Global and worldly Englishes: Discommunities and subcultural empires
English, community, discommunication
Under the headline “Doctor couldnt spell acute” an article in the Barrier Daily Truth (5/01/01; originally published in the South China Morning Post) reports that “A Hong Kong doctor left the word acute out of a dying heart patients diagnosis because he didnt know how to spell it…" The story goes on: “The patient was treated for a less-serious condition as a result and died in hospital hours after going to Dr Chau Chak-lam with chest pains…” The patient, Chiu Yiu-wah, was admitted only as an “urgent" case, two steps down from the “critical" case, as a result of the referral letter. At the inquest, the doctor admitted that he “should have put the word acute” on the instructions to the hospital. He “had acute angina pectoris in mind” but had omitted the word acute. The crux of this sad story is in the doctors explanation: “I was not sure about the translation" and “I did not know the English spelling…Asked by the coroner why he did not use Chinese, Chau said he was following the common practice in Hong Kong of using English in referral letters”. Unfortunately, the brief story stops there without further details about the use of English in Hong Kong medical contexts. All we have is a Hong Kong Chinese doctor and patient, a problem with English, and an avoidable death. It looks as if highlighting the issue of the doctor not being able to spell acute misses the point: It was more that he couldnt think of the English translation. And why indeed should he, as a Cantonese doctor with a Cantonese patient in a Cantonese city?
Let me jump to South Africa. Crawfords (1999) study of communication between patients, nurses and doctors in Cape Town (RSA) health services highlights “the problem posed by doctors being linguistically unequipped to care for Xhosa-speaking patients, whose numbers continue to grow rapidly as people move to town from the rural areas" (p.27). Here we see the complexities of relations lying behind a language barrier; at issue here are questions of language and power within medical contexts as well as within the whole broader context of South African society. “It is not possible," suggests Crawford, “to isolate the patient disempowered in terms of the language barrier from the whole biomedical discourse in which patients occupy a disempowered position” (p.29). Neither is it possible to see issues of language, interpretation and medical discourse as separate from the class, gendered and racial relations of South Africa: “The patients are positioned at the bottom, largely passive bodies whose own version or narrative of their illness is not considered central to the processes of diagnosis and formulation of a realistic treatment strategy. The nurses, often also used as (unpaid) interpreters in South Africa where a wide gulf of social class, race, language, and gender frequently separates doctor from patient, occupy a conflicted and ambivalent position intersecting the space between them” (p.29).
This gives us, then, a more complex picture than the newspaper sketch of a patient dying because his doctor couldnt spell acute. Here we see a fuller picture of how language is embedded in social relations and indeed is part of the system that perpetuates inequality. And, as Crawford argues, change can only be brought about by addressing questions of language as well as other social, economic and political concerns: “To fashion a new integrated social order out of a severely traumatized past, to accept and work with the reality of black suppression and rage at white domination, requires, among other things, a sophisticated grasp of the social meaning of the use of a particular language, and a commitment to overcome the discrimination against and exclusion from power of those who speak languages other than English" (p.32). While on the one hand, then, we may want to acknowledge the usefulness of English as a language of global communication, we clearly also need to acknowledge it as the language of global miscommunication, or perhaps discommunication. And I do not mean this in any trivial fashion - I am not merely talking here of misunderstanding, but rather of the role of English as a language that is linked to inequality, injustice, and the prevention of communication. Thus, when we talk of language communities and the possible benefits of communication they may bring, we must also consider who is simultaneously left out of such cultural empires and what the onsequences may be.
For my final example of English and medical discommunication, I would like to turn to a passage from Han Suyin's (1956) novel... And the Rain my Drink, which draws on her own experiences as a doctor in pre-independence Malaya:
Among the doctors few can speak to all the patients, for in Malaya a university education, by its very insistence upon excellence in English, hampers a doctor from acquiring the vernacular languages of this country.
And thus at night, when the patients confide in the darkness and in their own tongue what they have withheld from physician and nurse, I begin to understand the terror, the confusion, the essential need to prevaricate of those who are always at someone else's mercy, because they cannot communicate with those who decide their fate, except through an interpreter.
In the process, how many deviations, changes, siftings, warpings, and twistings; how many opportunities for blackmail and corruption, before, transformed, sometimes unrecognizable, the stories of the poor who do not speak English reach their rulers, who are handpicked, among their own peoples, on the basis of their knowledge of English. (p.31)
These brief stories - a newspaper story about a death in Hong Kong, a study of communication in Cape Town hospitals, a novel set in pre-independence Malaya - are inter-connected in a number of ways: All speak to the range of contexts into which English has penetrated; all speak to the ways in which English becomes linked to forms of institutionalized power; all speak to the ways in which English functions as a class-based language; all speak to the tension between local, multiple vernacular languages and the monolingualism of the language of power; all speak to the ways in which English is as much a language of global discommunication as it is a language of global communication. These examples, drawn from one interconnected domain - language use in medical contexts - but from diverse contexts, point to the many ways in which English has become a language (though not the only language) of global disparity and discommunication. Such a role, of course, needs to be seen in terms of the complex interplay between the local and the global. It does matter that the language in the examples is English, as one of the major players in global relations. It also matters that these contexts are in Hong Kong, South Africa and Malaya, all places that have felt the insidious effects of British colonialism and its socially and ethnically divisive policies. It matters too that the domain is medicine, as one that has become based on very particular formations of knowledge and practice, so that its practitioners work with forms of supposedly universal or global, rather then locally derived, knowledge.
There are many domains in which English plays similar roles, business and the economy being one of the most salient. In the Philippines, for example, “English continues to occupy the place of privilege - it being the language of the ruling system, government, education, business and trade, and diplomacy…The role of Philippine education... seems to be that of supplying the world market economy with a docile and cheap labor force who are trained in English and the vocational and technical skills required by that economy. As it is we do have a decided advantage in the export market of domestic helpers and laborers. Cite their knowledge of English as that advantage" (Ordoñez, 1999 pp19-20). Again we can see here the continued effects of colonialism (the particular effects of the US after the Spanish), the ways in which English is embedded in local institutional contexts (an education system that continues to favour English), and how these local contexts interrelate with broader global concerns such as IMF/World Bank pressures to develop particular types of economy, and the fact that the continuing poverty of the Philippines means that it exports its own people as cheap labour with a knowledge of English. Domestic helpers from the Philippines are popular in Hong Kong and Singapore in part because they can interact with children in English, something which is seen as a particular advantage in these two former colonies with their English-dominant language policies and dependence on global trade.
To start to understand the complex global role of English, we need to think outside questions of language communities and cultural empires. The notion of language community posits a problematic commonality both in terms of the common premises behind the term language and the usual assumptions of the term community. The notion of cultural empires is equally problematic, however, suggesting also a form of commonality, albeit an imposed one, and implying therefore that English reresents a similiarity of culture and thought. Both notions suggest a level of homogeneity as a result of a supposedly shared language. Alternative versions of the global spread of English propose a more heterogeneous version, whereby we have many Englishes and many worlds. And yet, as I shall argue here this version too has its flaws, based as it is on a supposed pluralization of Englishes based around newly emergent national linguisti