This paper draws on the experiences of the authors in designing and teaching a new course to educate speech and language therapists in Sri Lanka. This was the first speech and language therapist course in the country and was the result of collaboration between two universities, one in the UK and one in Sri Lanka. Rather than replicating established programmes elsewhere it was more appropriate to design a new course, suited to providing a comprehensive model of service, encompassing both social and medical approaches to rehabilitation. Issues about developing teaching and learning approaches to match pre-existing knowledge and experience of both staff and students are addressed. The particular ways of designing the programme to take account of cultural and language aspects of the Sri Lankan context are discussed.