Navigating East Asian language barriers in general practice

A glance at the patient’s notes fills me with mild anxiety, but not for the usual heartsink reasons. She arrives with her husband. I hear a wave of tones and sounds, which are familiar yet largely indecipherable to my ears. Her husband translates her complaint and my own questions back at her, but the rapport is understandably disjointed. I already know the question they will ask at the end of the consultation, so there’s nothing to lose. I dig deep into the crevices of my brain. “痛 ?”, I ask. Pain?  They stare at me and she nods. It’s time for the examination and I try a few extra words of Cantonese – by chance the few body parts I know are the ones I need to assess. The rest of consultation continues in English. A plan is made and they start to leave. I almost get away with it, but then the husband turns and asks, “where are you from?”.

My own East Asian language journey

I sigh inwardly and explain that my father is from Hong Kong, which not quite an answer but the one I know he’s looking for. “So you should know Chinese!” he exclaims. He says it would have been a lot easier if I had spoken this from the start. I hide my guilt as best I can and apologise that my Cantonese is “小小”. Practically non-existent.

I could explain that my parents are both bilingual, but English was their only common language so it was the solitary tongue spoken at home. I could explain that, whilst I’d attended Chinese School as a child, everyone else was already conversational in Cantonese and the focus was on reading and writing. I could explain my many attempts to try re-learning the language but studies, training, pandemics and trying to simultaneously learn my other mother language, Thai (which also failed), always seemed to get in the way.

But of course, none of that is really appropriate for a GP Consultation, so I allow them both to look slightly disappointed and leave.

Improving dialogue for East and South East Asian patients

There is a constant expectation to know the language that matches your face and name, and I’m as guilty as anyone else. The British National (Overseas) Visa, introduced last year for Hong Kong residents to live, work and study in the UK has led to further East and South East Asian (ESEA) migration and migrants who will require access to healthcare with possible language barriers along the way. I know I can do better for them as an ESEA GP. It’s time to stop the excuses, dust off those textbooks and try again.