The Language Barrier

Before we left for India, we were assured that everyone in the hospital spoke English just fine. And to be sure, the staff does know English, and indeed, cannot work without it, since virtually all the records are written in English. The only time Marathi (or Hindi--I never know which one they're using) is used seems to be when the patient or the patient's family would need to see it. However, that doesn't mean that we can always understand what is going on. Most of the conversations between people at the hospital is in some language we don't understand, and nearly all conversations with patients is in the patient's native tongue.

India has more English speakers than any other country in the world, so long as you use the term "English speaker" loosely. English is indeed becoming more and more prevalent, but Indian English is much different from American English, to the point where Indian English is sometimes unintelligible. In addition, many people have simply a cursory knowledge of English--enough to read and write patient records and pass their English courses in school, but not good enough to carry on a good conversation with American English speakers like ourselves.

A large component of our research relies on face-to-face interviews with the patient's families. This becomes difficult when the patient doesn't speak English and we have to use a translator. Sometimes we have difficulty communicating through them, which throws a bit of a loop into our study. Even simple questions like "How many children do you have" becomes impossibly difficult. I had a bit of a sick pleasure when I started watching the exasperated doctors try to communicate with the Iraqi family here for treatment, as they share no common language with anyone at the hospital.

The language barrier has been difficult to overcome, because it's hard to get involved when you don't understand what's going on. What it has taken on our part is the motivation to ask what's going on, repeat as necessary, and if they still don't understand, leave it be and move on to the next subject. In the future, I suspect that this problem will become smaller and smaller as more and more Indians learn English better and better. Language is indeed a powerful tool, and it's clear that mastery of it is a key to (or perhaps result of) success. The fact that English is the language of medicine has allowed us to have a far better understanding of what we're seeing than we would otherwise, and the fact that English is not the spoken language of the majority made me painfully aware of my own monolingual-ness.