Fieldset
Translation: True Voices of MSF

How can a psychologist work in a country where you don't speak the language?

Christine blogs from MSF Myanmar

Christine and Austin during his first week on the job at the Lashio Clinic

Every profession has its primary tool, the means by which a person is able to successfully accomplish their work. An accountant has his spreadsheets, a doctor her stethoscope, a dancer his or her body. And psychologists? Mostly we have language: spoken word, written trainings, guides and supporting documents, and nonverbal communication are what we rely on to assist and provide support to our clients and to contribute to the field of mental health at large. 

Granted, there is a lot of power in nonverbal language. I have become even more conscious of how my body movements and facial expressions are interpreted and how I can use them as a means of communication. And while they do communicate a lot, it is still extremely limiting to not be able to move beyond that into deeper and more meaningful interactions. 

Myanmar is an English-speaking mission and many of my coworkers in the Shan project speak some level of English, but on a broad range: from very basic to essentially fluent. Our beneficiaries, however, speak little or no English, which is an obvious barricade for me to function as a mental health professional as easily as I can and do at home. Essentially, I’m totally cut off from expressing myself in any natural way, aside from greeting and generically asking "how are you?" (to which they invariably reply with a smile and an equally generic "I’m fine").    

This has been a huge adjustment over the last 11 months. Many times, I’ve felt a bit like Ariel, the Little Mermaid, who exchanged her voice in order to escape to and explore a new world. I can walk and function on my own in this mission (well, most days anyway), but every time I open my mouth around a patient, I’m essentially voiceless. With no Disney or other fairy tale involvement to change this, I’ve instead learned to rely on the help of my treasured "Personal Assistant," or PA. 

In MSF, a PA is a national staff member hired to assist international staff with navigating their jobs in these new and novel contexts. First and foremost, then, is translation and interpretation. My current PA, who elects to go by the name "Austin," translates written words to and from English to Burmese to assist with training—protocols, procedures, and handouts for addressing various counseling challenges. He also interprets oral conversations and helps me understand cultural norms that influence my work.    

To carry out this interpretation, he is literally side-by-side with me for most of the day. We sit in counseling sessions together, he helps me provide supervision and consultation to the counselors and other medical staff, he interprets the content of meetings within our office and with other area NGO actors, and we talk. A lot. Much about work and related topics, but also about each other’s lives, cultures, likes and dislikes (his likes: Justin Bieber, rice mixed with pickled tea leaves, and learning American slang ["play it by ear" and "make it rain" being recent faves]). One of my many likes is that he’s a habitual gum chewer. We spend a lot of time in close proximity and, hey, that’s simply a solid practice for any interpreter. 

PAs deserve a lot of credit, and Austin deserves extra credit and beyond. He has interpreted challenging counseling sessions where people describe struggles with intravenous drug use, stigma and discrimination, or the ongoing civil war. Unforgettably, in his first week on the job, and his very first live counseling session, Austin had to interpret as the counselor taught the client how to use a condom and demonstrated its application on a specially designed wooden, ahem, implement. I found it highly amusing and gave him a lot of praise; he found it incredibly awkward and probably wishes the whole thing never happened.

Christine and RSR. Photo: Christine Rufener/MSF

My first Myanmar PA, who prefers to go by her initials, "RSR," also deserves a nod and more. She was my first PA, when I worked in a different Myanmar project, and what a spitfire she is. Just like Austin, she is extremely hard-working and dedicated to constantly improving her English, in addition to the other five languages she speaks fluently. At age 19. (Her likes: Bruno Mars, chocolate, and learning American slang, ["let’s bounce!" being a fave].) She used her personal experience to educate me about the life and struggles of internally displaced people (IDPs) in northern Myanmar and was my lifeline in my first few months of this, my first mission.   

In short, PAs are worth their weight in gold. They are the priceless assistive device to the otherwise impassable language barriers here in the field, and I’m incredibly indebted to the two PAs I’ve been fortunate enough to work with, for allowing me to do my job, but also for being all around charming and delightful coworkers and friends. Both have dreams of living and studying in an English-speaking country, and I would absolutely love to see that become a reality for them some day. They, along with countless other national staff, really make our work as expatriates possible. With their help, I am able to have the impact that I’ve been put here to do, and without them, I’d still be, at best, a floundering, voiceless MSF mermaid.