Saturday, 20 February 2016

"The limits of my language are the limits of my world" Ludwig Wittgenstein

Living and working in the UAE has been a pleasant experience so far. With all that is going on in the world, one tends not to take peace and quiet for granted anymore. I too take each day as it comes.

I am learning  key words I need, to communicate with my patients in Arabic, quite rapidly. But my patients come from all over the world. A lot of Indians I cannot communicate with because I don't speak Malayalam. Pakistanis most of them speak Urdu, even though some are more comfortable with Baloochi, Sindhi, Pashto or Punjabi. I honestly never imagined that Pakistanis weren't all super cultured people who spoke immaculate Urdu like Ghulam Ali Khan.

Then there are also the Big burly Afghans with baby faces, whose wives all need their husbands to translate. When I asked one husband what was the problem the wife had, he said in a resigned way- the problem is she doesn't speak Urdu. I had to then persuade him to find out if she had any medical complaints and what they were.

Then there are many patients of mine who are half Indian, mothers from Hyderabad or another place in India. There are those who are Pakistani or Indian but married to Arabs, who speak Urdu but speak fluent Arabic with their children and husband. Caucasians or Afro Carribeans from South Africa, Australia, New Zealand, America, Europe and UK are the easiest, because they mostly speak English. Syrians, Jordanians, Lebanese, Egyptians, Palestinians are the fair Arabs, whose Arabic apparently differs from the Emirati and Omani Arabic. A lot of them speak English and usually wear a Hijab but not the Abaya.

One woman walked into my clinic and said she will call her husband who can speak Arabic. Her nationality and the language she spoke was recorded as Iran and Persian. I waited until a tall bearded man in traditional Arabic dress complete with head dress arrived and we started communicating in broken Arabic. Soon realising I will need a translator I summoned one. Our translators are Pakistani young women who have been born and brought up here in UAE, hence speak quite a few languages.

The translator walked in, had one look at the couple and one at the file and with an air of experienced assurance said- "Doctor, he will speak Urdu" Apparently there is a population in Pakistan, which speaks Persian. The man looked crossly at me and said- "Doctor is speaking to me in Arabic, what am I supposed to do?" So I sent the translator away and started afresh taking a history in Urdu, much to the woman's relief.

Then there was a Filipino lady who I was struggling to make sense of and hence called one of the Filipino nurses to help and realised she is not making much progress because she is speaking to her in English- "Before, Before...", she seemed to be shouting. I asked her to stop and asked her why she wasn't speaking to her in the language of Philippines. Apparently apart from Tagalog, the common Filipino language, there are twelve others....... Life is not that simple, is it?

I am getting great practice of my Bangla though, with Bangladeshi patients...they always ask me if I am from Kolkata! Sometimes beyond how are you even their Bengali dialect differs and both of us revert to good old Urdu/Hindi

Then there are instances when I start speaking to women in Abayas in Arabic only to have them reply in an indignant tone in fluent English or Urdu. I now make sure I look at the nationality and occupation. Computer Engineers, Teachers, Call centre operators, students....UAE women constitute 60% of public sector workforce. They are a very visible force in all Government offices and get only 45 days maternity leave. However, they have lots of babies, if they can. They do get breaks every four hours to enable them to breast feed. Apparently the Quran encourages women to breast feed for two years.

With very close knit families and often marriages happening amongst cousins, the mammas, the elder women of the household who accompany women to the hospital during labour are a force to be reckoned with. They keep the caesarean section rates low. They discourage the women from opting for interventions, sedations, epidurals and they question the doctors who suggest any of this. I treat them as partners in my quest to ensure a natural yet safe child birth. However, I have to bank on translators to keep lines of communication open day!
Hopefully all this exposure to multiple cultures and languages will keep my mind active and Alzheimer's at bay!