August 11, 2014: Pierre Galea ’17
“Поиск ‘Шурале’ найти легенду татарскую.” I try my best to communicate my apologies via my facial expression, and reply: “ya ne ponimayu.” – “I don’t understand.”
The language barrier is probably the most challenging obstacle of being on our global health elective in Kazan, Russia. Barely anyone we encounter on the streets knows English. Bryce and I order food by pointing at something, and saying “pozhaluista” (pronounced “pa-ZHAL-sta,”) meaning “please.” Food we can manage, but I can’t imagine how we’d obtain a registration (required for legally staying here), deal with banking issues, or even activate a cell phone. It’s quite hard to communicate if you don’t speak the language.
In clinical practice, it is sometimes the patients who experience difficulty when communicating. Of course, they may be able to express their pain and concern through lay language, but they may not know that their swollen joint is a symptom of their rheumatoid arthritis, and that this disease may increase one’s risk for a heart attack. They might not understand why they need to take medications for hypertension, even if they are asymptomatic. Not everybody speaks the language of medicine. On a more literal level, we have learned that not every patient in Kazan hospitals speaks Russian. Kazan is a city where “East meets West,” having two main population ethnicities: Russian and Tatar (a Turkic ethnic group with a separate language). While practically all ethnic Tatar people living in Kazan do speak Russian, those traveling from rural places may only speak their native language, and this further threatens communication between patient and doctor.
Despite our own limited ability to communicate in Russian, Bryce and I are having a great stay here in Kazan. We did manage to obtain our registration, we are able to access our bank accounts, and we also have functioning cellphones. This was only possible because of our “contact persons,” who are knowledgeable and fluent in Russian. They recognize our needs, help us negotiate our obstacles, and inform us about the proceedings.
The doctors we shadow do the same thing for their patients. All the patient knew was that he had swollen joints. The doctor was able to diagnose the condition, provide treatment, and explain why it was important to be compliant with taking the medications which were prescribed. Some doctors who are ethnically Russian, make an extra effort to learn Tatar, in order to be better-equipped to treat the diverse populations whom they care for. They are the patients’ “contact persons,” receptive to the former’s concerns, and fluent in the language of medicine.
This trip has not taught me Russian or Tatar. It has not taught me the meaning of the first sentence of this blog. However, it has demonstrated how I need to act as a doctor. Also, by spending time with people coming from different cultures, it has made me a little bit more fluent in the dialects of a language that defies geographic borders; the language of human behavior.
Location: Kazan, Russia
Length of Stay: 7 weeks
Name of Program: Global Health Elective with Dr. Majid Sadigh (UVM College of Medicine/Western Connecticut Health Network)