Kathard Harsha, Pillay Mershen
University of Cape Town, South Africa.
Int J Speech Lang Pathol. 2013 Feb;15(1):84-9. doi: 10.3109/17549507.2012.757803.
In the context of the World Report on Disability, Wylie, McAllister, Davidson, and Marshall (2013) question how speech-language pathologists (SLPs) change practices to benefit under-served people with communication disability. This commentary provides a South African response premised on Political Consciousness. In South Africa, a grossly unequal society, the under-served population is not only those with communication disability but also include those who are at a communication disadvantage due to disabling conditions. As a consequence of the combined effects of a severe shortage of SLPs as well as maldistribution in service provision, the under-served are mainly poor Black South Africans who are the majority population. Political Consciousness allows one to examine how selected forces at the macro-level, meso-level, and micro-level may enable or limit services to the under-served majority. At a macro-level, this study appraises policies and actions advancing and impeding service delivery. At the meso-level it is argued that hegemonic professional knowledge is limiting and an equity-driven population-based approach is advocated. At a micro-level, the Relationship of Labouring Affinities is offered as a conceptual tool for critical engagement. In conclusion, it is suggested that the speech-language pathology profession must collectively become political actors at all levels to effect change.
在《世界残疾报告》的背景下，怀利、麦卡利斯特、戴维森和马歇尔（2013年）质疑言语语言病理学家（SLP）如何改变做法，以使服务不足的沟通障碍者受益。本评论以政治意识为前提给出了南非的回应。在南非这个极度不平等的社会中，服务不足的人群不仅包括有沟通障碍的人，还包括那些因致残状况而处于沟通劣势的人。由于言语语言病理学家严重短缺以及服务提供分配不均的综合影响，服务不足的主要是贫穷的南非黑人，而他们是多数人口。政治意识使人们能够审视宏观层面、中观层面和微观层面的特定力量如何促进或限制为服务不足的多数人群提供服务。在宏观层面，本研究评估了促进和阻碍服务提供的政策与行动。在中观层面，有人认为霸权性专业知识具有局限性，并倡导一种以公平为导向、基于人群的方法。在微观层面，劳动亲和关系被作为一种用于批判性参与的概念工具提出。总之，有人建议言语语言病理学专业必须集体成为各级的政治行为体以实现变革。
