By Loh Cheng
The foreign worker we speak to may not share our health beliefs or expectations of the health system. When we begin with different assumptions, even our simplest sentences may need to be decoded.
Migrant Workers
The drawing shows us the harsh working environment of some of these workers, as they slog in inclement weather doing back-breaking work. What has kept this man going is the well-being of his family back home. He endures hardship and seeks treatment for the pain only when it becomes unbearable.
The man expresses his pain ungrammatically as many, many pain and in present continuous tense, sky raining, my back paining…. very hot and everywhere paining. It is important to listen actively for the meaning behind the worker’s expression, in order to understand them in their cultural context. Even then, misunderstandings can occur.
After a stint at a teaching post at a university hospital in Yunnan, China, I prided myself on my fluency in English and Mandarin. I was in a busy Emergency Department in Singapore, job-shadowing before returning to full-time clinical work. I was given the task of arranging the follow-up management for a mainland Chinese worker who had sustained a bad knee contusion after falling into a drain. I was to convey the diagnosis, arrange outpatient orthopaedic follow-up, and for safety netting, include a polyclinic follow-up for extension of outpatient medical leave as needed. I thought I did a helluva job.
I was taken aback a few days later when the department received an email from a social worker seeking clarification about the two outpatient follow-up appointments. Apparently, the migrant worker was confused about being given both orthopedic outpatient and polyclinic outpatient follow-up. Having inadequate understanding of the purpose for the polyclinic referral, he had inferred that we belittled his knee injury!
Dr Loh Cheng is in public service and in the past has been involved in rehabilitation and elderly care training in Yunnan, China.
The commentary and vignette were reproduced with permission from the book “Being Human, Stories from Family Medicine” edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore.
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A/Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
