Medical menus bridge language barriers in China

Ayden Fabien Férdeline 2012-03-29

SHENZHEN, China, Aug. 15 (Ayden Fabien Férdeline/UPI) — With a veneer of uncertain optimism, an ailing Tibetan woman gracefully points to an illustration of a hot spring.

Unable to speak Mandarin, she cannot describe her condition and is unable to afford the services of a professional translator.

At a hospital in the southern Chinese province of Guangdong, Dr. Eilis Gu is elated by the simple gesture. From the small sketch, he deduces that the patient’s stomach feels like a boiling cauldron and diagnoses dengue hemorrhagic fever, an uncommon but not unfamiliar disease in the region.

“Many of our clients comes from disadvantaged backgrounds,” said Gu. “Must we demand an interpreter, I fear people would continue to ignore the symptoms of their condition. That would not be acceptable to me or the Hospital Authority.”

For centuries, Guangdong and its port city of Shenzhen were isolated from the rest of China by its mountainous topography, forcing the Cantonese to rely on their own pragmatism and innovation for survival. Overcoming language barriers was a regional tradition.

Illiteracy is endemic in many parts of China, and Gu said many people in eastern Asia would be unable to identify their home on a political map. Food in the People’s Republic, however, is diverse and region-specific.

“In the past, we had a map of China with all of her provinces — Shaanxi to Jiangsu, Henan to Inner Mongolia — and we pasted photographs of local cuisine over it to define the region,” said Gu. “This allows us to service ethnic minorities.”

Clinic staff once called translators to help in the diagnosis and treatment processes. But that system fell into disfavor as problems emerged. Fermi Wong Wai-fun, campaign director with the ethnic minority assistance group Unison Hong Kong, said the use of telephone translators was often ineffective.

“Few doctors or patients know about telephone interpreting. (Nobody) I know has used it,” she said. “And the translators I have met are not professional enough.”

Translators have no official accreditation and many lack the medical vernacular necessary to accurately describe symptoms. Some, Fermi said, are not even fluent in the language they claim to be interpreting or they abuse their status, particularly when working with regional languages such as Hindi, Nepali, Urdu and Punjabi.

“Patient lives are at risk,” she said. “When the translators even speak the language to begin with, they abbreviate what (patients) say, interpret incorrectly or exploit the vulnerable by (trying) to sell their interpreting services for use outside of hospital settings. They blackmail the vulnerable into believing that if they do not pay, they will not recover from their illness.”

While the average annual wage in China is the equivalent of less than $2,000, Mandarin to English stenographers and translators in Shenzhen often earn more than 10 times that amount.

So doctors resort to less expensive and more creative ways to learn what’s ailing their patients.

Laurel Bangzi, a 34-year-old maid, returned to Shenzhen earlier this year after working for seven years in northern Thailand.

“Soon after I moved to Thailand, I was infected with giardiasis, a parasite that left me feeling nauseous and bloated. I was fatigued and had intermittent diarrhea. I went to a doctor in Chiang Mai (Thailand) five years ago but the prescription was too expensive,” she said through a reporter’s translator.

Bangzi is ethnically Chiu Chow and speaks only Taejiu, a dialect of — but not mutually intelligible with– Mandarin. As she entered Gu’s clinic, the language barrier quickly prevented effective communication. So instead of calling a translator, the doctor tried a medical game of charades.

Bangzi started by acting out her symptoms. Gu responded with an exaggerated smile, signaling respect and compassion. He fetched a photo album from beneath his desk and flipped through the pages, his gaze fixed on the patient. As he turned the pages, each showing distinct cuisine and accompanying sauces, he noticed Bangzi’s face light up as she recognized deep-fried shrimp with honey sauce and “Iron Buddha” tea, staples from her home region.

Lifting a bucket of sand onto his desk, Gu ran his hand through the contents and gave an exaggerated sneeze. The question was, “Do you have an allergy?” Yes, Bangzi mimed in response, animal fur.

With diagnosis made and potential side effects considered, Gu handed her a package of pills. Bangzi had waited years for a cure. The doctor said she’d be fine by tomorrow.

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