Languages

“Why can’t everyone just speak the same language?” was my son’s blunt observation / question soon after we arrived in Togo.

We currently live in an Anufo speaking region. There are about 70,000 speakers of this tonal language in the entire world and only recently did this language begin to be written. Thus, there is much variability in meaning of words between families and towns. Most words consist of a consonant and a vowel which are strung together in phrases that might be the length of one of our typical English words. The translator I work with the most in clinic handles the English to Anufo dialogue very well. He is highly valuable to me. He can even revert to other widely spoken languages like Hausa if needed. It gets interesting though if a Moba or Mossi speaking patient from the north or a Gangam speaker from the east or nomadic Fulani shows up. That requires tracking down a hospital employee who knows that specific language. There is a printed list of which employees speak what language and I have found that these other go-betweens can be tracked down quickly.

History taking can can become quite a game of telephone though. When “how long has your abdomen been hurting?” turns into a long conversation between translators and the patient and comes back with the answer “she also says her eyes are stinging,” you just move on to the physical exam. I am always so pleasantly surprised when a patient (about 1 in 50) answers in Ghanian English and we can talk directly. 

Some of the translated answers can really surprise you too. My question - “Where is she from? Can she stay close to the hospital so we can do a post-op follow up next week?” ….. Translator answer - “Yes, she is from Niger but their herd of cows is only half an hour from the hospital right now so it is not a problem for her to come back next week.”

French is the official language of course and preferred by the hospital staff. Many patients don’t speak it though and also don’t read - a fact I just can’t seem to remember. Like when I tell the patient to go to “Echographie” - right behind the sign that says “Radiographie” and my translator pauses and says “Please, I want to show her,” and perhaps picking up on my incredulity, blurts out with a smile “She can’t read!”

Often I think that that non-verbal cues, smiles and conscientious care can transcend language barriers. The mother of our first surviving C-Section boy could understand my broken French enough today to say that she is eating and has minimal abdominal pain. She was happy to have me snap a picture of her little man. I am convinced she knows I love them both.

And the Fulani dad of the shepherd boy who fell from a high mango tree branch with the punctured lung, broken shoulder blade and broken humerus seemed to get my explanation of his sons injuries on a digital X-ray. He is so appreciative of the close watch I keep on his boy. He said that his son “has to make it” and as a dad of boys, we both get that. 

The staff here put up with my English and understand it better than they let on I think. My favorite nurse anesthetist told me “I want to teach you French but I don’t want to learn English from you because your accent is too difficult for me!” I am pretty sure he just means my pace is too difficult and I am trying to talk more slowly.

Yesterday though, I was taken aback a bit by Sanbo, one of the nurse assistants. He is a small framed man, about my age, with a characteristic Fulani face. Every morning that I see him around the nurses’ station I call out with a smile Saaan-Booooh like a sports announcer and every time he replies with soft and raspy “Oui, Dr. Na-tan.” On rounds together, we had just finished a long conversation with a female patient including discharge instructions. I asked “Can I pray with you in English?” and through the translating nurse she said “Yes, God can understand.” As we walked away from her bed Sanbo looked at me squarely and said, “Dr. Na-tan, it is important that you speak French.”

I know Sanbo, I know.

(photo credit Judy Bowen)