Translating mental health — finding language solutions in northeast Nigeria

If the sign at the mental health clinic read, “Services for mad people,” would you walk in for help?

Yet that is the reality for many people in northeast Nigeria because of the difficulty in translating concepts like ‘mental health’ into Nigerian languages. Translators without Borders (TWB) is working with humanitarian experts in mental health to better understand the nuances among languages so that words can encourage use of services rather than hinder access.

Northeast Nigeria is linguistically diverse, with more than 30 mother tongues spoken by 1.9 million people displaced by conflict. Often traumatized by the conflict, many internally displaced people (IDPs) could benefit from mental health services. Yet the translation of ‘mental health’ into the main two languages used in the response – Hausa and Kanuri – carries a heavy stigma, possibly keeping people away from clinics.


How can those working in the mental health and psychosocial support (MHPSS) sector communicate information about services, when the very name of the sector scares people away?


To address this question, TWB worked with affected people and sector specialists to identify terms that need to be communicated more effectively. The resulting terminology recommendations and the proposed language glossary, with terms translated into Hausa and Kanuri, promote the use of unambiguous and less stigmatizing language. Use of these terms may, by extension, increase the use of services by those who need them.  

TWB began by identifying 301 key mental health terms that are either difficult to translate, commonly misunderstood, or stigmatizing.

This list was then researched and discussed extensively. TWB facilitated a workshop with the International Organization for Migration (IOM) MHPSS specialists to identify particularly difficult words and discuss alternative translations, aiming to use plain language and to avoid words that stigmatize. A group of 53 internally displaced people then reviewed the translations. TWB tested comprehension among the group and explored alternative translations. Throughout the process, TWB discovered key areas where language posed a significant challenge in the delivery of mental health and psychosocial support services.

Points of confusion

One major finding was that many terms commonly used by English speakers when discussing mental health are heavily stigmatized or misunderstood in northeast Nigeria. “Mental health” in Hausa is literally “services for mad people” — a shocking example of stigma. An alternative way of discussing this sector may lie with the phrase “psychosocial support,” which TWB discovered did not carry the same stigma in Hausa.

Generic terms such as “abuse” and “stress” caused confusion as there is often not a comparable generic term in Hausa or Kanuri. In both languages, the translation of “abuse” was generally understood by respondents to refer only to ‘verbal abuse,’ similar to an insult. Similarly, “stress” meant only physical stress to respondents, such as the physical strain you feel after a day of hard labor. If an aid worker intends to communicate how to relieve “mental stress” or how to heal after experiencing “physical abuse,” it’s clear that miscommunication may occur. Therefore, it is best to always pair descriptive words like “physical,” “verbal,” or “emotional,” with “abuse” and “stress.”

A similar issue was found with the concept of a “safe space.” When used in an English-speaking mental health context, it refers to a physical space where one feels cared for and emotionally supported. However, those surveyed understood this concept as a place with armed guards. This is an example of how sector-specific jargon may not make sense to those who need services. In northeast Nigeria, the concept “accepted space” may translate better.

The TWB MHPSS Glossary


“This is a very laudable work that will hasten the delivery of services to the affected people of north east Nigeria.”  
– Dr. Muhammad A. Ghuluze. Director, Emergency Medical Response and Humanitarian Services


To provide a solution for these issues, TWB has updated its Glossary for Nigeria with the 301 MHPSS-related terms. This glossary app includes words, definitions, sample sentences, and audio recordings for the selected terms. It can be accessed on a computer, tablet, Android, or iOS device, and can be used both on- and offline, which is useful given the poor connectivity in northeast Nigeria.

The app is already being used in training sessions with positive results. Thomas Eliyahu Zanghellin, theMental Health and Psychosocial Support / Gender-based Violence Focal Point for the NGO INTERSOS in Maiduguri, Nigeria, has used the glossary in four training sessions already, generating “really fun group work with stimulating discussions.”

Language and terminology play a key role in the delivery of aid. Many sectors, including mental health and psychosocial support, use jargon and generic terms that do not readily translate in some cultures. Discussions about language allow the humanitarian world to challenge this terminology. The TWB Glossary for Nigeria provides a potential solution, allowing affected communities to access services and claim their rights in a language they understand.

Learn more about the TWB Glossary for Nigeria, and other TWB glossary projects here.

How soon is too late? How Translators without Borders responds to crisis

When a crisis or a major humanitarian event occurs, timing is everything. The ability to respond to urgent and vital needs quickly can help save lives. However, language is often the forgotten link at this initial stage of crisis response and communication fails because aid workers and affected populations don’t always speak the same language.

Crisis Response after Hurricane Matthew

The destruction that followed Hurricane Matthew which hit Haiti in October 2016 left thousands of people in urgent need of emergency assistance. Most hospitals were unfit to use, roofs from schools and houses were blown away, and thousands of people were left with no food or shelter. As soon as the news was received, aid agencies mobilized their teams in Haiti to assess the situation on the ground and to help those affected. While our aid partners were mobilizing their responses, Translators without Borders set about assembling 50 French and Haitian Creole rapid response translators to ensure that language barriers were not going to impede vital relief efforts.

The rapid response teams (RRT) worked non-stop translating vital content such as geographic mapping of the affected areas and cholera prevention messages. This visual guide gives a snapshot of how TWB responded to the crisis.

TWB crisis response
How TWB responds to crisis

Volunteer

Click here to apply to be a volunteer with the TWB Rapid Response translation teams

Blog AuthorBy Caterina Marcellini, Translators without Borders Communications Officer

“I want to ask myself, why are people dying every day?”

translation saves lives

A speaker of 5 languages, Jeanne Martin Goumou from Guinea, recognized the importance of giving people access to information in the right language during the Ebola crisis. In a country of almost 12 million people where more than 40 languages are spoken daily, Ebola prevention messages in French and English were not understood by the majority of the Guinean population. Making good use of her fluency in 3 local languages, Jeanne Martin decided to help by manning the lines of the free National Ebola Hotline, helping those across the country who were desperately seeking vital information in a language they
could understand. Because she knows that translation saves lives.

During my interview with Jeanne Martin, she told me about Guinea and the times of Ebola. “

“I want to ask myself, why are people dying every day?”

She spoke of a country with a high maternal mortality rate, and where malaria is one of the biggest killers of children. She spoke of a country where information arrives in European languages that the majority of the population doesn’t understand.

Jeanne Martin is one of the 12 recent graduates of the Translators without Borders’ translator training course in Guinea, a project in collaboration with eHealth Africa that aims to build language capacity in countries where there are few to no translators. She feels passionate about the training, and for her, the course was a professional opportunity to grow as a translator and to learn new information on important medical topics.

Translation saves lives
Image courtesy of Photoshare

Challenges

One of the biggest linguistic challenges she encountered during the training is emblematic of the importance of the very work she is doing. She says there are a great amount of “false friends” in the documents she translates; words that look or sound very similar in two languages but that have very different meanings. This is just an example, in the everyday life of a translator, that shows why information in the right language is so important – so that information is clear and there are no misinterpretations when vital health care instructions are given in a foreign language.

Looking to the future, Jeanne Martin wishes to continue to help people in Guinea access health care information in a language and format they can understand.

Blog AuthorBy Caterina Marcellini, Translators without Borders Communications Officer

 

Translating knowledge into practice – Dr Subas Chandra Rout on why #LanguageMatters in medicine

How does an orthopedic surgeon find the time to volunteer to translate 315,000 words of medical information – and why?

This week I spoke to Dr Subas Chandra Rout from his home in the Indian state of Odia. Since 2012, Dr Subas has been translating medical content from Wikipedia medical articles from English to Odia so that the people of even remote villages can get basic information about health and diseases using just a smartphone. Odia is a regional language spoken in India by over 40 million people, and Dr Subas is intent on getting simple yet critical medical information to Odia speaking communities; from Zika prevention messages to ways to recognize diabetes, to the dangers of diarrhea.

Helping by translating knowledge

It all started when Dr Subas was asked to translate an article about malaria on Wikipedia. He did it because he knew that people were not generally very conversant on medical topics, although these topics affected them greatly. When he studied medicine, it was through English, and he learned thousands of new technical terms. As a consequence, he found himself then having to learn those thousands of terms in the regional language of his patients so that he could communicate his knowledge across the language divide. This was not always easy, as some languages are often not as well equipped with medical terms as is English. Despite the difficulties, the doctor persisted, and today he continues to break down the barriers to information by translating for Translators without Borders (TWB).

When I asked him how he manages to find time to complete so many medical translations, he said:

“There is a proverb – where there is will; there is a way. I have a will to feed the Odia speaking people with medical knowledge and I will do it until my end.  Time is no barrier.”

He sees Translators without Borders as “a medium that transcends the barrier of space and time” to provide people access to unlimited and accurate medical knowledge.

While talking about the impact he thinks his translations have had on the Odia speaking community, Dr Subas replied that he has witnessed an increase in the number of people who are now aware of the availability of medical articles in their own language. “My labor is starting to bring color,” he said, “Some of the topics have adorned the pages of local newspapers. I am sure that 40 million people will gradually be knowledgeable in basic medicine.”

Translation for Wikipedia

Do you want to participate by translating knowledge? Read more about translation for Wikipedia on the Wikipedia website.

Blog AuthorBy Caterina Marcellini, Translators without Borders Communications Officer