AUGUST/SEPTEMBER The Linguist 19
FEATURES
to alert on-call nurses to any complications they are
encountering in the field with their patients. The nurses
can then help the midwives to triage and make a
decision about whether an emergency hospital referral is
required. If so, the nurses work to coordinate emergency
transport and facilitate receipt of the patient by hospital
staff. This arrangement has more than doubled the
number of patients delivering within the hospital setting.
A lack of native vocabulary
It is not enough to simply employ Mayan-speaking staff.
The Guatemalan universities and technical schools that
train healthcare workers provide instruction only in
Spanish, so many of our workers are initially very
uncomfortable providing services in Mayan languages,
despite being native speakers. This has to do mostly
with the fact that Mayan languages lack native words for
most of the technical medical vocabulary.
This is a commonly encountered problem for minority
languages, and one which language revitalisation
specialists have spent a lot of time thinking about. The
most common solution is to work with a community of
language speakers to develop – and then disseminate –
neologisms to cover the missing lexical items.
This was Maya Health Alliance's early strategy, and we
worked to develop many medical words in collaboration
with community and academic partners, including
Guatemala's Academy of Mayan Language. However,
this approach turned out to be very problematic because
most of the neologisms were completely unintelligible
to patients and ended up creating more communication
barriers than they solved. They also tended to reinforce
class differences between our providers and their often
much poorer patients, with many patients saying things
like, "I guess I don't speak Mayan as well as you do."
We reevaluated and came up with an unorthodox
solution. Essentially, we began encouraging our
providers to codeswitch between Spanish and Mayan
languages. The instructions go something like this: "If
you don't know the word in Mayan, your patients won't
either; just use the Spanish word." Our primary goal,
after all, is to understand and be understood, and
codeswitching freely is a distinguishing characteristic of
natural discourse in Mayan languages in all but the
highest register of academic or ceremonial speech.
This approach has also allowed us to be much
more focused and strategic in our use of selected
COMPREHENSIVE TREATMENT
A Wuqu' Kawoq doctor sees a patient in her native language
