Tamil Nadu, India
Year 2 Placement

Many people ask: How were you able to go to India? Aimee and I were recipients of the Chris Gandy International Outreach scholarship, which is a UofT scholarship for final year SLP students to spend their placement in a country with fewer rehabilitation resources than Canada. Luckily for us, UofT partners with Amar Seva Sangam (ASSA), a non-governmental organization which provides rehabilitation and education for individuals with disabilities in Ayikudy, a small town in the beautiful southern Indian province of Tamil Nadu. So, we reacted with great excitement when we found out we were headed to Amar Seva Sangam. 

We were welcomed with open arms to ASSA to learn, serve their clients and families, and participate in the local culture. A sign over the administration office reads in Tamil and English: Your visit brings happiness to us. Within hours of our first day, we were invited to a wedding of an ASSA employee and hopped on the bus to join the group of colleagues heading to the venue in a nearby village. We continued our adventures by travelling almost every weekend, venturing further afield each time as we explored Tamil Nadu and the neighbouring province of Kerala. In our travels we frequently encountered friendly locals who took pride in explaining their beautiful culture and rich history to us. Some highlights included hiking through a tea plantation in search of elephants, kayaking through a mangrove forest, joining the throng of people jostling at the base of famous waterfalls, and taking a tuk-tuk to town to purchase clothes and visit intricately carved, colorfully painted temples. And then, of course, our unforgettable placement experience. 

Within the ASSA compound, room and board were provided so we could focus on our learning. Our amazingly dedicated Canadian clinical educator, SLP Tracey Norman-Rice, joined us in person for two weeks and mentored us virtually for the remainder of our time at ASSA in partnership with our Indian clinical educator, SLP and Audiologist Selvakumar. 

Coming from Toronto, where there are many different organizations offering Speech-Language Pathology services and therefore most positions involve care for only one specific population, working at ASSA was a perfect final placement because it gave Aimee and I experience with a broad range of clients. During our time there, we worked with children in ASSA’s preschool Autism program, school-aged children from their school for children with disabilities and from the integrated school on campus, and adults with acquired communication or swallowing disorders following strokes or other brain injuries. 

I am also often asked how I provided speech and language therapy in a language that I do not speak. Although many of our clients at ASSA spoke Tamil as their primary language, we had incredible translation support from our translator and mentor Kaushik, and therefore found that not speaking Tamil was rarely a substantial barrier in therapy. Some of our adult clients spoke English as a first language, or spoke English in some areas of their life such as work so they were motivated to improve their English as well as their Tamil in rehabilitation. 

That being said, much of Aimee’s and my new learning centred on developing culturally and linguistically appropriate assessments and therapy materials as there were few “ready made” resources available to us at ASSA. Unlike in our previous practicums, we could not pull a standardized assessment off the shelf prior to our session. Often, our attempts at translating with the help of trusty search engines lead to learning opportunities for us. For example, when I attempted to make a visual calendar of different months for an adult client I learned that the seasons of “fall, winter, spring and summer” which I had translated word-for-word were not usually used in Tamil Nadu, but instead seasons relating to the different monsoons throughout the year. Some questions required more in-depth research and interviewing of our local colleagues, mentors, and clients. 

As our clients came from a variety of socio-economic backgrounds, the resources available to them at home were also variable. It was difficult to accept at times that we could not provide some services that we believed would improve the quality of life for a client - such as a technology-based Augmentative and Alternative Communication system, or in-home/virtual therapy sessions for clients with financial barriers impacting attendance. On the other hand, the dedication and passion of the employees at Amar Seva Sangam was exceptional as many came to the organization through a personal experience with accessing rehabilitation services for themselves or loved ones - therefore, many went above and beyond to meet client needs. Meanwhile, ASSA was continuously working to expand its impact both locally and nationally. For example, they have developed a mobile application for improving access to speech-language therapy, occupational therapy, and physiotherapy. This app is now used by community workers and parents across India to complete assessments and design intervention plans for children with disabilities even when access to professional services is not available. 

Another aspect of care at ASSA was a holistic approach to healthcare that included supporting spiritual, mental and nutritional health. There was an emphasis on serving food to the children who lived onsite that was healthy and balanced, recreation was provided for children including visits to a garden where they could spend time in nature, quotes from Hindu scriptures were posted throughout the campus, and frequent events were held to promote community connection, celebrate the members of the community, and mark religious and cultural days of significance.