Day 216, The Language Barrier

Day 216, Communication was always going to be difficult being somewhere so foreign to me. The predominant language spoken by most of the patients is Zulu. However a number of the doctors speak Afrikaans, whilst some patients from north of the border speak Tongan or Shangaan. If that wasn’t difficult enough, even the English spoken is heavily accented and filled with South Africanisms that constantly remind me how much of a foreigner I actually am.

After several months working my Zulu has evolved somewhat. No longer can I merely greet someone and wish them well on their daily business and I even developed a reasonable pronunciation of the various clicks in the language represent by the letters Q, X and C. Of course, the setting of my Zulu education being the hospital OPD it is rather functional. I doubt that I would have too much use for phrases such as, “lie down looking up”, “bend it” and “burning urine” at my next Zulu speaking cocktail party.

Yet my vocabulary is nowhere near comprehensive enough to conduct a consultation independently. There are always willing translators in nurses, general orderlies and nursing students who will sit with you during the consultation. However as they are not professional interpreters I often find myself feeling much like Bill Murray in Lost in Translation. I will ask how long the patient has been coughing up blood for and after several minutes of gesticulation and animation my intermediary will turn to me and say, “yes doctor, coughing a lot”.

Even when the interpreters translate accurately it doesn’t always solve the riddles. People’s perceptions of their bodies and their health beliefs are very different to back home. A patient here would often describe abnormal sensations such as pins and needles as creatures crawling inside them. They often also relate being unwell to having a bird of some sort inside them, these are culturally accepted descriptions and do not usually warrant a psychiatric evaluation. I even had a patient who was convinced the bird was the reason she couldn’t climax.

My miscommunications have provided much comic relief to both my friends and the nursing staff. It is always a source of joviality when the foreign doctor attempts to learn a new zulu word, much as my colleagues will mock my pronunciation of the such national treasures as boerowors and Windhoek beer.

After over six months here I may be able to walk the walk, but despite my best efforts I am still far from talking the talk.

http://www.youtube.com/watch?v=pEmatTKuPMw