The Language of Trust

What if someone you love was sick, but no one in your community spoke the language of the only doctor in town? What would you do? How would you communicate your loved one’s symptoms? How would the doctor communicate what was needed for her care? Far too often, medical providers and their patients are unable to communicate effectively due to language barriers. And that can lead to tragic results.

Africa is a continent full of thriving, vibrant language communities. It is a place rich in history and culture—the very cradle of humanity. Over the past decades, African economies have begun to transcend, on their own initiative, a heritage of colonialism and abuse that long siphoned off much of their wealth and human capital. Despite astonishing progress, however, many African nations still face unique challenges that disrupt their development and leave them reeling.

FROM FLICKR  @DAVID STANLEY  CREATIVE COMMONS

FROM FLICKR @DAVID STANLEY CREATIVE COMMONS

One such challenge that even those of us living at a great distance from the African continent may be aware of is the West African Ebola virus epidemic, which began at the very end of 2013 and continued until 2016. This epidemic dominated the global news cycle and resulted in an estimated more than 11,000 deaths, as well as around 17,000 survivors—many of whom suffered from severe post-Ebola symptoms.

It was the largest Ebola outbreak in history.

While the West African Ebola virus epidemic was declared to be over in June of 2016, Ebola itself has not been eradicated and there is currently another Ebola epidemic going on in the Democratic Republic of Congo—the worst ever in that country’s history, and the second-largest Ebola epidemic on record.

One challenge making this outbreak even harder to treat is misinformation about the disease, which this past Friday likely played a role in the tragic killing of Dr. Richard Valery Mouzoko Kiboung, an epidemiologist from Cameroon who was in the DRC with the World Health Organization.

While it’s likely that community mistrust and misinformation about the disease were not the only factors that led to the attack, it is clear that better methods of communication are required.

One part of the problem is suspicion on the part of smaller language communities regarding the massive influx of money and attention being spent to address this one, particularly “newsy” medical issue, when there are other problems (like Cholera, for example) that are largely ignored by the international community. When your history is so full of exploitation, it’s perfectly reasonable to expect more exploitation in the present day.

But beyond the politics of aid coming from the nation’s capital or from abroad is the simple fact that no community anywhere in the world is likely to give support to interventions that language barriers make impossible to understand.

The excellent piece entitled ‘Chanjo’? Ebola warnings puzzle communities in Goma by Jenny Lei Ravelo, outlines some of the issues facing medical aid workers during the current outbreak in the DRC.

The availability of an experimental vaccine is seen as a game changer in the ongoing Ebola outbreak in the Democratic Republic of the Congo. But some residents in the North Kivu province capital city of Goma, in particular women over 35 years old, aren’t so sure.

For starters, they don’t know what ‘vaccine’ is, nor its equivalent in Swahili, ‘chanjo.’ They only know of ‘ndui,’ a Congolese Swahili term that refers to prenatal vaccines, Ellie Kemp, head of crisis response at Translators without Borders, told Devex.

‘That's the word they understand for vaccination, while men were more likely to understand the formal Swahili word for vaccination. But unless you know that and test the comprehension of some of these keywords...then you could miss out [a significant part of] the population,’ she said.

That’s just one example of the language-based challenges health workers must face before they can even begin to reassure local communities and properly address a crisis. These challenges aren’t new, but it’s only recently that they’ve begun to really come to the fore. This same article goes on to say, "Looking at the importance of language for effective risk communication is still quite new in the humanitarian sector. Kemp, who has worked in the sector for 20 years, said the aid community tends to disregard language as a factor of communication. Most of the time, aid agencies leave that to their national staff, assuming they ‘can handle the burden of communication in multilingual settings,’ ” which is exactly the approach that we at SIL LEAD have run into in our interactions with health-providing organizations.

Language is so basic to our daily lives that many of us—especially those of us who can read and understand a dominant language such as English—never really think about how difficult life can be when differences can cause a barrier to all kinds of access.

This is why “Health Localization” is one of SIL LEAD’s three primary areas of focus.

Today in the Democratic Republic of Congo, it is becoming very clear that the work of helping communities, governments, and development partners translate and adapt vital messages accurately in a community’s distinct language, culture, and context isn’t just some abstract academic exercise—it is work that will save lives.