Bilingual Edition?

We’ve discussed the idea of creating a bilingual edition of Where There is No Doctor for use in Mali, that would have both French and Bambara, on facing pages. The reason? Most doctors, nurses, and health workers are educated exclusively in French. However, most rural people do not speak French well, if at all. This can cause trouble*–when it comes to subjects like medicines and dosages, communicating clearly can mean the difference between life and death. In response, the Ministry of Health and others have published lexicons, or lists of French and Bambara words, for use by health workers.

A bilingual Where There is No Doctor is meant to be much more. It is a comprehensive guide for community health workers, covering a wide range of topics in its 450 pages. Here is what it might look like. Please share your thoughts. Would this be helpful? How might different groups use it? (View on Issuu, or download a PDF.)

* A 2004 study in Bougouni, Mali by epidemiologists from Johns Hopkins and the University of Bamako found that “drug consultations done in both French and the local language, Bambara, had higher scores than those conducted exclusively in Bambara.”

Here, “higher scores” means the provider gave the patient more complete information about a prescribed drug. It means, for example, explaining to a parent the importance of finishing a prescribed antibiotic treatment, even after the child gets better. This is a surprising result. Most of the patients in the study claimed not to understand French, so how can speaking to them in a foreign language possibly help? Wouldn’t patients be better served by getting information in their native language? The researchers seemed puzzled themselves, and offer this hypothesis as partial explanation:

It is likely that health care providers had difficulty in translating scientific language and concepts about drug regimens into the local language and relied on French even when the local language might have been better understood and thus more appropriate. This is supported by the fact that 70% of bilingual consultations were observed among caretakers who reported having no ability to speak or understand French.


Gilroy, K, P.J Winch, A Diawara, E Swedberg, F Thiéro, M Kané, Z Daou, Z Berthé, and A Bagayoko. “Impact of IMCI Training and Language Used by Provider on Quality of Counseling Provided to Parents of Sick Children in Bougouni District, Mali.” Patient Education and Counseling 54, no. 1 (July 2004): 35–44. doi:10.1016/S0738-3991(03)00189-7.