It’s hard to believe it’s already been a week. Well, five days, but that’s a workweek, and tomorrow is my first weekend here.

I have a few thoughts about how things here are different from what I’m used to. There’s the stuff you expect, like how no one bats an eye at a power outage interrupting a meeting, like having actual cases of actual malaria, like residents doing surgery without a proper scrub, because the taps weren’t working that night.

Then there are the things I hadn’t expected. For one, every single student and resident here is learning medicine in a second or third language–English. So while I may have difficulty interacting with patients due to the language barrier, at least I have no trouble with the lectures. It becomes even more apparent on rounds, when simple questions from the attendings stump the residents, usually from a lack of understanding the question. Considering that English is not any of their first language, they do remarkably well.

For me, the language barrier is worse than I had planned for, though that is mostly because I hadn’t thought much about it before leaving. It’s impossible to talk to patients on my own, which means I need to ask someone to translate for me. But I hate the idea of taking someone away from their actual job, which means that I usually don’t. When I do, I have to think carefully about what information I really need from the patient, since I’ll only get one or two questions translated before the translator goes back to their own work. I suppose that it’s made me more thoughtful and focussed in my history-taking, but it’s still frustrating that I can’t, for example, counsel a patient about the risks of future pregnancies.

The language barrier also limits my interactions with my peers. Even though they theoretically speak English, they often don’t understand my accent, and vice versa. Outside of lecture, students and residents speak Kinyarwanda. It probably doesn’t help that I can come off as aloof when I’m uncomfortable. Fortunately, the Rwandan students seem to be slowly warming up to me. I could probably stand to learn a few more words of Kinyarwanda, too. It’ll come.

But I have to admit that I’m looking forward to being back in an English-speaking country. I’d even settle for French- or Spanish-speaking, I’m not picky. In the meantime, I’m trying to get involved in research projects here. Research was one of my original objectives for the trip, and is now even more attractive to me as it wouldn’t require any Kinyarwanda.

Published on 28 November 2014 and tagged as
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