Programme sees doctors learn second language to close communication gap
Young doctors learn value of 'mother tongue' for patients
When Dr Morné Kahts walks into the surgical ward at Groote Schuur Hospital in Cape Town, the eyes of patient Lucky Felisono light up.
"Heita Lucky," says Kahts, to which the Atlantis security guard responds, "Heita daar". Then the doctor examines the surgical wound on the security guard's neck and asks: "Uziva njani ngoku... kusebuhlungu? [How do you feel now... is it still sore]?"
"Ndifuna ukugoduka ngoku... ndiziva ndingcono kakhulu. [I want to go home now... I feel much better]," Felisono replies.
Even though Kahts, 29, and Felisono, 30, were brought up in post-apartheid SA, it is unusual for a young white doctor to address his black patient this way.
Not only is he greeting him informally, but conversing with a patient in his mother tongue is rare.
Kahts's fluency in Xhosa is thanks to the language immersion programme at the University of Cape Town medical school, which gives English-speaking students the chance to live with an Afrikaans- or Xhosa-speaking health worker for two-and-a-half weeks while doing research at a community clinic.
The experience, during which they are banned from speaking a word of English unless there is an emergency, allows them to integrate culturally and socially with their host families and community.
UCT family medicine head Professor Derek Hellenberg, who helped to start the programme for second-year students nine years ago, said its aim was to create equitable communication between health professionals and patients.
It is a strand of the "becoming a doctor" study course, which requires medical students at UCT to learn Afrikaans or Xhosa during their training - and which has recently been expanded to include sign language.
"Through this programme we see students taking a holistic view of their patients. We hope that knowing their patients' culture and social environment will go a long way in improving intercultural relationships between these English-speaking doctors and the communities they serve," said Hellenberg.
It's worked for Kahts, who said: "Speaking with my patients in a language they understand makes my life as a doctor so much easier. It's easy to establish rapport and it just opens the gates of communication in a different way.
"Patients relate to you so much better when addressing them in their mother tongue and don't feel so distant from the treating doctor. It takes away those invisible barriers."
When he arrived at UCT, the medical intern couldn't speak a word of Xhosa. Today, as well as conversing with patients, he sings in vernacular, and last year his contemporary a capella band, AnecNote, won SA's Got Talent.
Their winning medley, which included Brenda Fassie's Weekend Special, Thath'isgubhu by Bongo Maffin and Xigubu by DJ Ganyani, earned a standing ovation at the final show. None of the group's four members - three white English-speakers and a Ugandan - were brought up speaking a South African vernacular language.
Dr Ian van Rooyen, an Afrikaans convenor of the "becoming a doctor" course, said other programmes included Afrikaans and Xhosa grammar courses and the integration of languages into bedside teaching for fourth-year and fifth-year students.
The bedside programme requires students to communicate with their patients for about seven weeks, take medical history and give feedback in Xhosa or Afrikaans.
Van Rooyen said that by the time they left medical school, most students were so confident that they no longer needed interpreters, who posed a threat to doctor-patient confidentiality.
"We are trying to produce independent language users and have self-sufficiency," he said.
Ncumisa Mafuya, a registered nurse who has worked with Kahts at Groote Schuur, said the young doctor was well liked by patients and staff. "Most doctors tend to use a lot of medical jargon, but it's different with him," she said.
"He has a way of simplifying things and patients love him... they always demand to speak to the 'tall white doctor' instead of dealing with nurses. His ability to speak the language also saves us a lot of time as nurses are often called in to interpret."
Sibusiso Nkosi, spokesman for the Pan South African Language Board, said multilingualism remained limited, particularly among English and Afrikaans speakers, and the use of indigenous languages could improve if their study was compulsory from basic to higher education.