Babelfish

I wrote a bit about language before I arrived, but I think it's worth revisiting now that I've been here a while.

While in Mada, French was common enough in the city to get by, but in most of the country, Malagasy was the prevalent language. Thus, a little French helped, but it was better to learn some Malagasy words, and most of us had at least the basics down pat. Misaotra, Madagascar, for having such a beautiful language! I miss it! I was a "casualty" during our last fire drill, and a couple of our Malagasy crew that are still with us carried me down the stairs on a stretcher to the hospital. It was so wonderful to hear them bantering back and forth! I had to resist the urge to smile and say, "Tsara be!" (very good). I was supposed to be unconscious. With a head injury and a hemothorax. It was a fun time. ;)

At least we made out better than that guy in the back!

The fire drill was quite the experience...we learned first hand how genuinely impossible it is to navigate in a smoke-filled room. But now I'm on a tangent.

I'm supposed to be talking about language.

There were a few regional dialects in Mada, but NOTHING like the linguistic diversity in Benin.

Map showing the major dialects of Benin. 

Fon (or Fongbe) is the predominant language in the south of the country, and many Beninoise do speak fluent French, but as you can see, there are MANY more languages. And the older a person is, and the more rural their hometown, the less likely it is they know very much French. While we have an incredible and talented day crew, there are only so many of them that can speak certain dialects. Bariba, for example, which is fairly common in the north, is only spoken by 4 day crew in the entire hospital. When you're trying to schedule for 4 different wards, plus outpatients, rehab, and the OR...well it's just plain impossible to have one of them available all the time. So, when we have Bariba-speaking patients, we often end up trying to cram all of our teaching into the morning shift the day before they are discharged home, in case there's no translator available the next day.

Patient M (on the left) speaks Bariba, but she had her
own sign language she tried to use all the time.
It mostly consisted of wagging her finger at me
the air and putting her hands on her hips.
She's a bit of a sassy one. I love her.

Alternatively, it's not unusual at all to have to borrow another patient to use as an intermediary translator. Sometimes we have 3 or 4-way translation going on to get a message across! You certainly have to be patient while waiting for the day crew to translate what you said into French, then a patient translates that into Bariba, then another patient translates the Bariba into Fulfulde...and then the whole process goes backwards to get the patient's response back to you!

Patient M, a rare exception who speaks excellent English!
Although I'm so used to speaking to my patients in French I often forget! 

The Ward church service for patients is another place where the diverse array of languages is very apparent. The service is usually led by one of our chaplains in English (though her native language is Dende, I believe), then translated by another chaplain into Fon. Although the sound system is usually deafeningly loud, you might sometimes catch a murmuring in the seated crowd. The patients aren't distracted or chatting amongst themselves, but will seat themselves in groups around one patient or caregiver who can translate the Fon into their regional language. I've mentioned it before, but this is another one of those heartwarming examples of the supportive and caring relationships we often see forming in our wards.

Sometimes, however, the language barrier can be quite isolating. We pluck patients up out of their homes and communities and bring them miles away where there may be very few who speak their particular dialect. It was definitely a struggle with patient B, pictured above. None of our translators speak Fulfulde (her language), but when she first arrived there was a younger woman in the next bed who was able to convey things to her, and kept her in good spirits. B had to stay about a week longer than her, however, and it was a tough week. We did our best to communicate with gestures and the occasional help of a caregiver from another ward, but for most of the day she had no one to talk to. She smiled very rarely, but when she did, she did so with her whole face. Half the time I think it was a, "boy these yovos (white people) are WEIRD" smile, but a smile none the less.

The one time she consistently smiled was during our routine walk/sing/dance in the hall time! The best way to get African ladies out of their beds is with a good djembe beat! B danced her way into the dress ceremony last Sunday, shared her story (which was translated by a patient to a day crew and summarized for us in English), and I had the honor of presenting her with a parting gift bag.

The bags contain items that are both practical and symbolic, as they start a new chapter in life. Soap, moisturizing lotion, and a mirror. Soap, to represent the cleansing of sin, and the washing away of the smell that used to haunt them. Lotion, so that they may have smooth skin like a bride preparing herself for the Bridegroom. And a mirror, so that they can see the beauty that is (and has always been) inside and out.

Debbie, one of our fantastic Charge nurses, handing out a gift bag in Mada

I am thinking of patient B often this week as she will soon return to her farm in the north to tend to her cows. I hope she finds new joy and peace in her life from now on. And I hope, as we urge all our fistula patients to do, that she shares her story to help raise awareness about the condition, how it can be prevented, and that there IS help available for those who suffer from it.

Oh dear. I've run off on another tangent. It's almost like when I ask the day crew to translate, "are you having pain," and the patient prattles on for a full minute in response. It's a very common reaction to simple yes or no questions, somehow. Oh well. I suppose I should wrap things up for now.

A la prochaine!
-D