A month ago, I was fortunate enough to go to Vietnam and train a group of post-graduate Vietnamese students at the ENT Hospital in Ho Chi Minh City (Saigon). The clinical education training is part of a relatively new post graduate course offered through a collaboration of professionals from the University of Medicine in Saigon and the Trinh Foundation. The Trinh Foundation consists of dedicated Australian speech pathologists who donate time and resources (and well, some of them have even moved there for a few years). My visit timed nicely with the advent of the International Communication Project 2014 (ICP 2014). This project aims to highlight the importance of human communication – and how communication disabilities severely impact every aspect of life.
Specifically, (and I’m quoting from the website) the ICP 2014 has three primary aims:
- To raise the profile and status of communication disabilities with international health bodies and policy makers.
- To increase public awareness of communication disabilities and the severe impact they have on people’s lives.
- To encourage people around the world to join together and make a difference in the lives of people living with a communication disability.
The Trinh Foundation is either intentionally or unintentionally reflecting these goals at a grassroots level. This naturally applies not only to the staff and volunteers working with the Trinh Foundation, but also to the Vietnamese students and staff who are pioneering an entirely new profession in their own country.
Heading to Vietnam, I’m not sure what my expectations were. I certainly felt excitement – but sitting on the plane at Sydney International Airport, I had a sudden rush of butterflies (“What am I doing?!!”) Fortunately, the excitement won out and I geared myself to have a good time and put everything into it. The trip is certainly no holiday, but the freshness of new faces, new challenges and a new environment was just as good. These things cause you to consider your own practice and your own methods, and can be the catalyst for new ideas and new clinical questions. Coming from a country where speech pathology is relatively well established, it was educating to enter a health and education system where speech pathology is very much in its infancy. Here are just a few of my reflections.
1. Speech Pathology?
In Australia, when someone asks me what I do for work, I reply, “I’m a speech pathologist”. Some people get it in one go, but most of the time, I have to clarify with, “A speech therapist” before the light dawns. In Vietnam, my standard conversation ended up being much longer, and much less fruitful. I was meeting and chatting with a large group of young, educated, English speaking Vietnamese on a Sunday. It was incredibly difficult to convey what I was doing here. As soon as I mentioned working at a hospital, I was given an instantaneous medical degree; “Ah you’re a doctor!” We’ve worked hard in Australia to build the profile of allied health, but it’s taken a fair bit of time. I think we are most assuredly at the starting line in Vietnam.
2. Enthusiastic Runners
Speech Pathology in Vietnam might be at the starting line, but the country (without being overtly aware of it) has a dedicated collective of professionals that are keen for their country to have speech pathology services. In other words, Vietnam has enthusiastic runners at the starting line. To employ an overused cliché, everything begins somewhere, and while 16 Vietnamese speech pathologists in a country of 88 million seems like a drop in the proverbial ocean (it IS a drop in the ocean), the stark and lovely reality is that there is now a framework from which this profession can grow.
If we are looking for inspiration from other countries, we should look to the countries in East Africa. In September last year, 130 delegates from 17 countries gathered for the 5th East African Conference on Communication Disability in Mombasa, Kenya. Speech pathology is growing in this area of the world too, providing hope for parents who thought that nothing could be done for their child, or helping adults meet their basic communicative needs after stroke. You can read more about one group that is working in Kenya here: www.yellowhousechildrens.org/our-story. As the author mentions, and I second, never underestimate what people can do when given the opportunity and resources. In our world where everything happens quickly, it’s important to recognize that some things do take time. Establishing a new profession is less of a sprint and more of a cross country marathon (hurdles and all).
3. Seeking for sustainability
A few years ago I read a book called ‘Band-aid for a Broken Leg’. It’s the story of South-African born Australian Damien Brown. As a young doctor he heads to Africa to work with Medicines Sans Frontieres. The author’s frank reflections written after his time in Angola and the Sudan had a profound effect on my thoughts about ‘overseas aid’. To quote the final chapter, ” …So, is there really any point to this line of work? Is there any lasting benefit to the people that MSF tries to help? Or does the aid industry just bumble on blindly, patting itself on the back for ‘at least trying’, all the while perpetuating its own existence?’
This caught me by surprise, all the while knowing it was not a new argument or train of thought. Dr Brown (and others) identify that often ‘aid’ can: a) place an additional financial burden on the community b) not really be wanted or needed by a community and c) be unsustainable for the community. In spite of his concerns however, Dr Brown’s conclusion at the end of the book provided a balanced, hopeful look to the future. “My head says it is futile. My heart knows differently. I hope to be in the field again sometime soon.”
It’s an encouraging thing to know that the work being done to develop the speech pathology profession in Vietnam has been instigated and supported by a community of Vietnamese health professionals. This is the second round of graduates coming through this year. After finishing the course, students will resume their regular jobs and incorporate their speech therapy skills into that job. We had a diverse cohort of students at the ENT clinic placement, including ENT doctors, physiotherapists, psychologists and nurses. Each of them had had different ideas about how they would use their new qualifications in their other profession and it was great to hear their enthusiasm (In fact, not surprisingly, working with the students was the highlight of the trip). Hopefully at some point in the future, specific speech pathology roles will be created.
4. Why do we go?
Communication is such a seemingly simple thing. We often take it for granted. When the ability to communicate is lost, or changed, we then realise just how important it is. It’s a good feeling to have directly helped a few people communicate well again, but more importantly, it’s encouraging that there is a way forward for this profession and its services in Vietnam. Just this last week, the Trinh Foundation celebrated its 6th Birthday. The celebrations that occurred were a well-deserved acknowledgement of the birth of a new idea that has, and will, lift the lives of many.
Contact us for results focused speech therapy
This article was written by our speech pathologist Jenna Butterworth who is a Speech Pathology Australia member.
If you have questions about speech pathology or communication, contact your local doctor who will arrange for you to see a speech pathologist.