Under other circumstances there could have been a fatal failure to communicate when a Tanzanian woman who had recently immigrated to Canada consulted a Toronto doctor about her labored breathing. But her inability to speak English did not slow the diagnosis. The woman, in her mid-
50s, had called on Dr. Victor KumarMisir, a general practitioner and hospital emergency physician who has devised a technique to bridge the potentially lethal language gap between immigrant patients and Canadian doctors. Kumar-Misir used a detailed questionnaire written in the woman’s native Gu-
jararti and swiftly determined that she was on the brink of heart failure. Without the questions, the doctor says that he would have been forced to perform a battery of tests and wait at least a week for results. “But in that time,” says Kumar-Misir, “she could have had a heart attack and died.”
Other Canadian emergency room medical staff are not so fortunate, and their misinterpretation of symptoms can be disastrous for Canada’s growing number of immigrants. Since 1980 Canada has experienced an influx of 173,679 new arrivals who were unable to communicate in either official language. And although most immigrants can find translators in larger urban hospitals, the Ontario Hospital Association (OHA) and various ethnic groups admit that there are not enough to meet the demand. As a remedy, Kumar-Misir began six years ago to develop his “multilingual information gathering system”—made up of 125 key but simple health questions that demand only “yes” or “no” answers. A question from the cardiovascular section, for one, asks, “After walking three blocks or climbing three flights of stairs, do you experience shortness of breath?” The queries have now been translated into 20 languages, from Mandarin to Swahili, and Kumar-Misir has produced a version in braille as well as one in sign language on a video cassette.
The system, which the doctor has already used with about 1,000 of his own patients, has won support from ethnic groups and medical organizations like the OHA. But the Ontario government’s reluctance to provide $117,000 for further research into additional translations and new applications has stymied efforts to have the binder of questions mass-produced. Kumar-Misir believes that hospital emergency wards, private practices and public health nurses across the country could use the kit. At the Montreal Royal Victoria Hospital’s emergency department, which some weeks treats more than 50 patients who speak neither English nor French, surgeon Dr. Herbert Poison says, “This certainly seems to be something worth trying.”
Others are not so sure. In Toronto, York University sociology Prof. Anthony Richmond, who has studied immigrant adaptation, says that “a literal dictionary translation of terms is not enough. A physician should understand the patient’s culture, which may have views about health care very different from our own.”
But until immigrant groups produce enough doctors to treat patients in their own language, Kumar-Misir’s questionnaires may offer some assurance to non-English-speaking Canadians that their complaints will not fall on deaf ears. —ANN KERR in Toronto.
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