From Volunteering to Academic Programming: A Case Example A speech-language pathology master's program that grew out of a partnership between the University of Zambia and a U.S.-based charitable organization, Connective Link Among Special needs Programs (CLASP) International, has just been completed in Zambia. The review of this program is outlined according to the suggested principles for community-based partnerships, ... Article
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Article  |   October 06, 2016
From Volunteering to Academic Programming: A Case Example
Author Affiliations & Notes
  • Cindy Gill
    Department of Communication Sciences and Disorders, Texas Woman's University, Denton, TX
  • Sneha Bharadwaj
    Department of Communication Sciences and Disorders, Texas Woman's University, Denton, TX
  • Nancy Quick
    Speech and Hearing Sciences PhD Program, University of North Carolina, Chapel Hill, NC
  • Sarah Wainscott
    Department of Communication Sciences and Disorders, Texas Woman's University, Denton, TX
  • Paula Chance
    Department of Communication Sciences and Disorders, Texas Woman's University, Denton, TX
  • Disclosures
    Disclosures ×
  • Financial: The authors have no financial interests related to the content of this article.
    Financial: The authors have no financial interests related to the content of this article.×
  • Nonfinancial: The authors have no nonfinancial interests related to the content of this article.
    Nonfinancial: The authors have no nonfinancial interests related to the content of this article.×
Article Information
Professional Issues & Training / Part 1
Article   |   October 06, 2016
From Volunteering to Academic Programming: A Case Example
Perspectives of the ASHA Special Interest Groups, October 2016, Vol. 1, 7-11. doi:10.1044/persp1.SIG17.7
History: Received May 18, 2016 , Revised July 22, 2016 , Accepted September 9, 2016
Perspectives of the ASHA Special Interest Groups, October 2016, Vol. 1, 7-11. doi:10.1044/persp1.SIG17.7
History: Received May 18, 2016; Revised July 22, 2016; Accepted September 9, 2016

A speech-language pathology master's program that grew out of a partnership between the University of Zambia and a U.S.-based charitable organization, Connective Link Among Special needs Programs (CLASP) International, has just been completed in Zambia. The review of this program is outlined according to the suggested principles for community-based partnerships, a framework which may help evaluate cultural relevance and sustainability in long-term volunteer efforts (Israel, Schulz, Parker, & Becker, 1998).

Guiding Principles for Partnerships With Cultural Relevance and Sustainability
There has been a growing interest in short-term and long-term volunteering among speech-language pathologists (SLPs), audiologists, and students in these fields. These efforts have the potential to offer many positive benefits for the volunteers as well as their host countries. Nevertheless, this burgeoning enthusiasm has also provoked important discussions about cultural safety, ethical concerns, and the dangers of neo-colonialist perspectives (American Speech-Language-Hearing [ASHA], 2014; Hickey, McKenna, Woods, & Archibald, 2012).
The literature has more frequently addressed these concerns within short-term volunteerism than with long-term efforts (Guttentag, 2009). There has been a significant increase worldwide in the number of international partnerships, and increased interest in development of programs in communication sciences and disorders, particularly in countries where access to services has historically been nonexistent or severely limited (Barrett & Marshall, 2013; Gill, Wainscott, Green, & Bharadwaj, 2016). Given the global demand for clinicians and academic programs to train them, there are increasing opportunities to volunteer in training contexts that have goals for long-term sustainability. These training programs serve future professionals as well as individuals with communication disorders who are embedded within social, political, and economic systems. In order for services to be both meaningful and accepted in unfamiliar contexts, cultural appropriateness is of the utmost importance (Wylie, McAllister, Davidson, & Marshall, 2013). Despite good intentions, it is difficult to circumvent the pitfalls of neocolonialism, or the exportation of Western ideas and methods of practice that are culturally irrelevant (Karle, Christensen, Gordon, & Nystrup, 2008) when the culture, language, and world view of volunteer trainers is different from that of their students (Bourke-Taylor & Hudson, 2005). Furthermore, the establishment of a small, relatively unknown profession requires planning for successfully navigating the transition from reliance on substantial international support to community-developed resources (Atherton, Dung, & Nhân, 2013; Barrett & Marshall, 2013).
Similar issues of cultural safety, ecological validity, and sustainability arose in the development of community-based participatory research (CBPR) within the United States. Nine key principles were identified that support successful research partnerships: (a) recognize community as a unit of identity; (b) build on strengths and resources within the community; (c) facilitate collaborative, equitable involvement of all partners in all phases; (d) integrate knowledge and intervention for the mutual benefit of all partners; (e) promote a co-learning and empowering process that attends to social inequities; (f) involve a cyclical and iterative process; (g) address health from both positive and ecologic perspectives; (h) disseminate findings and knowledge gained to all partners; and (i) cultivate long-term commitment by all partners (Israel et al., 1998). These principals may provide a useful framework for evaluating cultural relevance and sustainability in long-term volunteer efforts by ensuring that all partners contribute expertise and share decision making and responsibilities.
A Case Example of a Partnership Between a Charitable Organization and Universities
Partnerships between charitable organizations and local university programs is one model for academic training program development in low income countries (Barrett & Marshall, 2013). The recent implementation of a master's program in Zambia is an example of such a partnership that proposed to keep cultural sensitivity and sustainability at the forefront. Using the CBPR principles as a framework of analysis, the elements of the partnership between Connective Link Among Special needs Programs (CLASP) International and the University of Zambia (UNZA) will be reviewed.
Recognize Community and Build on Strengths and Resources
Zambia represents an ethnically rich community of identity, with over 73 different ethnic groups represented and 46 commonly spoken languages (Ethnologue Languages of the World, 2016). Therefore, it was to be expected that for every shared value and norm identified, there would be many more diverging interests, values, and customs. In order to better understand the varied communities, community surveys that were conducted for over a month provided stakeholders the opportunity to identify areas of need, and evaluate the benefit of speech-language therapy services to the community. The surveys also promoted discussion regarding elements that should be incorporated into a university training program in speech-language pathology. The UNZA offered a variety of degrees in related health and education professions such as psychology, education, and nursing. This existing university program offered the potential for many of the fundamental elements essential to a new degree program, including administrative oversight and facilities for Internet access, libraries, and classrooms. The established university also provided the potential for collaboration for program development and potential avenues for student recruitment into future Communication Sciences and Disorders (CSD) programs. An infrastructure of schools, orphanages, hospitals, and clinics in Lusaka that provided a variety of educational services, in addition to health assessment and child care management, were also identified. These contacts were considered essential for developing a future referral network.
Health From Positive and Ecological Perspectives
One of the first steps initiated by the founder of CLASP in 2007 was to increase public awareness about PWD and identify children in need of services (CLASP International, 2009). The CLASP hired Zambian nationals to act out short plays which demonstrated that PWD were individuals worthy of being loved and respected. These public village performances sometimes resulted in hidden children being allowed out to meet their neighbors (see Figure 1 for a picture of the acting troupe performing for the villagers). Churches, charities, and orphanages assisted in identifying children in need of therapy and providing locations in which they could work.
Figure 1.

Acting Troupe in Zambia Depicting Acceptance of a Child With Autism.

  Acting Troupe in Zambia Depicting Acceptance of a Child With Autism.
Figure 1.

Acting Troupe in Zambia Depicting Acceptance of a Child With Autism.

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Next, CLASP arranged for SLPs from the United States to travel to Zambia to introduce and model speech-language therapy. The SLPs provided culturally-sensitive information sheets and children's books about the adventures of children who had various disabilities and shared them with the mothers at the therapy settings. Caregivers reported being surprised at the open acceptance toward PWD depicted in those materials (C. Gill, personal communication, March 1, 2015).
During preliminary discussions with community stakeholders and the UNZA, cultural feedback was provided regarding wording (e.g., Zambian partners, not Zambians), sensitive topics (e.g., how to address a parent), and approaches (e.g., avoiding directiveness). The CLASP members then worked to develop brochures which provided straightforward explanations of several disabilities, such as hearing loss, dysphagia, aphasia, and cleft palate. Once the Master's program in speech-language pathology began, graduate students identified common beliefs and myths surrounding PWD and made suggested changes to the information brochures. The students then assisted in the translation of information brochures on different disabilities into two of the common languages: Nyanja and Bemba. The students hope to eventually publish the translations in order to enable widespread distribution of the information.
Collaborative Involvement for the Mutual Benefit of All
The CLASP developed a graduate SLP training program in conjunction with the UNZA. The curriculum was jointly drafted by the UNZA and CLASP members, particularly those who were affiliated with university speech-language pathology programs. The UNZA assisted with recruitment and registration, and provided educational facilities and resources such as internet access, classrooms, and libraries. The UNZA provided coursework in research and methods and oversaw the administration of all examinations. Professors from Texas Woman's University, George Washington University, Texas Tech University, and several clinics, volunteered as lecturers, conducting classes in CSD via interactive distance technology. The academic program was directed by a professor from Texas Woman's University who regularly consulted with the Deans from UNZA. The SLPs flew to Zambia six times a year, initially to provide observation experiences, and later to supervise the practicum of students. Practicum sites were offered by local charitable organizations, orphanages, medical facilities, and churches, all of whom worked with the organization to help recruit and identify persons in need of speech-language pathology services. A practicum director from Great Britain, who was conducting research while living in Zambia, agreed to serve as the program director to oversee the organization and supervision of practicum for the final year of the master's program.
Cyclical and Iterative Process
Over the course of the 2-year training program, many changes were made based on feedback from stateside instructors, clinical supervisors, staff from the University of Zambia, and the students themselves. Instructors became sensitive to issues with Internet access. Internet access was reliably inconsistent, and creative offline solutions were needed to communicate course content. For example, word documents required less bandwidth than pdfs, and therefore were easier for students to download. Some lectures were recorded that could be viewed at a later time and others were recorded on DVDs and physically transmitted to Zambia on practicum trips. Face-to-face class lectures occasionally occurred during lunch or after practicum days, especially when the practicum involved a specific diagnosis (e.g., during the weeks of cleft palate camp). At the beginning of the program, most students did not own computers, so efforts to secure donated laptops continued until each student had his own. Sharing the limited number of textbooks did not provide optimal learning opportunities for students who lived far apart, so efforts were made to provide each student his own text for every class. Many pedagogical changes were made by the instructors as they became more familiar with the learning styles of the students (Gill et al., 2016).
Disseminate Findings
On December 7, 2015, 18 students were awarded their Master's degree in speech-language and communication disorders (UNZA, 2016). At the graduation, attended by over 3,000 Zambians, the new degree was announced and the experiences and history of each of the master's students was reported, as well as their future plans. These included new speech therapy jobs as well as jobs incorporated into their existing profession (e.g., some elementary teachers planned to incorporate services into and after the traditional educational day).
Long-Term Commitment by All Partners
From the very beginning, discussions were initiated with the Ministers of Health and Education regarding the creation of job positions for the graduates of the Speech-Language and Communication Disorders program. Discussions continue to be ongoing. In order to ensure program sustainability, five graduates from the master's program were assisted in applying to a doctoral program in the United States. Two students were admitted to the University of Louisiana-Lafayette with funding to work on completing their doctoral degree over the next three years. The future PhD graduates hope to establish an ongoing academic training program in a university in Zambia (CLASP International, 2016).
Conclusion
Partnerships between charitable organizations, universities, and local agencies have resulted in the introduction of the profession of speech-language pathology in places where it did not previously exist. Hopefully, ongoing discussions will provoke continual evaluation of cultural safety, ecological validity, and sustainability of the efforts. The principles of CBPR may offer one framework for beginning thoughtful discussions and critiques. Establishing a small, unknown profession through partnerships across cultural contexts is challenging and difficult work, requiring ongoing discussion, compromise, diplomacy, and negotiation. Yet, participating in service development to increase the human resource capacity of professionals in communication disorders has untold potential reward and benefit for the volunteers, the host country, and individuals with communication disorders.
Acknowledgement
The lead author of this review served as the academic director for the program described herein and the first four authors served as teachers in the program.
References
American Speech-Language-Hearing Association. (2014). Engaging in ethical and sustainable international experiences. SIG 17 Live Chat, Octboer 23 . Retrieved from http://www.asha.org/Events/live/10-23-2014-Ethical-Sustainable-International-Experiences/
American Speech-Language-Hearing Association. (2014). Engaging in ethical and sustainable international experiences. SIG 17 Live Chat, Octboer 23 . Retrieved from http://www.asha.org/Events/live/10-23-2014-Ethical-Sustainable-International-Experiences/ ×
Atherton, M., Dung, N. T. N., & Nhân, V. H. (2013). The World Report on Disability in relation to the development of speech-language pathology in Viet Nam. International Journal of Speech Language Pathology, 15(1), 42–7. doi:10.3109/17549507.2012.743034 [Article] [PubMed]
Atherton, M., Dung, N. T. N., & Nhân, V. H. (2013). The World Report on Disability in relation to the development of speech-language pathology in Viet Nam. International Journal of Speech Language Pathology, 15(1), 42–7. doi:10.3109/17549507.2012.743034 [Article] [PubMed]×
Barrett, H., & Marshall, J. (2013). Implementation of the World Report on Disability: Developing human resource capacity to meet the needs of people with communication disability in Uganda. International Journal of Speech-Language Pathology, 15(1), 48–52. doi:10.3109/17549507.2012.743035 [Article] [PubMed]
Barrett, H., & Marshall, J. (2013). Implementation of the World Report on Disability: Developing human resource capacity to meet the needs of people with communication disability in Uganda. International Journal of Speech-Language Pathology, 15(1), 48–52. doi:10.3109/17549507.2012.743035 [Article] [PubMed]×
Bourke-Taylor, H., & Hudson, D. (2005). Cultural differences: The experience of establishing an occupational therapy service in a developing community. Australian Occupational Therapy Journal, 52, 188–198. doi:10.1111/j.1440-1630.2005.00493.x [Article]
Bourke-Taylor, H., & Hudson, D. (2005). Cultural differences: The experience of establishing an occupational therapy service in a developing community. Australian Occupational Therapy Journal, 52, 188–198. doi:10.1111/j.1440-1630.2005.00493.x [Article] ×
CLASP International. (2009). Retrieved January 2, 2012 from http://claspinternational.org/our-story
CLASP International. (2009). Retrieved January 2, 2012 from http://claspinternational.org/our-story ×
CLASP International. (2016). Retrieved May 8, 2016 from http://claspinternational.org/blog/
CLASP International. (2016). Retrieved May 8, 2016 from http://claspinternational.org/blog/ ×
Ethnologue Languages of the World. (2016). Retrieved from http://www.ethnologue.com/country/ZM
Ethnologue Languages of the World. (2016). Retrieved from http://www.ethnologue.com/country/ZM ×
Gill, C., Wainscott, S., Green, L., & Bharadwaj, S. (2016). Evolution of strategies for international distance learning: The first speech-language pathology master's training program in Zambia. British Journal of Education, Society & Behavioural Science, 17, 2. ISSN: 2278-0998.
Gill, C., Wainscott, S., Green, L., & Bharadwaj, S. (2016). Evolution of strategies for international distance learning: The first speech-language pathology master's training program in Zambia. British Journal of Education, Society & Behavioural Science, 17, 2. ISSN: 2278-0998.×
Guttentag, D. A. (2009). The possible negative impacts of volunteer tourism. International Journal of Tourism Research, 11(6), 537–551. doi:10.1002/jtr.727 [Article]
Guttentag, D. A. (2009). The possible negative impacts of volunteer tourism. International Journal of Tourism Research, 11(6), 537–551. doi:10.1002/jtr.727 [Article] ×
Hickey, E. M., Mckenna, M., Woods, C., & Archibald, C. (2012). Ethical Concerns in Voluntourism in Speech-Language Pathology and Audiology. Perspectives on Global Issues in Communication Sciences and Related Disorders, 2(2), 40. doi:10.1044/gics2.2.40 [Article]
Hickey, E. M., Mckenna, M., Woods, C., & Archibald, C. (2012). Ethical Concerns in Voluntourism in Speech-Language Pathology and Audiology. Perspectives on Global Issues in Communication Sciences and Related Disorders, 2(2), 40. doi:10.1044/gics2.2.40 [Article] ×
Karle, H., Christensen, L., Gordon, D., & Nystrup, J. (2008). Neo-colonialism versus sound globalization policy in medical education. Medical Education, 10, 956–8. doi: 10.1111/j.1365-2923.2008.03155.x [Article]
Karle, H., Christensen, L., Gordon, D., & Nystrup, J. (2008). Neo-colonialism versus sound globalization policy in medical education. Medical Education, 10, 956–8. doi: 10.1111/j.1365-2923.2008.03155.x [Article] ×
Israel, B., Schulz, A., Parker, E., & Becker, A. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review Public Health, 19, 173–202. [Article]
Israel, B., Schulz, A., Parker, E., & Becker, A. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review Public Health, 19, 173–202. [Article] ×
The University of Zambia. (2016). Retrieved from http://www.unza.zm/
The University of Zambia. (2016). Retrieved from http://www.unza.zm/ ×
Wylie, K., McAllister, L., Davidson, B., & Marshall, J. (2013). Changing practice: Implications of the world report on disability for responding to communication disability in under-served populations. International Journal of Speech Language Pathology, 15(1), 1–13. doi: 10.3109/17549507.2012.745164 [Article] [PubMed]
Wylie, K., McAllister, L., Davidson, B., & Marshall, J. (2013). Changing practice: Implications of the world report on disability for responding to communication disability in under-served populations. International Journal of Speech Language Pathology, 15(1), 1–13. doi: 10.3109/17549507.2012.745164 [Article] [PubMed]×
Figure 1.

Acting Troupe in Zambia Depicting Acceptance of a Child With Autism.

  Acting Troupe in Zambia Depicting Acceptance of a Child With Autism.
Figure 1.

Acting Troupe in Zambia Depicting Acceptance of a Child With Autism.

×
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