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Wednesday, October 9, 2013

Experiences with an Interpreter

By Dr. Kusuma Ruberu (nee Jayasuriya)

We all respect experienced doctors, teachers etc. I would like to tell my experience with an interpreter. At that time I was working in a missionary hospital in Ondo state, Nigeria. Ondo state was 2/3rd the size of Sri Lanka and in late seventies, there were only two hospitals for the whole state - a state hospital and the missionary hospital. 

I had an interpreter as I had no knowledge of the local language named “euroba”. His name was Emmanuel but fondly called Manuel. He was a taxi driver but unfortunately lost his whole left arm during a car crash. So the Irish nuns who were in charge of the hospital had employed him as an interpreter. His knowledge of English language was very good. His job was to interpret for me and to keep a record of the name, age, sex and the diagnosis of the patient. 

One day I saw a child with swellings of interphalangeal joints resembling rheumatoid arthritis. So I told Manuel that the diagnosis is juvenile rheumatoid arthritis. Manuel looked at me and said madam in your country that may be the name, but in Africa we call it sickle cell arthritis. I have never seen a sickler before and when I looked at the child’s old notes it said that he is a sickler. Then I knew that Manuel is correct. So I told him to write sickle cell arthritis. 

Another day an old man came with dry gangrene of his little toe. I looked at Manuel and said that the man has dry gangrene. Tthen he said yes, it is an ainham. I have never heard of this diagnosis and I did not Know the treatment. So I told Manuel that I will write some medicine. Manuel said yes a pain killer would help him, otherwise nothing should be done as it falls off on its own. So I read my Baily and love as soon as I came home and there it was in small print.” Ainham” a dry gangrene of toe specifically found in Africa and it falls off as Manuel said. 

The patients who come to the OPD stay seated on benches till their number is called. Manuel had the habit of bringing ladies out of the queue. At first I thought they were known people to him but he said no, I am bringing ladies whom I think has ectopic gestation because if they wait in the queue their condition will become worse. Everytime I examined them they all had ectopic pregnancies. I was puzzled and I wanted to know what makes Manuel to suspect them as ectopics. So I asked him. His reply was that he notice them because they look pale and sick so he goes and asks them about their periods and bleeding PV. 

Then he used to call men out of the queue telling me that they have tetanus. When I examine they do have tetanus. Again as a reply to my inquiry he said that he notices their walk which is very stiff and then he suspects tetanus. 

Also Manuel had the habit of walking to the wards when I am having my tea. One day he told me that the house officer is treating a child with meningitis as malaria and he wanted me to check. As usual manuel was correct. So the lesson I learnt is to respect even your interpreter’s experience.


  1. Thanks Kusuma for those wonderful anecdotes. Overbearing pride, presumption and arrogance has been the hallmark of our profession. It is comforting to know there are a few who are willing to give credit to whom credit is due.
    Nihal D Amerasekera

  2. Kusuma, first of all thanks for taking the time to post this most educational experience you had. It speaks highly of you as one with an open mind who is willing to listen to a person, who although may not be blessed with knowledge gained through formal education, has enough intelligence and powers of observation to recognise patterns and their meaning. I can think of many doctors who could do with doses of humility of varying strengths! Sometimes even what we call "old women's' tales are worth considering".

    (I often wonder why sexism has arisen in that phrase, don't old men too have tales!).

    Somewhat related to your post albeit in a slightly obtuse manner, just read this bit of interesting information. If you haven't already heard about him I am sure you will enjoy listening to Sugata Misra (An Education Scientist) who presents some fascinating studies he has done about how young Indian children who cant speak english and have no formal education, yet are able to learn and teach what they self-learn about a range of highly sophisticated topics, to other chidren when left exposed to a computer which they have never seen or handled before. The link is to the TED site. It is quite amazing and just shows that children have a natural tendency to acquire knowledge irrespective of external influences such as teachers. Your interpreter, although not a child, has clearly learnt a lot through pure observation and an enquiring mind. The link is