clinical practice
You said miscommunication isn’t just about language, and in
your article you gave the example of silence on the part of the
Indigenous person. What does silence mean in conversations,
and how should health professionals approach it? deference. They avert the eyes, which gives totally the wrong signal
to the health professional, police officer or judge.
In English, we have a low tolerance for silence. We answer
questions quickly, and if there’s a silence, we tend to ask another
question. But speakers of Indigenous languages tend to have
longer silences, particularly if the question is important. They
give it a longer period of silence to give it more consideration and
to formulate their response. So there’s a mismatch between the
length of silence that’s tolerated.
Also, in English, if someone asks us a question, we feel duty-
bound to answer it, even if the answer is “I don’t know”. But in
the norms of communication in Aboriginal languages, if it’s not
appropriate for someone to answer, or they don’t know the
answer, they’ll leave it unanswered. There’s no feeling that they
have to respond.
Eye contact is another thing which often leads to a breakdown
of communication. In English, in wider Australian culture, when we
communicate we expect eye contact. It tells us the person is paying
attention. But in traditional Aboriginal cultures, eye contact is really
an assertion of authority, and if the person is talking with a police
officer, judge, doctor or someone in authority, the last thing they
are going to do is give direct eye contact, because that’s a challenge
to that person’s authority. If they’re going to be respectful, they pay First we need to take Aboriginal languages seriously, and do our
best to learn something of those languages, even if we can only
say hello or goodbye. It helps to build rapport. Even a few words
make a huge difference.
When I worked in the Kimberley, we had a flying doctor visit.
He’d be in Balgo one day, Fitzroy Crossing the next. All over the
place. He probably encountered a dozen different languages.
Now, I can’t expect that doctor to have a good command of all
those languages, so the next best thing is to employ medical
interpreters. Interpreters are reasonably well taken up in the legal
sphere, but they’re under‑utilised in the health area.
There were Aboriginal health workers who were expected to
be that cultural broker, but while they’re expected to do that job,
they themselves – and I’m pretty sure this is true to this day – have
no training in interpreting and translation, which is a specialised
skill. It’s quite different to, say, interpreting in Spanish, Chinese or
another major world language. Of course, most interpreters of
Spanish or Chinese haven’t got a background in health, but if they
encounter terms they haven’t heard before, they can pull out their
iPhone and look it up. However, most of those specialised Western
concepts are not yet encoded in Aboriginal languages. ■
How can the gap in communication be reduced?
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