Plain Talk in Pearl Lagoon
by Sallie Weissinger
Several of the volunteers and doctors speak fluent Spanish; many more, while not fluent, speak Spanish well enough to interview patients in Nicaragua, picking up key details of their medical histories. We thought before coming here that in the Pearl Lagoon area many of the people spoke English, but weren't prepared for the fact that their English and our English weren't the same. Here the prevailing language is Creole, English spiced with its own Caribbean flavor.
Our patients' names sound English: we've seen women named Brenda, Joyce, Ellen, Jenny, and Mary. Their surnames are Fox, McCoy, Williams, and Temple, names that sound like those of friends back home. But, in the beginning of the week, when they began talking with us during the PINCC intake process, the challenge began. It's been even more daunting with women of indigenous Miskito origin.
As the week has progressed, we've improved in asking questions and understanding the women's answers. And when we've faltered, we've been able to enlist local clinic staff to interpret for us.
First, we don't ask for an address. We ask the village and the barrio (sector). Sometimes a woman gives a description: two miles from village X, next to the church or across the street from the hardware store. If we want to know her phone number, we don't ask about her phone (that means landline); she will say "I no have phone." You ask for her cellular number. Sometimes she has one, sometimes she doesn't.
Asking about a woman's medical history has gotten easier, as we have learned, in our various ways, how to frame questions. The hardest thing for me to ask about was total number of pregnancies, including miscarriages. It got easier once I began asking "How much baby born alive? How much childs alive now? How much baby born to blood (miscarriages)?" and then have summarized for understanding, asking, " Five times pregnant? One baby die in blood? One baby die age two? You have three children live now?"
Another potential misunderstanding was cleared up after a patient told me she'd been pregnant four times and had five children. I asked her to repeat her comment. She said, "One appear at two baby." I said, "twins?" and she didn't understand. So I said "gemelos", Spanish for twins, and she said yes.
We also want to know how they delivered their children - vaginally or by C-section. For a vaginal delivery, they say "normal" and flush the back of their hand down their laps, between their legs. For a C-section they simply say "cut." (For tubal ligation, or "ligadura de trompas," they say "cut to not have baby" and then there's "cut out womb", or hysterectomy. For the few women we've seen who have had hysterectomies, we ask the reason they had the operation. If it was because of a cancerous tumor, we will examine them. If it was because of fibroids or some other reason, we don't examine them because they don't run a risk of cervical or related cancer.)
There are other translations we've learned: diabetes is "sugar problem"; they often say "sick" instead of menstrual period. And so on....
By the end of the week, I've found myself talking my version of Creole 'Crenglish?"), asking "How much childs you have?" without putting "did" and "do" in front of my verbs. I've been dropping the definite article "the" and the occasional preposition and talking primarily in present tense. I wonder how I sound to the warm, welcoming people of this area. They listen to my questions and answer them as fully as they can, at times squinting to show me I need to repeat, using different words. They can't know that I would love to be able to replicate the musical lilt of their Jamaican-sounding (to me) accent. To me, it's what a smile would sound like, if smiles had sounds.