The connection between language and stroke is well-documented. About one-third of strokes result in aphasia, a language disorder that affects how people process language in their brains. When people lose the ability to understand or use language, they experience frustration, confusion and isolation.
This story, however, explores a different link between language and stroke. It sheds light on the difficulty of accessing disease information for speakers of the more than 4,000 indigenous languages in the world. These include the mind-boggling 840 languages spoken in Papua New Guinea, the 711 languages of Indonesia and the 517 spoken in Nigeria.
In Colombia, where this story is located, there are 70 languages spoken by various communities, 65 of which are indigenous. This, says Angels consultant Magda Cueto, poses a communication challenge for medical personnel in healthcare institutions.
Cultural diversity is a valuable teacher. It can inspire creativity and teach us about different ways to live in the world.
The International Work Group for Indigenous Affairs (IWGIA) states: “Each indigenous language is a unique expression of our diversity that holds a single understanding of the world . . . If we lose any of these encyclopedias of knowledge that dates back thousands of years, we suffer an irreplaceable loss that diminishes all of us.”
But, says Magda, effective communication in medical practice is necessary to “generate empathy, helping to understand the experiences and feelings of the patient and their family members” – and linguistic diversity, however crucial for defining indigenous identity, can be a barrier to inclusive and effective healthcare.
One such challenge is to be found at the northernmost tip of South America, in the department of La Guajira. In this hidden gem of the Caribbean coast, almost 45 percent of the population is made up of five indigenous groups whose mode of communication is the Wayuu language (also wayuunaiki).
Wayuunaiki belongs to the Arawakan family of languages that developed among ancient indigenous people in South America. One of its unique characteristics is that it has ten tenses: the present-past, the near future, the general future, the future intentive, the past perfect, the near past, the current past, the former past, the remote past, and the frequentative past.
Efforts by the Colombian government to preserve the language have included translating some of the novels by Gabriel García Márquez (whose grandparents were from the Guajiro capital Riohacha) into wayuunaiki. There is also an illustrated Spanish-Wayuunaiki dictionary used in schools and Microsoft has launched a computer dictionary in wayuunaiki, opening the doors of technology to the Wayuu indigenous people. There is also a radio service and newspaper to keep the community abreast of issues concerning their culture.
Magda says that the younger members of the community who have moved away for education or work, serve as translators when interacting with the Spanish-speaking population. “This makes communication difficult when they are not present. One of the challenges for the medical community is providing care for these patients when they seek help in healthcare institutions outside their communities. It is also worth noting that the majority of the Wayuu population only understand wayuunaiki orally and not in written form.”
Faced with these circumstances, staff at two hospitals in the region, Maicao Clinic in the city of Maicao and Renacer Clinic in the city of Riohacha, have developed content in wayuunaiki to teach the community to identify the symptoms of stroke and what to do if they or someone close to them displayed any of these symptoms.
The content is structured around the acronym “CORRE” (meaning hurry). This servies as an aide-mémoire for stroke symptoms and at the same time reinforces the central message, which is to seek urgent medical care. For the campaign, videos were recorded in wayuunaiki featuring hospital staff from the Wayuu community, adorned with face paint in traditional spiral shapes. These videos are displayed on waiting room televisions, social media platforms, and other regional media. The aim is to reach as many people as possible with a message that could save lives.
Magda says that, while the stroke incidence in this community is not known, the population has a high cardiovascular risk. “They have little access to traditional health therapies due to the geographic location. Traditions and ancestral medicine also play a role; there is little uptake of classic Western medicine.”
Her consultancy in this region began in 2021. Maicao Clinic is now a stroke-ready centre, while a stroke service is under development at Renacer Clinic.
Magda says, “As the development of the stroke code progressed at these institutions, the need grew to educate the community about stroke.”
The team responsible for the campaign took inspiration from existing educational initiatives for overcoming language barriers in relation to other pathologies, she says.
The campaign was welcomed by the community and has sparked an interest in public awareness in the medical establishment but it’s an initiative that has to be sustained in order to make a meaningful impact, Magda says.
The Guajiro project for communication and multiculturalism in stroke patient care can therefore be expected to continue in the near future, the general future, and the future intentive.
