Thursday, July 12, 2012

Express Yourself

The following phrases you hear ALL THE TIME here. Some of them make sense in English and some not at all.

Question: “on dit quoi?” = we say what?
Response: “on est la”= we are here
                 “on est ensemble”= we are together

“Ah ça?”= Ah that?
Ø  Most often used in the negative sense. Someone might say “there’s no food left” to which you could reply “ah ça?” But, it can pretty much be used to express anything from surprise to disgust.

“C’est comment?”=It’s how?
Ø  This is sometimes directed to a person (“toi tu est comment?”=you are how?), which more or less means “what’s wrong with you?”

There are also a series of noises that people use frequently, the most common one being “Oh.” I would venture to say that it’s typically in reaction to something negative, and it is frequently added prior to the phrase above. It’s a loud, emphatic, OH that one frequently says with a grimace. However, you can also add “ohhhh” to the end of a word, rendering if more friendly. You hear all the time “bonsoir-ohhh!” “maman-ohhhh!” etc.

I tell you all this because I just may carry these idiosyncrasies back with me to the States. This way you’ll know what I’m trying to say.

These are the delightful little quirks that sneak into your vocabulary, but there are some things that are less pleasant.

Any American who has health care provider options would never tolerate being treated the way patients are treated here, and for the most part, I’m talking personally not medically. Doctor-patient encounters here frequently involve a lot of (what I think are) insults and humiliation. And always a lot of yelling. Patients are scolded/insulted for coming too late, for putting a carnet in the wrong place, for making too much noise during labor. And they are scolded in front of anyone and everyone. My roommate recently witnessed a room full of nurses/midwives yelling at an 18 year old who was having a miscarriage because she was crying too much. At the same time, patients are depressingly passive. They avoid eye contact and are nearly impossible to engage in conversation. It’s a vicious cycle and surely never produces a sufficient health history. And both sides can be equally as frustrating: sometimes you want to shake the doctor/nurse and tell them to quit yelling at this poor shell of a person, and other times you want to shake life into the shell itself.

I really don’t think this phenomenon is specific to this place though; actually I know it’s not because I saw the same thing in Haiti. Sometimes I think people use culture as a scapegoat for things. It would be a lot easier to say, “this is just how Gabonese people express themselves.” I think it really comes down to social class. In countries where the majority of people do not have college let along high school diplomas, you can see how those who have achieved that level can feel a sense of entitlement. And patients expect it of them. When you ask patients what’s wrong or what they need from you, they’ll respond, “I don’t know you’re the doctor.” I’d like to give the doctors a big dose of humble and the patients a spoonful of confidence.

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