English Medical Translation

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ENGLISH-EDO MEDICAL TRANSLATIONOmoregbe Esohe Mercy a

a University of Benin, Nigeria

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ENGLISH–EDO MEDICAL TRANSLATION

Omoregbe Esohe Mercy, University of Benin, [email protected]

AbstractEvery time languages are in contact, there are areas of ‘untranslatability’, linguistic or seman-

tic areas that do not match in the languages. These vary all the time between specific languages, but translators meet with them whatever their field. The present article discusses instances of such ‘untranslatability’ as they challenge medical translators and interpreters in Edo-speaking regions (Benin) in Nigeria. They can be divided into broad categories such as linguistic and cultural ones, and translators can tackle them in various ways, the most obvious one being by providing explanatory commentary, based on some in-depth knowledge of the specific disease and its symptoms. On the linguistic side, language professionals can rely on a number of loanwords from English, but on the cultural side they have to be aware of taboos and other sociological factors in Edo society. It is only by keeping in mind and by identifying the multiple factors in problem areas and a�empting to find ways of overcoming them that translators and interpreters can fulfil their task and help improve communication between doctors and their patients. In the process they not only further the general state of health and the medical establishment in a country, but they also enhance local medical terminology. These are all aspects that should be applicable and consequently of paradigmatic interest to language professionals in the health services in many emerging nations in today’s globalised society.

Key-words: Language pair: Ẹdo-English; medical translation; medical interpreting; cul-tural problems; linguistic problems; world knowledge.

IntroductionThe present article focuses on the translation of medical text between Eng-

lish, varieties of English, and Edo, which is the main language spoken in Benin City, the capital of Edo State in Nigeria.

In a Translation Studies context, it is taken for granted that to do an adequate translation, translators must understand not only the texts in hand, but also the physical world and culture in which they are produced originally. This implies that translators should be familiar with the everyday life in the source location and that their activity is not merely a manipulation of linguistic data. Trans-lators handling medical texts do not have to be trained as doctors or nurses, but it is imperative that they understand all the associated implications – the linguistic, medical, social, and cultural contexts in which they work. This they can do by having sufficient world knowledge, first to assume the role of the communicator of the source text (writer, speaker, etc.), and, subsequently, that of the listener og reader in the target language: translation is a means for com-munication.

In a medical context, communication is central to both professionals and pa-tients. General practitioners, for example, have to infer what the patients are trying to say and they must grasp the hints that patients may drop about ail-ments that worry them. General practitioners must also explain to patients what is wrong: good doctors believe that being able to discern hidden meaning in what their patients say is one of their skills.

There are numerous problems when doctors and patients speak different lan-guages or even different varieties of the same language (which is frequently the case when Edo–speaking doctors a�end to Edo–speaking patients in the Edo community). Tanner (1976) rightly points out that, in addition to emotional

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Omoregbe. English–Edo Medical Translation.

and other extraneous factors, the ease of communication in a doctor-patient dis-course depends on how well and clearly the parties express themselves: clarity of speech is a necessary requirement for proper diagnosis and treatment.

This is where translation and interpreting come into the picture. Catford de-fines translation as: “The replacement of textual material in one language, [the source language,] by equivalent textual material in another language, [the tar-get language].” (1965: 20)

Although this definition is dated in many contexts, it still has some bearing on textual material in the medical field, regardless of the language pair involved. As hinted, translators are a kind of creator the moment they bridge language gaps and render a source text in the target language: they create the specific form of the target-language message and in order to do so, they must be competent in both languages (Uwajeh 1994). The specific nature of medical communication that merits focus in regards to Catford’s statement is the terminology used in the health sector, which o�en requires specific renditions, lexical equivalents, etc. This means that interpreters and translators may meet with terms and phrases in the source language that rule out, as it were, a total transfer of information from the source to the target language. This could also be termed untranslat-ability, where pa�erns or meanings differ between languages, as pointed out in Dollerup’s observation:

[t]he process of transfer is … limited in terms of time and space: it is mostly individual; straddling two languages at the same time, this is where we find the phenomenon of untranslatability; it is not part of neither static, nor dynamic texts in the source or tar-get language, but something which turns up exclusively when two language systems meet in the transfer of a text. Untranslatability is part of the process, of the assessment of the process of transfer. (Dollerup (1988: 145) as quoted by Mohanty (1996: 164))

The present study endeavours to identify concepts that appear to be untrans-latable in English–Edo medical se�ings, in order to consider the problems and strategies for overcoming them.

For exemplification we may consider the following dialogue:

Conversation 1 (in English).

Doctor: “How are you and what is wrong with you?”Patient: “Fine. My ear dey pain me.”Doctor: “Which of them, le� or right ear?”Patient: “Le�, sometimes it makes noise.”Doctor: “Are you feeling pain now?”Patient: “Yes.”Doctor: “Go and use these drugs… you are suffering from tinnitus, noise from the

inner ear which is likely to be from drug effect or so …”1

In this conversation, the notion of ‘pain’ to the patient is “noise” - she hears noises in her ear, which the medical practitioner calls ‘tinnitus.’ The linguistic middleman handling a text like this is expected to know the usage and to render the meaning as closely as possible in his translation.

There is an immediate and specific reason for the study described here: in order to improve the health care system in the Edo community, in Nigeria, there is a need to examine the communication strategies used for passing informa-tion between patients and doctors and vice versa. The study may lead to be�er health care and enhance communication and interaction between patients and

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medical staff.In a larger context, some of the strategies uncovered may well be of inter-

est for medical translation beyond an Edo-English context and apply to other language pairs as well: thus Feinauer and Lu�ig (2005) also examined and un-covered major problems in medical translation in South Africa with groups and se�ings that are – to some extent – comparable to the ones included in the study described here.

MethodologyThe data collection

The data were collected at the General Out-Patient Department of the Central Hospital in Benin City as well as at some private hospitals in Edo South of Edo State, Nigeria. The data were elicited by means of interviews with doctors and patients and by observing doctors’ interviews and consultations.

This data were supplemented with information from books, magazines, and newspaper articles as well as television and radio programmes on health is-sues.

General features of untranslatabilityCatford (1965) identifies two levels of untranslatability: linguistic and cultural

untranslatability. Linguistic untranslatability occurs when the target language has no lexical or syntactic equivalent for a source-language item. Conversely, cultural untranslatability occurs when the there are no situational features in the target language that correspond to those of the source language text. Cat-ford cites the example of a language community that does not have a male deity and suggests that such a community would not be able to distinguish between God the Father, God the Son, and God the Holy Ghost.

In such a case, no communication or translation is possible. When the two languages of Ẹdo and English are in contact in this study, untranslatability is more complex than what Catford proposes. In the first place, many medical terms in English do not have lexical equivalents in Edo. This goes for such terms as Acquired Immune Deficiency syndrome (AIDS) and sexually transmi�ed diseases (STD). There are also some ailments in Edo that resist translation, e.g., “emiamwe eghian”.

Linguistic untranslatabilityLinguistic untranslatability, the absence of lexical equivalents, is in part due

to differences in the structures of the source and target languages.In terms of syntax, English and Edo have the same basic subject-verb-object

word order as can be seen in the following example:

(Source language: English): John killed the goat.(Target language: Edo): Egioni gbe nene ewe.

In these examples, the structural pa�erns correspond on the word-for-word order. But, there are fundamental differences as is shown in the following ex-amples:

2005. Perspectives: Studies in Translatology. Volume 13: 4270


(Source language: English): The short woman died yesterday(Target language: Edo): *nene netekpu okhuo wu node(Target language: Edo): nene okhuo netekpu wu node

The point is that adjectives are positioned differently in relation to noun phrases in English and in Edo. In English, adjectives precede the nouns they qualify, while they follow immediately a�er the nouns in Edo, as is shown by the adjective ‘netekpu’ in the last line. Apart from such differences in structures, there are instances in which Ẹdo has no lexical equivalents at all for English terms. Such instances abound in medical texts. In some cases, there are equiva-lent terms that are somewhat limited in use. Consider the conversation below.

Conversation 2.

Doctor: “… the test is negative. It shows you have not seen your period for the past two months.”

Patient: “Yes, sir. Does that mean that I am pregnant?” Doctor: “No. Loss of blood could be caused by stress, sickness, menstruation etc.

Watch for your period for another month while taking your drugs.”Patient: “Yes, sir.”Doctor: “Do an ultrasound if you have money and come back a�er one month.”Patient: “You mean I should go and check my belly?”Doctor: “Yes.”

In this conversation, “loss of blood”, for cultural reasons, is associated only with ‘pregnancy’ to the woman patient. But the doctor states it could be the out-come of stress, sickness, and other diseases. Even the term “ultrasound” means to ‘check my belly’ for the patient, that is, to check for pregnancy, though this is not the likely cause. Ultrasound can be used to check the abdomen for a variety of health problems. In this context, it is the task of the interpreter to consider what the key medical problems are, identify the key terms, and translate them into Ẹdo with the appropriate medical meaning:

English EdoLoss of blood fian eheUltrasound ghee eko

Conversation 3.

Doctor: “How are you?”Patient: “Fine.”Doctor: “Did I not see you yesterday?”Patient: “No, last month. My drugs don finish.”Doctor: “Your blood pressure is 140/85 which is good. It has come down. Continue

with these drugs and [I’ll] see you in two weeks’ time.” Patient: “Doctor you mean I have plenty of blood or hypertension?”Doctor: “No, that is not what I mean by ‘blood pressure’. I mean that your blood

flow is normal. Go home and continue with your drugs.”

The patient in this conversation believes that “blood pressure” is either (1) to have too much blood, or, (2) to have hypertension.

O�en patients’ knowledge of biology is so poor that they do not fully un-derstand the nature of their health problems. When this is so, doctors and pa-tients are communicating at different levels, but the situation can be improved by providing a clearer explanation of the problems or terms used. The linguis-tic untranslatability in these cases connects with the way the crucial terms are

Omoregbe. English–Edo Medical Translation. 271


misconstrued by patients. The problem can be solved not merely by proposing word-for-word equivalents of source-language terms but by providing explana-tions relevant in the situation.

Another category of medical terms that pose linguistic untranslatability prob-lems concerns terminology such as the following:

EnglishHIV and AIDSSARSSTDUltrasound Lassa feverCoronary diabetesAppendicitisParkinson disease.

In these cases, translators (interpreters, etc.) must understand the terms be-fore deciding how to translate them into Edo, since none of these terms have exact lexical equivalents in Edo. Studies of the history and symptoms of these diseases sometimes provide near equivalent terms and expressions, explana-tions, or even descriptions. The manifestations can then determine the form of the appropriate renditions. Even ‘descriptive naturalisation’ may be used to overcome translation problems. For example, HIV and AIDS are o�en trans-lated as ‘Uugiagbe’ (i.e., unkillable, incurable) in Edo. ‘Uugiagbe’ is based on the fact that it is a killer–disease for which there is no cure, witness:

E e e o Aids dey for town oE no get i cure o o ………..!

This jingle – and many others – indicates that AIDS is a deadly disease that is contracted mainly through sexual contact with infected partners. Though de-scriptive naturalisation is an effective means of circumventing untranslatability, the scientific knowledge hidden in such source-language terms as AIDS is not reflected in the target language term of ‘Uugiagbe’. There is therefore a problem in so far as translators are supposed to convey the same information from one language to another. An appropriate translation of AIDS from English to Edo therefore, in principle, should be the sum total of the meanings of the individual terms.

At the same time, it should be noted that the rendition of AIDS as ‘Uugiagbe’ does not distort the meaning, as ‘Uugiagbe’ still conveys that AIDS is incurable and deadly.

Cancer is another deadly disease, but it does not have the same history and manifestation as AIDS. Among speakers of Ẹdo, cancer is understood to be a kind of internal sore that eats deep into the body. An equivalent translation of cancer, taking into account this notion, is ‘ete oghe uwuegbe’ [sore inside the body]. However, in view of the fact that there are different types of cancers, such as breast cancer and cancer of the uterus, translators must associate the part of the body affected by the disease in the Ẹdo translation.

Furthermore, in linguistic mediation, cancerous sores must be distinguished from ordinary sores, such as stomach ulcers, which translate as ‘ete eko’ [sore of stomach]. In such renditions, the information conveyed between the two lan-guages will o�en be determined by the type of available text on sores. But this



is only an indication of further linguistic untranslatability, since Edos do not distinguish between parts of the body in the same fashion as Westerners do. So interpreters and translators have to convey a multi-faceted description allowing for all these aspects of the disease and the parts of the body affected in order to fulfill its objective.

Cultural untranslatabilityCultural untranslatability occurs when the target language has no relevant

matches to contextual features in source-language texts. The Sapir–Whorf hy-pothesis of linguistic relativity (1956) states that thoughts are relative to lan-guages. Uwajeh interprets this to mean that thought pa�erns or meaning struc-tures of language differ from language community to language community (2002: 65). There are culture-specific words, objects, ideas, and even expressions in every culture and these pose serious problems in linguistic mediation. Cul-ture in the broad sense includes not only the arts and music, but also religious beliefs and worship, as well as the language of a people. There are potential translation problems at all levels, including proverbs, idioms, riddles, and in-cantations, which are highly figurative in nature.

In the medical field, there are ailments in Edo, the names of which pose prob-lems. These ailments occur in different categories and they pose peculiar prob-lems of cultural untranslatability. They relate to ailments that are considered as taboo in Ẹdo and in the translation of the diseased body parts.

Ailments considered taboo in EdoThis category comprises names of ailments that exist in Edo communities

and have lexical equivalents in English, but whose mention either orally or in writing is forbidden and taboo in Edo culture. The use of the terms is to be avoided because it is commonly believed that if they are mentioned, this will cause epidemics in the land.

These ailments include:

English Edo taboo word or translation Euphemistic AlternativeSmall pox esalo erhon nokhua rash big [Big rash]Leprosy oti emwi rre egbeken thing be body wall [something on the wall]Elephantiasis eve okpolo Biggy [something big]Epilepsy owa emiamwe udemwe [falling sickness]

The taboo translations are near-equivalents of the English terms for these dis-eases, but being taboo, they cannot be used by translators. The only option is to use the euphemisms for the ailments as stipulated by Edo culture.

Translators face a dilemma as to what to do since the euphemistic alterna-tives are metaphoric and may not have any clear relationship with the diseas-es. Translators must be mindful of the cultural demands about such ailments. Translators may adhere to the euphemistic usage but will then have to add explanatory notes. This may overcome the problem of untranslatability, espe-



cially for terms that are highly figurative. But the problem must be solved in the linguistic mediation, since doctors cannot be expected to have the time to tell patients in great detail what the problem is and what should be done. The linguistic middlemen must be aware that there is great therapeutic value and consequently it is important for patients to be well-informed about their specific problems.

Translation of diseased body partsOther health cases that may pose problems of cultural untranslatability in

Edo include names of diseased body parts. In this part of the world, it is consid-ered unethical and indecent to mention the names of some body parts outright and bluntly because they are considered sacred and inviolate. They include:

English Edo translation Euphemistic alternativeVagina uhe emwin [thing]Penis ekia emwi [thing]Scrotum iviekue ivin [coconut]Breast ewen ekokoPubic hair eto uhe irunmwun [grass]

A patient who has a health problem involving any of these body parts finds it difficult to communicate what is wrong to a doctor. For example, a woman cannot say outright ‘uhe mwe tolo mwe’ [my vagina itches], but only insinuate that this is the case by using appropriate euphemisms, such as ‘emwi mwe tolo mwe’ [my thing itches] or ‘emwi rro mwe uwegbe’ [something is inside my body].

A translator handling a text concerning such diseases cannot render the ‘vul-gar’ equivalent and must therefore resort to euphemisms, but, of course, may add some commentary or notes for listeners and readers.

The point to note is that the translation must convey the same information as the source language text. Provided there is some shared knowledge between the sender and the ultimate addressee, the problem of untranslatability recedes and translation is successful.

Coping with untranslatabilityIn the above, we discussed untranslatability in English–Edo translation of

medical terms. Therefore, it is appropriate to outline strategies that can be used by Edo translators – and others working in similar linguistic and socio-cultural environments - to overcome translation problems.

Needless to say, translators must be familiar with English medical practice and terminology without necessarily having a formal medical background. But translators should also have a thorough knowledge of Edo language and cul-ture, preferably as bilinguals or near-bilinguals. They must know the contexts in which medical terms are used and be able to distinguish them from everyday terms. Translators therefore must render medical terms in such a way that the medical flavour and impact is felt in the target language. Sometimes they will not only have to render the terms between English and Ẹdo, but also between Ẹdo and Deep Ẹdo. In the la�er case, patients and doctors will get some in-depth knowledge of the culture as well as terminology development. For instance, it will help them to know and distinguish between common and deep Edo terms



associated with ailments. Consider the following example:

English Common Edo Deep EdoLeprosy emwi rre egbe eken ekatakpi or otiBlindness arhuaro afuozu

There are many medical terms still unknown to Edo speakers. Translation efforts conducted with knowledge and respect for the two cultures involved will be immensely helpful to both the patient and the medical personnel. It will also enrich the vocabulary of Edo medical language and make doctor–patient interactions in Nigeria and in other countries where this problem is addressed in public funded research more successful.

In order to improve communication, translators can study the history, signs, and symptoms of the different diseases so as to make them easily identifiable to patients. Let us take the case of rheumatoid arthritis, a chronic generalised inflam-matory disorder, which involves the synovial joints and tendon sheaths and may eventually lead to permanent joint damage and deformities. Edo transla-tors can relate this information to the situation on hand and translate appropri-ately. A translation can therefore take the following form:

English EdoRheumatoid arthritis obalo oghe ukoko [joint pain]

In their renditions, translators must take into account that arthritic pain can affect the ankles, spine, wrists, fingers, and toe joints, as well as the neck.

Diabetes offers another example of the need for a knowledge of symptoms. These include excessive production of urine, called ‘polyuria’ in medicinal ter-minology, extreme thirst (polydipsia), and weakness. Translators can identify and describe the symptoms, the amounts of urine, and translate the disease as:

emiamwe ahio ahio [emiamwahiahio]sickness urine urine[i.e. Passing of excessive urine sickness]

In this case, the translation strategy used is reduplication. This morphologi-cal process is used to indicate excessiveness by many Edo patients when they communicate with doctors. Interpreters working out of Edo into English face a variety of such terms as shown in the conversations below:

Conversation 4.

Doctor: “Mama how u dey?”Patient: “eko wa khiamwe ‘khekhekhe’.”Interpreter: “Her stomach is paining her very well.” She has terrible pains in her

stomach]

Conversation 5.Doctor: “Mama what is wrong?”Patient: “I waa hewe fuen – fuen.”Interpreter: “She is always breathing fast.” [i.e., She is always panting]

Conversation 6Patient’s mother: “Good morning, sir.”Doc: “Good morning, what is the problem?”Patient’s mother: “The baby’s chest dey nak ‘kpi kpi kpi’.”



Conversation 8Doctor: “Oga what is the problem?”Patient: “My heart dey do me ‘gbi gbi gbi’.”

In these exchanges, ideophonic concepts are seen to feature prominently in the patients’ speech and they help doctors to have a good idea of the problem. We observe that most of expressions in quotation marks describe the patient’s breathing in relation to the heart. Translators must consider all aspects involved to convey the meaning adequately in the absence of a one–to–one correspon-dence and show their creative ability.

This also is true in terms of modifications when medical mediators are faced with medical terminology that is ultimately based on English loanwords, such as:

English Edo Cancer ekansa Diabetes ediabetis Cholera ekolerra Malaria emalaria Migraine emaigrane Stroke estroki Appendicitis apendis Typhoid fever etaifodi Ulcer osa

With the introduction of such loanwords, the Edo lexicon is expanded to en-able the Edo language users to cope be�er with communication in medical set-tings. The principles behind them are naturalisation and derivation. The Eng-lish medical concepts are ‘Edonised’ in the sense that the terms are pronounced as Edo words. The loanwords are modified so that they follow Edo syllable structure for nouns (all Edo nouns begin and end with vowels).

Other strategies open to translators conveying the adequate meaning be-tween languages include coinage, appositions, paraphrasing, as well as descrip-tions or explanations of health problem. Each of these is a form of loan from source-language texts and cultures. Translators may be accused of fabricating texts, but we observe that such fabrications provide a way around problems of untranslatability when they convey the appropriate information.

Translators in medical se�ings have to be competent and creative to render the meanings of words adequately. This goes a long way towards improving the communicative competence of doctors and patients and making their interac-tions more productive and less problematic and awkward.

ConclusionIn this article, we examined the translation of English medical terms into Edo

and vice versa in terms of linguistic, social, and cultural contexts. We discussed how translation is an a�empt to convey the unity of meaning from the source to the target texts. The article emphasises that translators of medical texts are obliged to do so in order to serve the interests of their clients, doctors as well as patients, as best they can. The problems were discussed in terms of social and cultural implications and obstacles, and we presented some strategies that make for successful communication. These were based on the interpreters and translators’ intimate knowledge of the cultures involved, on the diseases, their



symptoms and histories, on the adequate use of description, explanation, modi-fication, and paraphrasing. In addition, we noted such strategies as nativisation, coinage, and the like.

The study behind the present article is one of many that are being conducted all over the world. We focus on the need to develop Nigerian languages in the area of medical terminologies. Ventures and efforts such as this are meant to en-hance communication and reduce illiteracy and ignorance in the area of medi-cine in many emerging nations. Translation Studies are central to such efforts by language experts to develop indigenous languages, of which Edo is one, not only in the medical field but in many areas in today’s globalised world.

Notes1. The conversations were recorded mostly at the General Out-Patient Department of the Central Hospital in Benin City.

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