Lost in Translation

In medical school they teach you a diagnosis can be made by taking a good history.  Here in Nalerigu a good patient history is impossible to come by.  The majority of patients speak Mempruli, however our patients come from all over the place and speak many different tribal languages.  Translators are imperative to have at the hospital.  I know that translating is a hard job, but I am really never quite sure I am getting the whole story.  When the patient talks for 15 minutes and the translator turns to you and says, the patient has waist pain and a headache, I know that I have missed a bit of information.  Many times the story goes through multiple translators.  The patient will talk for 15 minutes, the first translator 10 minutes, the second 5 minutes, and then the last will turn and say, “The patient has GERD.”  Thanks for making the diagnosis for me!  Sometimes they speak languages that none of the nurses or translators know, then they just throw their arms and say, “Language barrier” leaving you more lost.  In the end, I never really feel like I have the whole patient story, you just sort of go off of what you can get and your physical exam to make your diagnosis.