Point
Healthcare training in local languages is critical.

Jim Harries

Americans want to teach Russians how to pull painful teeth. Americans do not know Russian medical terms. Should (a) all Russians learn medical terms in English or should (b) some Americans learn to translate into Russian?

Let’s assume the English-speaking world has the best medical knowledge there is. Let’s say there are 400 million native English speakers in the world. Then 5,600 million people are not native English speakers. Should 5,600 million people (or is it 14 million medical doctors?) be forced to learn English (at a sufficiently advanced level to comprehend modern medicine)? Or should a few native English speakers learn other languages and translate for them?

Translating into a language will empower, stretch and challenge that language. It will empower, stretch and challenge the owners of the language. You don’t have to translate into all languages. Just translate helpful information into representative languages. When business people and concerned folk in neighboring language groups see the benefits of what is happening they will extend it. Neighboring languages tend to be related, and their people’s issues are related; solving problems related to one language and culture, will assist neighboring languages and cultures to solve their problems.

Just imagine what an amazing impact the above could have. You can’t learn people’s language without learning their culture. This means that native-English speakers would be in close contact with cultures all around the world. Just imagine what it will do to people, say in Africa, to have such attention given to their language and way of life. It could stir up all sorts of activity!

“This would be messy”, medical people may say. Medics are scientists. Scientists like things to be done in precise ways. Science is often defined using English. As soon as you leave English, you get problems. Is it not better to tell people precisely what to do and have them do it than to get medical terms all confused using local languages?
Yes, the process may be messy. There are real problems out there when it comes to inter-cultural communication about health. Will those problems be addressed, or ignored? People often do not realize that ignoring problems might not make them go away. Simply using English actually means ignoring critical problems. If addressed, who knows whether they might not be solved?

When communication on health comes to someone in a foreign language, it is very hard to take it to heart. Poorly understood procedures and poorly understood reasons for following those procedures results in poor implementation of procedures. The real challenge – is to bring medical procedures to a point at which they make sense to people from within their own worldview. If this process does not occur, medical practices may continue to be used only as long as they are paid for by foreign subsidy. Bringing about local ownership of good health practices is a vitally important consideration for future global health, in all cultures. This requires health procedures to be communicated in people’s own languages.

Counterpoint
English teaching is necessary to empower local populations to participate in a globalized knowledge base.

Jeffery L. Deal

When Schweizerische Medizinische Wochenschrift, a multi-lingual journal, became Swiss Medical Weekly, the editors admitted being motivated by an awkward reality. Non-English language journals were rarely cited and therefore believed to have a lesser impact upon international narratives and practice patterns than journals published in English. While not officially designated as such, English has evolved into the international language of the sciences, a position formerly held by Latin, and further back in time German or Greek. Having such a common languages allows for the globalization of communication and widespread participation in cumulative scientific knowledge.
A common experience I have noted in training medical personnel in over a dozen countries, is that they consistently ask that the training occur in English, even when the trainers possess adequate skills in the local languages, often citing their wish to be competent to read medical textbooks and journals. Those of us for whom English is our native language may feel unnecessarily guilty over this phenomenon.

There is an additional practical matter. As I trained personnel in South Sudan, I would gladly have used a textbook in Dinka. The only written texts available were extremely basic and often outdated. The same is true for hundreds of languages spoken by small, politically disempowered people. While we may wish to honor and re-empower the local population, such efforts may come at a cost that outsiders appear more willing to pay than do indigenous populations. One such risk is that failure to teach English, or at least another more widely spread language, fixes the population in a stage of development where they cannot participate in global legal, scientific, medical, or philosophical narratives. Failure to teach English does not empower the local population as much as it does those few multilingual individuals by creating cultural mediators who may or may not reflect dominant local thought.
In our zeal to create local agency, we cannot lose sight of the fact that such agency only has meaning within a larger context where people can represent themselves. It is acceptable to speak about a people in whatever language the speaker can access. It is an entirely different matter to attempt to speak for a people to world where the dominant discourses are in English.

Jeff Deal is adjunct professor of anthropology both at the College of Charleston and the Medical University of South Carolina. He also serves as Director of Health Studies for Water Missions International. His ethnography of the Dinka Agaar (A Land at the Centre of the World) was published in 2011.