It’s early morning in the village of Dhadgaon, Nandurbar, in Maharashtra, India, where villagers are mourning the death of a little girl. The child had been suffering from diarrhea for several days and began vomiting violently the night before. Her mother couldn’t access medical care until morning, and frantically tried everything she could to save her daughter.
She knew nothing about treating dehydration or diarrhea; while the Indian government distributes medical information pamphlets and posters to the villages, the information is almost always written in Hindi or English and not translated into the local languages. Without medical treatment, the girl passed away in the night. Nand Wadhwani, founding trustee of the Mother and Child Health and Education Trust and founder of HealthPhone, happened to be in the area and visited the mother in her hut the same day to offer his condolences. When he arrived, he was heartbroken to find that in her kitchen area, right beside her in a corner of the same hut, the mother had containers of sugar, salt and water: all of the ingredients necessary for an oral rehydration solution that could have saved her child. Says Wadhwani, “This child did not die from dehydration caused by diarrhea. She died from a lack of access to medical information in her parents’ native language.”
Bridging the language gap
If you’re reading this, you’re probably among the lucky 27% of internet users who have consistent access to health care information online in your native language. Just by virtue of being an English speaker, you can read an estimated 57% of all internet sites without second language skills or translation. It’s a convenience that many speakers of dominant commercial languages take for granted. If your child, friend, neighbor or grandparent is showing signs of illness, you can start to identify the symptoms and take action right away.
Villagers in Maharashtra are not so lucky. Most people in this region speak Marathi, the local language. Unless their parents can pay to send them to expensive schools in the city, they will not study English or Hindi until secondary school, and then their overall mastery of these languages remains low. Importantly, those who do have an elementary level of English or Hindi may still struggle to understand medical vocabulary in a second language. To ensure comprehension of this life and death information, readers need to have it in their native languages. In spite of the fact that there are over 72 million native Marathi speakers (it’s the fourteenth most commonly spoken language in the world), Marathi speakers have access to only a very limited number of websites in their native language. For the villagers of Maharashtra, this makes it next to impossible to obtain crucial health care information when they need it.
Tragic, unnecessary deaths like this little girl’s are not unique to rural India. Last April, Translators without Borders (TWB) cofounder Lori Thicke interviewed Peter Kamande, a TWB project manager in Kibera, Kenya. When asked to describe the consequences of medical information that is not translated into local languages, Kamande recalled the story of a friend who died from complications following an unsafe abortion. Though her community has access to various birth control methods, the information about where to find these resources and how to use them is available almost exclusively in English. When she got pregnant, Kamande’s friend visited a medical center and was given pamphlets of information in English. She then went to a pharmacy and bought medication to accompany her abortion. But she couldn’t read the pamphlets or the instructions for the medication. Confused, she asked friends to help her translate the information. With their limited foreign language education, her friends mistranslated the medication instructions. This sequence of events resulted in her tragic death a few days later. She was just 18 years old.
Kamande expressed this frustration to Thicke: “If the information had maybe been in Swahili or a language that the woman understood better, preferably Sheng, that woman would have followed the correct procedure to procure a safe abortion or maybe even been talked out of the whole situation.”
The truth is, Kamande said, “We have many more stories like this one.” In visiting with members of these rural communities, TWB representatives met hundreds of bright, educated people seeking the information they need to protect themselves and their families from unnecessary death and the spread of disease. One survey, carried out especially for TWB by Common Sense Advisory in May 2012, showed that 63% of African translators believed greater access to translated information could have prevented the death of a family member or close friend.
The good news is that general access to information is becoming much more widespread. In addition to printed information, many people now have regular internet access even in rural areas. Cell phones are rapidly becoming the most affordable and efficient way for people in rural and developing communities to access information online. According to BBC News, “India already has the third largest internet user base in the world after China and the US.” The same article states that, “Of the 120 million internet users in India, around 20 million are mobile-only internet users.” In Africa, according to Intelligent Life Magazine, there are already 84 million internet-enabled mobile phones, and it is predicted that 69% of mobile phones in Africa will have internet access by 2014. It is no coincidence that those with the most limited access to health care information in their native languages also represent some of the world’s highest death rates from preventable causes.
In 2012, most local language speakers have plenty of information right at their fingertips; they just can’t read it.
The Wikipedia project
To address this information gap, TWB is teaming up with Wikipedia, Wikimedia Canada and major cell phone service providers to deliver essential medical information in local languages via mobile phones. In order to do this, the Wikiproject Medicine team first identified the top 80 Wikipedia medical articles in English, each of which is viewed millions of times per month. Every one of these pages is reviewed by a team of doctors led by Dr. James Heilman, head of Wikimedia Canada, to ensure medical accuracy. The next step is to render the Wikipedia articles into simplified English. This is done by a team of editors from Content Rules, a US-based company specializing in content globalization that has donated its services to TWB. Once these simplified articles have been approved by Heilman’s medical team, they are posted by Wikimedia volunteers on the Simplified English Wikipedia site. This ensures that people without any medical background will be able to understand their content. As an added benefit, the simplified articles are much easier to translate.
With the help of translation manager Enrique Cavalitto and the TWB Workspace powered by ProZ.com, volunteers translate the articles into their native local languages. Since most of the medical articles are already available in the dominant global languages such as English, French, German and Chinese, this project focuses on languages with almost no reliable medical content available. This means that TWB volunteers are native speakers of languages such as Bengali, Macedonian, Dari, Gujarati and Tamil, to name just a few. The initial goal is to translate the top 80 Wikipedia articles in 80 local languages, which together go a long way toward reaching the many hundreds of millions of people who lack access to basic medical facts.
Thanks to mobile phone companies such as the French company Orange, cell phone users will have unlimited free access to the medical articles in their native languages via mobile phones. For parents like the mother that Wadhwani met in India, this accessible, free information could mean the difference between losing a child and saving her life.
Meanwhile, in India, Wadhwani created and founded HealthPhone, a company that produces instructional videos with basic medical content and makes them available preloaded on mobile devices. Like the Wikipedia articles, these films provide basic, essential medical information. Several of the films focus on helping new mothers take care of themselves and their babies. One of them explains how to make the rehydration solution that could have saved the little girl in Maharashtra. To assist HealthPhone, TWB volunteer translators are subtitling the films in as many local Indian languages as possible to ensure that access to vital health care information is not exclusive to the elite and the city dwellers. TWB, Wikipedia, Orange and HealthPhone are working together to alleviate the information gap that has already cost villagers like those of Dhadgaon, Nandurbar, too many of their sons and daughters.