1.7 million deaths 30 years ago.
Today both countries have vast pockets of poverty and thousands of citizens in dire need of speech and hearing services. The traveling SLPs visited rehabilitation centers, children’s hospitals, colleges, and schools, and found that services for communication disabilities often take a back seat to those for physical disabilities.
“Although there are some professionals coming in and doing some occasional work through programs such as Operation Smile, it’s certainly not enough,” Johnson said. “There really is no educational training for speech-language pathologists in Vietnam, so therefore there aren’t any.”
Carol Koch, chair of Rockhurst University’s department of communication sciences and disorders, was one of the SLPs in the group. Although she felt prepared to understand the professional situation in the two countries, the degree of poverty and need surprised her.
“On an emotional level it was so hard to see such a need for services,” she said, “especially the children who had communication needs. You know the potential they have, but they won’t get the services. I kept reminding myself that that’s why we’re on this trip—so in the future there will be services for children and families who need them.”
In the tradition of such ambassadorial trips, Koch organized the group to make donations to the people they met. The visitors handed out books and toys to teachers, health workers, and families and all gifts were received with deep appreciation, Koch said. “They were overwhelmed, especially by the books—every family who received a book immediately opened it and started looking through it.”
Despite the tremendous challenges the group witnessed, they also found inspiration from the burgeoning efforts. In one instance the group met with the special education faculty members at the National College of Education in Ho Chi Minh City (formerly known as Saigon) who are eager to begin a speech-language pathology program and are sending one faculty member to attend a PhD speech-language pathology program. In another instance, the group met with a pediatrician in a children’s hospital who is developing a psychology unit to provide speech-language services to children with communication disorders. But because of the meager resources and staffing, physical therapists on staff are providing the services.
The hospital has dedicated four or five physical therapy positions to learn to work with the parents of young children to focus on helping them to communicate, Johnson said. “They are working with these children in a way that looks very much like what we would call speech treatment.”
The group also met with Western-born travel writer Paige Stringer, who has created a new foundation, Global Foundation For Children With Hearing Loss. Stringer, who was born with hearing loss, is raising funds to bring a panel of 15 American experts to Vietnam this summer. The panel, which will include audiologists, SLPs, and educators, will work with Vietnamese teachers on educating infants and children ages 0–6 who have hearing loss. The foundation is hoping the program will extend into three consecutive years and possibly develop into a larger degree program that includes mentorship and distance-learning possibilities.
There are some signs of progress in Cambodia as well. Cambodia also has no formal training programs for speech-language pathology or audiology, but one American SLP, Alice Smith, lives in Cambodia nine months out of the year and works with Cambodian children (see sidebar). A British audiologist, Glyn Vaughn, runs an audiology clinic in Phnom Penh called All Ears Cambodia. Together, these two professionals “are the Cambodian Speech-Language-Hearing Association,” Johnson remarked.
Overall, the travelers agree, the take-away from this trip was a sense of optimism. Johnson and Koch commented on how everyone they met on the trip was upbeat and welcoming.
“I think we all discovered how resilient these people are,” Johnson said. “It’s amazing how they have bounced back and have such energy.”
How To Help
  • The Global Foundation For Children With Hearing Loss, supported by the University Lions Club of Seattle, is seeking expertise and contributions.

  • For more information about research opportunities centered around speech development in Vietnamese children with hearing loss, e-mail info@childrenwithhearingloss.org.

  • To join the team of experts lecturing in Vietnam July 12–Aug. 6, 2010, send a resume and overview of experience to paige@childrenwithhearingloss.org.

  • To make a contribution to help bring the training program initiative to life, donate online, or mail contributions to The Global Foundation for Children with Hearing Loss, 8 West Howe #3, Seattle, WA 98119.

An American SLP in Cambodia

Alice Smith, PhD, CCC-SLP, and adjunct assistant professor at the Department of Communication Sciences and Disorders at the University of Iowa, spends nine months every year providing speech-language services to children in Cambodia. She serves as the chair of the Speech Council for Operation Smile International and as the director of E&E Speech Education and Therapy Clinic in Phnom Penh, Cambodia.

Q: When did you become interested in Cambodia?

I adopted two children in Cambodia, both with cleft lip and palate, in 2000 and 2001. In 2002, I volunteered with Operation Smile for their first cleft mission in Cambodia and continued to participate on every international mission since then.

Q: What made you decide to dedicate the majority of your time to living in Cambodia?

There were limited SLP services in Cambodia and so I would see kids on missions and talk to parents about working on speech but no one was available to help follow through. In 2005, I began spending increasing amounts of my time teaching classes about clefts at the International University Medical School to raise awareness about speech treatment needs. I began teaching workshops to nurses and other staff at various hospitals serving kids with clefts. The workshop approach provides a beginning, but has limited carryover. So in 2008 I began to live here on a regular basis, with frequent trips back home to see my family. Awareness is growing as occasional SLP groups come and give workshops and recently an Australian SLP spent a year here.

The appeal for me is the people of Cambodia. They are warm and friendly and in great need of services to help their children. My children have had the advantage of many hours of speech treatment and a comprehensive cleft team at the University of Iowa. Children in Cambodia do not have that advantage and deserve the chance to get help.

Q: Who are you serving primarily in Cambodia? Is this self-funded?

I’m primarily seeing kids with cleft conditions but I also evaluate many children with hearing impairments and language delays. I am working closely with NGOs (non-government organizations) and hospitals to help develop in-house services. My work is primarily self-funded, though I am starting to receive donations from generous people and some limited funding from some of the organizations/hospitals where I volunteer to help pay lodging, transportation, etc.

Q: What are your hopes for your work in Cambodia?

My primary hope is to no longer be needed in Cambodia! I hope to continue to raise awareness about the need and the possibility for speech treatment for children while continuing to train paraprofessionals to provide services. I am also working with others toward the establishment of an SLP degree program.

Alice Smith can be reached via e-mail at aesmith1999@gmail.com.

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March 2010
Volume 15, Issue 3