2. ‘Difference’ and communication
2.1 A communication ‘problem’?
This course starts by exploring at a general level the relationship between ideas of ‘difference’ and issues of interpersonal communication. In the first activity, you will consider a brief case study that offers a way into discussing these issues, which can at times seem quite complex and entangled. The case study is taken from research into the health and social care needs of black communities in the Brighton, Hove and Lewes area in the south of England (Yazdani and Anju, 1994, quoted in Robinson, 1998, p. 92).
Case Study 1: Experiencing a communication ‘problem’
My main problem is communication. Because of the language problem often I feel dumb and can’t express my positive or negative feelings … I stayed in hospital for two weeks. Two of the nurses neglected me. Of course I didn’t know whether it was because of my colour or because of the communication problem … I am still not sure about the exact medical term of the operation.
(Source: Yazdani and Anju, 1994, cited in Robinson, 1998, p. 92)
Activity 1: What is the problem?
The speaker in case study 1 above is a Bangladeshi woman living in the UK. Having read the case study, think about the following questions.
What is the nature of the communication ‘problem’ experienced by the speaker?
Whose problem is it?
What are the consequences for the speaker?
Note that the speaker herself identifies the existence of a ‘problem’ and relates it specifically to ‘communication’. Initially, she analyses this as a problem of ‘language’. Presumably (although we do not have all the facts) she is referring to her perception that her spoken English is not sufficiently proficient to enable her to express her feelings as she would like to. She goes on to mention a specific experience, in which she was in hospital for two weeks. Here the precise nature of the problem becomes rather less clear. She says that two of the nurses ‘neglected’ her, and that she is unsure whether this was ‘because of my colour’ or because of the ‘communication problem’, by which presumably she means the language issue she mentioned earlier.
This raises the question of whether the real communication ‘problem’ was the woman’s inability to speak English, or the racism of some of the hospital staff, which resulted in them failing to communicate important information to her. That racism might have been expressed in a very direct way – simply by ignoring the patient ‘because of my colour’ – or more indirectly, by failing to provide the services (perhaps a bilingual worker or an interpreter) that would have made communication possible.
Whatever the nature of the ‘problem’, the consequences were potentially very serious, in that the speaker was discharged without knowing the precise nature of the surgical procedure she had undergone. A failure or breakdown in communication can lead directly to poor quality care being provided.
This brief case study demonstrates both the importance and the complexities involved in issues of communication and difference in the context of care. The questions were not straightforward, and they were designed to show the complex and contentious nature of the issues, rather than to produce easy answers. In a sense, how you answered the questions in Activity 1 depends on your understanding of the nature of ‘difference’ – whether of ethnicity, gender or disability – and both how difference is produced and how it should be responded to.