I can't understand my patient's language!

[Diagnostic]

Did that happen to you before?
We know that most of us is studying or studied medicine in different countries and it's easy to feel this language barrier especially during clinical rounds & exams, how to communicate with your patients? what will you do if that happen to you? do you think that having your colleague as a translator is enough to take history from your patient?
Diagnostic

[Dr.keyf]

olyotya diagnostic.i believe wat ure facing is wat we all face as medical students except the few who r studying in english speaking countries or those who speak the language of their locality.it has been one of my greatest challenges especially coz here in pakistan patients have several different languages as they hail frm different provinces.but hey,we hv to tackle this problem in any way we can.for example,u get a friend who speaks the language,n initially theyll translate for u,then write down all history points on a rough pad n write down all translations next to it.then daily try to practice by using ur rough pad as ur referrence.as time goes by,u get used to these words n when u think of fever or cough or watever ,the questions spring to mind.its exactly how we memorize the history n gpe steps in english.do tht for a while n ull be an expert even just after a year.hope tht helps

[Admin]

Thanks diagnostic for this topic..

Yes, this happened to me before, & I can't forget it till now..

I had an Internal Medicine exam 3 years back when I was given a long case about a young man from southern sudan.

Southern sudanese people don't speak arabic especially those who arrived recently from there & they are the most difficult people to communicate with..

The worst thing that I found was that he was drunk with no co-patient. The patient next to him told me that policemen brought him in last night and they have left.

I was really shocked that time, because how can I take history from a person who is drunk and who can only speak his own extinct language.

I went to the boss in charge and told him what I have seen, he asked me this question: "If this man comes to your clinic, how are you going to act?" I replied: "I will sort something out...".

Then he replied mockingly: "Ok, go then and sort it.."

I went back to my case & I just did only examination then I found out that this guy was sick with TB complicated with pott's disease.
& the patient next to him told me that 2 doctors came this morning and took sputum sample.

I went back dragging my legs to the professors to present my case, being sure that I would fail because I did'nt have anything to say about history apart from the examination that I have done in my uncooperative patient.

First I told them that my patient is drunk with no co-patient and he does'nt speak arabic and he is from southern sudan, he asked me: "Then what have you done?".

I replied: "I have done only an examination ".

He said: "Tell us your findings", I told them in a perfect way, while trying to screen the gap in history.

At last, they congaratulated me saying: "A good doctor is someone who can act in every situation".
dr.keyf, the southern sudanese people speak a different and difficult language than pakistani people, even you can't understand them when they speak arabic.
Their language is not written, when you listen to them, the only thing you can figure out is the letter (dh) so (dha dhi dhu) means something which you can't understand. Beside that they are very rare in universities and therefore you will not find a southern sudanese colleague who can translate for you.
I hope none of you will face such a situation.
Dr.Mahdi

[Moha]

it happens u r rite....i once had to take a history from an old guy who came from rural areas of a province called Baluchistan,and he spoke only his local dialect called The Brohi,and we were in another province called Sind ...but the funny thing was none of the people around could speak it...i was so bewildered and amused by the fact that everybody around instantly became like me(a foreigner!),unable to converse with one of their own! they were all Pakistanis basically!...and then one of the ward cleaners told us that he knew a Brohi kiosk owner down the hospital road...off we went to ask the guy to help us translate..it helped...soo at least i learnt few  Brohi words! Naa antaa haalee...(how are u)....khushust(fine)....

[Kamal]

in USA is discourage to use family and friends as interpreter, clinic are responsible to provide an interpreters or bilingual staff for the patients, in US insurance pay good money for the medical and legal interpters to do such services, i do understand  some country they do nt have enough money to pay that services, and it is sad if you can nt undersand your patients,
one other thing you can do is  as doctor learn words in as money languages as you can, you wil never know when you will need,
 i know some American doctors do try hard to say some words in Somali... actual i know one eye surgeon Dr who love to talk somali in somali...but they laugh at him...

[Waxbaro!]

We all agreed that communication is the basis of good health care.

Around 80 per cent of the information the doctor needs to make a correct diagnosis comes from what the patient say, understanding your patient's native language is very important.

Sometimes using body language is helpful to overcome this language barrier & I remember a story happened to me when I was working in a hospital located in Somalia.

"Waxaa ii timid islaan somaaliyeed oo wadata cunugeda oo jiran, markaan waraystay waxay ii sheegtay in wiilkeeda uu ka sheeganayo MARWAXAD, waan istaagay oo waxaan damiyay marwaxadda qolka, kadib markaan u soo laabtay oo su'aalo kala weydiiyay ayay iigu soo celisay isla kalmadii, waxaan iri: MARWAXADDA waa maxay? kadib sharax dheer kadib ayaan fahmay in MARWAXADDU ay thaay QUFAC.

So everyone is susceptible to misunderstanding!
Waxbaro!

[Diagnostic]

Thank you all.
It seems that most of us had such an experience.
Amazingly it also happened to Waxbaro who works in Somalia.

[Abdullahi!]

We all agreed that communication is the basis of good health care.

Around 80 per cent of the information the doctor needs to make a correct diagnosis comes from what the patient say, understanding your patient's native language is very important.

Sometimes using body language is helpful to overcome this language barrier & I remember a story happened to me when I was working in a hospital located in Somalia.

"Waxaa ii timid islaan somaaliyeed oo wadata cunugeda oo jiran, markaan waraystay waxay ii sheegtay in wiilkeeda uu ka sheeganayo MARWAXAD, waan istaagay oo waxaan damiyay marwaxadda qolka, kadib markaan u soo laabtay oo su'aalo kala weydiiyay ayay iigu soo celisay isla kalmadii, waxaan iri: MARWAXADDA waa maxay? kadib sharax dheer kadib ayaan fahmay in MARWAXADDU ay thaay QUFAC.

So everyone is susceptible to misunderstanding!
Waxbaro!

If you as a doctor practicing in Somalia experienced difficulties with the language barrier, what about us people who were raised abroad?. 
This would be a real pain if we decide to come and work in Somalia.

[Yaxya]

don't say that abdulahi it is not pain to work in your homeland,even if you face some diffculties no problem coz u r helping ur ppl.
i my self face this challange few months ago :patient came from baydhabo  to the hospital where i work complaing from urine retention.
the prblem was both of  us  don't understand the other,suddnly one of the secuirty guys enter the room and solve our problem coz he knows both languages.
so even if know somali well u will face such problem.

[Dr.Fatima]

Dear colleagues,

Misunderstandings have many degrees and many forms. Even misunderstanding could occur in ones own language, but then u have the opportunity to correct it by asking more direct question. The key is if you have the ability to ask to be understood. I have studied half of my studies in Poland, and this country have language belonging to Slavic Indo-European language. A language group which benefit you if you learn it because you can communicate with Polish, Czech, Slovak, Slovene, West Ukraine, West Belarus, and so on. So it is a huge language group with many million ppl who speaks it. It was obligatory for foreign students to learn and speak it fluently. The first years we had pre-clinical studies and had not much contact with patients, after the 2nd year was clinical years. In the beggining some of the teaching doctors were nice and were able to translate most of the contact we had with patients. The university I was attending was a private university and I had to pay for my tuition fee. Thats why the teachers were obliged to help us in the beginning. But afterwards, the rest was up to us. Poland is a huge country with many villages. Many of the ppl from these villages speak their own dialect. So it was even more challanging for us foreign students. Bodylanguage was helpful in the beginning but later own to ask more deeper and spesific questions things became harder. But I think as long as you become creative and try to solve the problem one way or the other will gain you alot and you will be an extraordinary doctor. So never give up dear colleagues, there is always hope.
Thank you.

[Munim]

don't say that abdulahi it is not pain to work in your homeland,even if you face some diffculties no problem coz u r helping ur ppl.
i my self face this challange few months ago :patient came from baydhabo  to the hospital where i work complaing from urine retention.
the prblem was both of  us  don't understand the other,suddnly one of the secuirty guys enter the room and solve our problem coz he knows both languages.
so even if know somali well u will face such problem.

yes that's right i agree with  yaxya

[Abdullahi!]

Dear Yaxya and Munim,

When I mentioned pain, I didn't mean that it would stop me from working in my own country.
There is nothing that can stop me from helping my people except fate.
If non-Somali humanitarian aid organizations can work in Somalia, why can't we Somali doctors do the same?!!