A Groundbreaking Study on Transforming Audiology Training
In the evolving landscape of South African higher education, a newly published paper is sparking vital conversations about making audiology programs more inclusive and relevant. Titled 'Decolonising audiology education: Epistemic barriers and opportunities for Black African students,' this research from the University of KwaZulu-Natal (UKZN) dives deep into the challenges faced by Black African First-Language Speaking (BAFLS) students. Led by Musa Makhoba alongside Sarasvathie Reddy and Mershen Pillay, the study highlights how Eurocentric curricula often clash with the cultural and linguistic realities of these learners, urging a shift toward Afrocentric approaches.
Audiology, the science of hearing and balance disorders, is crucial in a country where hearing loss affects millions, yet training has long mirrored Western models. This paper, fresh off the press in the South African Journal of Communication Disorders on April 08, 2026, uses qualitative insights from 10 BAFLS graduates to expose gaps and propose fixes. It aligns with broader decolonisation efforts in South African universities, where movements like #RhodesMustFall have pushed for curricula that honor indigenous knowledge systems.
The Roots of Audiology Education in South Africa
Audiology training in South Africa kicked off in the mid-20th century, primarily at institutions like the University of Pretoria (UP), University of the Witwatersrand (Wits), University of Cape Town (UCT), and UKZN. These four-year Bachelor of Audiology degrees blend theory, clinical practice, and psychology, preparing graduates for roles in diagnostics, rehabilitation, and hearing aid fitting. Sefako Makgatho Health Sciences University (SMU) also offers related programs in speech-language pathology and audiology.
Historically, the profession was dominated by white practitioners during apartheid, with slow transformation post-1994. Today, the Health Professions Council of South Africa (HPCSA) registers about 3,266 professionals, with 47.4% dual-registered as audiologists and speech therapists, 33.5% speech therapists only, and 18.9% audiologists. Over 94% are female, and while racial diversity is improving, Black African representation lags, mirroring broader health sciences inequities.
Community service year post-graduation is mandatory, but unemployment remains high, with many newly qualified audiologists struggling to secure positions amid economic pressures. This context amplifies the need for education that equips all students—especially BAFLS ones—to serve diverse, resource-limited African communities effectively.
Understanding Epistemic Barriers in the Curriculum
Epistemic barriers refer to structural obstacles that privilege certain knowledge systems—here, Western, English-dominant ones—while marginalizing others. The study, framed by Cowen’s Logical Model of Curriculum Development, reveals how UKZN's undergraduate audiology program (the 'University of Interest') falls short for BAFLS students.
Key issues include curriculum content disconnected from African realities. For instance, protocols assume access to high-tech equipment rare in rural clinics, ignoring low-cost, context-appropriate interventions rooted in local practices. Linguicism—bias against non-English languages like isiZulu or isiXhosa—manifests in English-only lectures and assessments, forcing surface learning over deep understanding. Participants reported feeling 'alienated' by jargon-heavy texts that don't resonate with their worldviews.
Racism and classism compound this: microaggressions in classrooms, assumptions of lower ability based on background, and financial hurdles for practical components. One theme: assessments biased toward rote memorization rather than contextual application, leading to high failure rates among BAFLS students.
Student Experiences: Voices from the Frontline
The hermeneutic phenomenological approach captured raw narratives from 10 purposively selected graduates. Common threads: 'I felt like an outsider in my own field,' echoing epistemic violence where African knowledge is deemed inferior. Many described 'survival mode' learning—cramming for exams without grasping concepts applicable to township or rural patients.
Underpreparedness hits hard post-graduation. Graduates noted discomfort in community service, where Western tools failed amid cultural stigmas around hearing aids or traditional healing preferences. One recounted: adapting protocols on-the-fly for patients viewing hearing loss through spiritual lenses, a skill not taught in class.
These stories underscore surface vs. deep learning: BAFLS students prioritize passing over mastery, perpetuating a cycle where the profession remains untransformed.
Pathways to Decolonisation: Practical Recommendations
The paper charts clear decolonisation routes. First, recontextualise content: integrate Afrocentric case studies, like noise-induced hearing loss from mining or traditional ear cleaning practices. Second, multilingual assessments—oral exams in home languages or translated materials. Third, anti-bias training for educators to dismantle linguicism and racism.
Using LMCD, it calls for iterative redesign: select relevant knowledge, structure inclusively, and evaluate via diverse metrics. Broader interventions: partnerships with traditional healers for holistic care models and community-engaged learning in underserved areas.
Inspired by prior works like Pillay and Kathard's 2015 paper on decolonizing speech therapy/audiology, this builds momentum. Universities could pilot 'decolonised modules' in anatomy or electrophysiology, blending Western science with ubuntu-informed ethics. Read the full paper here for detailed frameworks.
Broader Challenges in South African Health Sciences
Audiology mirrors wider health sciences struggles. Post-apartheid, enrollment diversified, but curricula linger Eurocentric. #FeesMustFall (2015-2016) amplified decolonisation demands, leading to reviews at UP, UCT, and Wits. Yet, progress stalls: only 25% of health curricula reportedly Afrocentric per recent audits.
Stats paint urgency—6 million South Africans with disabling hearing loss, mostly underserved. Black practitioners, vital for cultural competence, face dropout rates 20% higher due to epistemic exclusion. Unemployment post-service (up to 30%) pushes many abroad, exacerbating shortages (1 audiologist per 100,000 vs. global 1:10,000).
University Responses and Case Studies
UKZN leads with this study, but others act. UP's Speech-Language Pathology and Audiology department incorporates indigenous languages in training. Wits' program emphasizes psychology for diverse populations. UCT pilots community placements addressing cultural barriers.
A case: Stellenbosch University's decolonisation workshops in allied health, reducing BAFLS attrition by 15%. Scalable? Yes, via national HPCSA guidelines mandating cultural competence. HPCSA standards now stress transformation, aligning with this research.
Stakeholder Perspectives and Expert Insights
Mershen Pillay, co-author now at Massey University, has long championed this: his 2015 work flagged similar issues in speech therapy. Experts like Kerushka Khoza-Shangase (Wits) advocate tech-infused, decolonised preventive audiology.
Students via SASLHA (South African Speech-Language-Hearing Association) echo findings: 70% report cultural mismatches in practice. Policymakers at DHET push epistemic justice, tying funding to transformation metrics.
Future Outlook: Toward an Afrocentric Profession
Optimism abounds if acted upon. By 2030, fully decolonised programs could boost BAFLS graduation rates 25%, diversify the workforce to 40% Black African audiologists, and tailor services—e.g., mobile clinics with sign language interpreters fluent in African languages.
Challenges persist: resource constraints, resistant faculty. Solutions: DHET-funded redesign grants, inter-uni collaborations. This paper isn't endpoint but catalyst, positioning South African audiology as global leader in equitable, context-driven care.
For aspiring professionals, explore opportunities at AcademicJobs South Africa listings.
