Programm 80. StuTS

The ability to feel pain is universal to all human beings, regardless of ethnicity, gender, or age. It has been shown, however, that the exact nature of one’s pain experience, i.e. how humans perceive and react to pain, is all but universal and can differ greatly depending on one’s cultural and social identity (Craig and MacKenzie 2021). This becomes especially clear when observing pain communication in multi-cultural and multi-linguistic environments, where misunderstandings frequently occur when medical practitioners and their patients derive from different cultural backgrounds (Zborowski 1969).
This study explores how the Quechua people of Bolivia, South America, use language to describe and express painful sensations. More specifically, we investigated how the Quechua people communicate pain among their community members and in medical settings, and how cultural and linguistic barriers may lead to issues in pain diagnosis and treatment. For this purpose, we conducted semi-structed interviews with 7 native speakers of Bolivian Quechua and 12 medical practitioners (monolingual Spanish as well as bilingual Spanish and Quechua speakers) with extensive experience in treating Quechua patients. Interviews with Quechua participants were conducted in the Quechua language within different rural towns of the Cochabamba region in Bolivia, while interviews with medical practitioners were conducted in Spanish in Cochabamba City.
Thematic analysis of the collected material suggests that linguistic competence in the Quechua language is immensely important when treating Quechua patients. This is due to multiple reasons. The first one is the obvious communication barrier that occurs when the patient has little or no knowledge of Spanish and the medical practitioner has little or no knowledge of Quechua. In this case, patients usually must rely on family members to interpret, which can cause important information to become lost in translation (see also García Camacho 2019). The second reason is that, to understand some patients’ explanations for why they feel pain, it is necessary to have knowledge of concepts from Andean cosmovision that do not have a Spanish equivalent, such as the concept of jap’iqa (lit. grabbing or taking). It refers to the idea that when one has angered the Pachamama (the “principal deity of Andean religion” that embodies the earth itself, Bolin 1998: 32), she may take hold of one’s spirit as punishment which can result in different maladies, like pain. Without knowledge of the Quechua language, it becomes difficult to fully understand this reasoning. And thirdly, fluent command of the Quechua language is extremely important when building up trust with a Quechua patient so that they feel comfortable enough to share details about their pain. Lack of knowledge about the Quechua language may be interpreted as lack of knowledge about Quechua culture itself, which in turn makes patients more likely to see medical practitioners as outsiders and feel less comfortable with speaking freely about a highly personal topic such as pain.
The results of this study support the general view that linguistic competency is of crucial importance for healthcare systems with culturally diverse populations (Bouchard et al. 2012; Marquine and Jimenez 2020).

References:
Bolin, Inge. 1998. Rituals of Respect: The Secret of Survival in the High Peruvian Andes. New York, USA: University of Texas Press.
Bouchard, Lise, Mario Incayawar & Knox H. Todd. 2012. Linguistic Approach for Understanding Pain in the Medical Encounter. Culture, Brain, and Analgesia: Understanding and Managing Pain in Diverse Populations, 0. Oxford University Press.
Craig, K. D. & N. E. MacKenzie. 2021. What is pain: Are cognitive and social features core components? Paediatr Neonatal Pain 3(3). 106-118.
García Camacho, Angélica. 2019. Apoyo en la interacción comunicativa entre el paciente adulto mayor quechua hablante y el profesional de la salud castellano hablante mediante la interpretación comunitaria, coadyuvando en la superación de las barreras lingüísticas en el acceso a los servicios de salud pública del hospital clínico viedma. Cochabamba, Bolivia: Universidad Mayor de San Simón Trabajo Dirigido.
Marquine, María J. & Daniel Jimenez. 2020. Cultural and linguistic proficiency in mental health care: a crucial aspect of professional competence. International Psychogeriatrics 32(1). 1-3.
Zborowski, M. 1969. People in Pain. Jossey-Bass.