Saved in translation

The Eastern Cape is where Xhosa is spoken (or isiXhosa as it is more properly called); a very small proportion of locals also speak English. Some residents whose origins are from further afield variously speak isiZulu, Setswana, Ndebele and the like, but Xhosa is the lingua franca and the language of business and social interactions. All languages have their historical quirks – the locals here would no doubt find it amusing that we name the days of the week after mythical Norse gods and Saturn, the Sun and Moon. Xhosa is no exception; my limited knowledge of it already reveals it to be a language which is heavily embedded in local culture and daily life, sometimes in a rather homely and engaging way. The full word for noon, emini emaqanda, means ‘the eggs will have been laid (by now)’. Xhosa sometimes uses animals in a quasi-allegorical fashion. Imfeni lakho indala means ‘you are late’ but actually says ‘your baboon is old’ whilst imfeni lakho iyaphala congratulates you for being on time by observing that ‘your baboon is running’. Onomatopoeia is deftly employed; ngqonkqoza means ‘knock’, with the two clicking ‘q’s making a ‘knock knock’ sound’, and one of the most gloriously descriptive phrases, when everything is in confusion is ngumdodo wamasele – ‘it is a dance of frogs’.

The senior doctors and many of the other health care staff here speak Xhosa to a greater or lesser extent, although even they will sometimes ask the translators for assistance when communicating more complex issues and to ensure their health care messages are getting across. For those of us with no Xhosa the problem could be considerably greater than it is. I have begun to learn some basic words and phrases in the hope that it might enhance my ability to take a clinical history from the patients, and to communicate what I wish them to do when I examine them: – khamisa ‘open your mouth’, veza ulwimi ‘put your tongue out’, phefumla ‘breathe’, as well as words for ‘sit up’, ‘lie down’ and the vital ‘umntwana shukuma kakuhle?’ – ‘is your baby moving (kicking) well’. My attempts seem to be warmly received although whether this is because I am making the effort to speak their language or (more likely) that I have inadvertently said something bizarrely funny or inappropriate is not certain. My grasp of Xhosa at this stage is little more than an ice-breaker and I could not function clinically without a translator.

Amongst its many motivated and remarkable staff groups Zithulele has a team of translators to help out the linguistically challenged newcomers such as myself. All those that I have met so far are young women in their 20’s, fluently bilingual in Xhosa and English. They are without exception a cheerful, smiling, bright and empathetic group of individuals with a well-developed sense of humour – but at the right time. They are serious as befits the circumstances – and there are not infrequently sombre moments. They lack even the merest hint of superiority at their linguistic skill and how this contrasts with my own stumbling simplistic efforts. They do their job well and are respected for this and we try to do ours well which they in turn respect. In writing that last sentence it dawns on me that this simple reciprocal appreciation of each other’s worth is in decline in the West, but I can simultaneously feel accusations of a selective and nostalgic recall heading my way.

These girls* have a huge responsibility; not only must they translate accurately in both directions whilst at the same time traversing major cultural differences and negotiating subtle social nuances, but also on their young shoulders rests an enormous burden of confidentiality. Daily they elicit privileged information, which may often be relatively innocuous, but can on occasion include details of less savoury issues such as rapes, stabbings and family violence.

In the UK, with the increasingly cosmopolitan hospital patient clientele, we are routinely turning to telephone based translation services when, for example, monoglot Amharic speaking asylum seekers or East European migrant agricultural workers are admitted to the ward. However in cases such as this the translator doesn’t know the patient and confidentiality is enhanced by the remoteness of the telephone link. The Zithulele translators all live quite locally. Some must know personally the families whose lives and troubles they are translating into English, yet in the patients from whom they are translating I have never thus far sensed the slightest hesitancy to disclose information; the abiding impression is that they are all both absolutely trusted and discreet.

For those of us who need their skills they are the oil which keeps the health care engine turning smoothly. Ideally one eventually will acquire enough Xhosa to manage largely independently since, however good they are, it must be better to speak directly to a patient rather than by proxy, but that is still a very distant prospect. Until and unless that unlikely circumstance pertains I shall continue to be indebted to the translation team, as I suspect are all the patients that I see. Without them other health care professionals would be distracted from their real jobs in order to translate. Without them medicine for newly arrived doctors would be veterinary. To make a diagnosis there would be the bare minimum of verbal clues and far too much reliance on the imprecise art of clinical examination. The time that is saved by having instant translation is incalculable but it also allows every doctor patient relationship in Zithulele to be exactly that – a relationship – rather than, at worst, it being reduced to something resembling the interaction between a car mechanic and a gearbox.

You will note that I said the hospital ‘has’ a team of translators. The hospital does not employ them all, it is the charity which the modern-day medical pioneers of Zithulele, Ben and Taryn Gaunt and Karl and Sally Le Roux, manage, the Jabulani Rural Health Foundation**, which employs a significant number of them. Whilst it is almost impossible to imagine working adequately without translators I find it equally bewildering that the government does not provide funding for them. Any audit that was performed of the time that is saved, the better use of resources, the enhanced quality of care and the general patient (and doctor) satisfaction would reveal unequivocally what amazing value for money they are.

If my UK neighbour Anne Corsellis, who is Vice Chairman of Council of the Chartered Institute of Linguists and who wrote the definitive textbook ‘Public Service Interpreting’, reads this, I hope it will provoke a pleased (never smug – she is too gracious) smile. As an ex Magistrate there may also however be a raised eyebrow as she notes the striking parallel with the UK where the government, in a stellar example of myopic, dogma-driven cost cutting, has decided that state-run translating services for the Law Courts are too pricey and could safely be privatised. Perhaps it was just the triumph of hope over experience but the result might be described as ngumdodo wamasele

* Update – there are splendid male translators too

**website http://www.jabulanifoundation.org/index.html

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