(essay)
Under the headline “Doctor couldn’t spell ‘acute’” an article in the Barrier Daily Truth (5/01/01; originally published in the South China Morning Post) reports that “A Hong Kong doctor left the word ‘acute’ out of a dying heart patient’s diagnosis because he didn’t know how to spell it…" The story goes on: “The patient was treated for a less-serious condition as a result and died in hospital hours after going to Dr Chau Chak-lam with chest pains…” The patient, Chiu Yiu-wah, was admitted only as an “urgent" case, two steps down from the “critical" case, as a result of the referral letter. At the inquest, the doctor admitted that he “should have put the word ‘acute’” on the instructions to the hospital. He “had acute angina pectoris in mind” but had omitted the word ‘acute’. The crux of this sad story is in the doctor’s explanation: “I was not sure about the translation" and “I did not know the English spelling…Asked by the coroner why he did not use Chinese, Chau said he was following the common practice in Hong Kong of using English in referral letters”. Unfortunately, the brief story stops there without further details about the use of English in Hong Kong medical contexts. All we have is a Hong Kong Chinese doctor and patient, a problem with English, and an avoidable death. It looks as if highlighting the issue of the doctor not being able to spell ‘acute’ misses the point: It was more that he couldn’t think of the English translation. And why indeed should he, as a Cantonese doctor with a Cantonese patient in a Cantonese city?
Let me jump to South Africa. Crawford’s (1999) study of communication between patients, nurses and doctors in Cape Town (RSA) health services highlights “the problem posed by doctors being linguistically unequipped to care for Xhosa-speaking patients, whose numbers continue to grow rapidly as people move to town from the rural areas" (p.27). Here we see the complexities of relations lying behind a ‘language barrier’; at issue here are questions of language and power within medical contexts as well as within the whole broader context of South African society. “It is not possible," suggests Crawford, “to isolate the patient disempowered in terms of the language barrier from the whole biomedical discourse in which patients occupy a disempowered position” (p.29). Neither is it possible to see issues of language, interpretation and medical discourse as separate from the class, gendered and racial relations of South Africa: “The patients are positioned at the bottom, largely passive bodies whose own version or narrative of their illness is not considered central to the processes of diagnosis and formulation of a realistic treatment strategy. The nurses, often also used as (unpaid) interpreters in South Africa where a wide gulf of social class, race, language, and gender frequently separates doctor from patient, occupy a conflicted and ambivalent position intersecting the space between them” (p.29).
This gives us, then, a more complex picture than the newspaper sketch of a patient dying because his doctor couldn’t spell ‘acute’. Here we see a fuller picture of how language is embedded in social relations and indeed is part of the system that perpetuates inequality. And, as Crawford argues, change can only be brought about by addressing questions of language as well as other social, economic and political concerns: “To fashion a new integrated social order out of a severely traumatized past, to accept and work with the reality of black suppression and rage at white domination, requires, among other things, a sophisticated grasp of the social meaning of the use of a particular language, and a commitment to overcome the discrimination against and exclusion from power of those who speak languages other than English" (p.32). While on the one hand, then, we may want to acknowledge the usefulness of English as a language of global communication, we clearly also need to acknowledge it as the language of global miscommunication, or perhaps discommunication. And I do not mean this in any trivial fashion - I am not merely talking here of misunderstanding, but rather of the role of English as a language that is linked to inequality, injustice, and the prevention of communication. Thus, when we talk of language communities and the possible benefits of communication they may bring, we must also consider who is simultaneously left out of such cultural empires and what the onsequences may be.
For my final example of English and medical discommunication, I would like to turn to a passage from Han Suyin's (1956) novel... And the Rain my Drink, which draws on her own experiences as a doctor in pre-independence Malaya:
Among the doctors few can speak to all the patients, for in Malaya a university education, by its very insistence upon excellence in English, hampers a doctor from acquiring the vernacular languages of this country.
And thus at night, when the patients confide in the darkness and in their own tongue what they have withheld from physician and nurse, I begin to understand the terror, the confusion, the essential need to prevaricate of those who are always at someone else's mercy, because they cannot communicate with those who decide their fate, except through an interpreter.
In the process, how many deviations, changes, siftings, warpings, and twistings; how many opportunities for blackmail and corruption, before, transformed, sometimes unrecognizable, the stories of the poor who do not speak English reach their rulers, who are hand‑picked, among their own peoples, on the basis of their knowledge of English. (p.31)
These brief stories - a newspaper story about a death in Hong Kong, a study of communication in Cape Town hospitals, a novel set in pre-independence Malaya - are inter-connected in a number of ways: All speak to the range of contexts into which English has penetrated; all speak to the ways in which English becomes linked to forms of institutionalized power; all speak to the ways in which English functions as a class-based language; all speak to the tension between local, multiple vernacular languages and the monolingualism of the language of power; all speak to the ways in which English is as much a language of global discommunication as it is a language of global communication. These examples, drawn from one interconnected domain - language use in medical contexts - but from diverse contexts, point to the many ways in which English has become a language (though not the only language) of global disparity and discommunication. Such a role, of course, needs to be seen in terms of the complex interplay between the local and the global. It does matter that the language in the examples is English, as one of the major players in global relations. It also matters that these contexts are in Hong Kong, South Africa and Malaya, all places that have felt the insidious effects of British colonialism and its socially and ethnically divisive policies. It matters too that the domain is medicine, as one that has become based on very particular formations of knowledge and practice, so that its practitioners work with forms of supposedly universal or global, rather then locally derived, knowledge.
There are many domains in which English plays similar roles, business and the economy being one of the most salient. In the Philippines, for example, “English continues to occupy the place of privilege - it being the language of the ruling system, government, education, business and trade, and diplomacy…The role of Philippine education... seems to be that of supplying the world market economy with a docile and cheap labor force who are trained in English and the vocational and technical skills required by that economy. As it is we do have a decided advantage in the export market of domestic helpers and laborers. Cite their knowledge of English as that advantage" (Ordoñez, 1999 pp19-20). Again we can see here the continued effects of colonialism (the particular effects of the US after the Spanish), the ways in which English is embedded in local institutional contexts (an education system that continues to favour English), and how these local contexts interrelate with broader global concerns such as IMF/World Bank pressures to develop particular types of economy, and the fact that the continuing poverty of the Philippines means that it exports its own people as cheap labour with a knowledge of English. Domestic helpers from the Philippines are popular in Hong Kong and Singapore in part because they can interact with children in English, something which is seen as a particular advantage in these two former colonies with their English-dominant language policies and dependence on global trade.
To start to understand the complex global role of English, we need to think outside questions of language communities and cultural empires. The notion of language community posits a problematic commonality both in terms of the common premises behind the term language and the usual assumptions of the term community. The notion of cultural empires is equally problematic, however, suggesting also a form of commonality, albeit an imposed one, and implying therefore that English reresents a similiarity of culture and thought. Both notions suggest a level of homogeneity as a result of a supposedly shared language. Alternative versions of the global spread of English propose a more heterogeneous version, whereby we have many Englishes and many worlds. And yet, as I shall argue here this version too has its flaws, based as it is on a supposed pluralization of Englishes based around newly emergent national linguistic identities.
In the rest of this paper, I shall take up these issues from various perspectives in order to open up an understanding of current scholarship on the community of English speakers. I shall argue that we cannot come to an understanding of English without a complex appreciation of globalization as both a global and local process, as both an impositional and an oppositional set of relations that produces something new (neither the same nor merely pluralized) in the doing. First, I shall look at current debates over the global spread of English, looking particularly at the arguments over homogeny and heterogeny in the world. One of the central arguments here will be that one’s understanding of English as part of a cultural empire or a language community depend very much on the model of globalization that one employs. Second, I shall look briefly at colonial language policy in order to make several points: colonialism created more complex empires than simple language communities. By this I mean that spreading the colonial language was only one tool and goal of colonialism. The use of vernacular languages as both a policy of pragmatic vernacularism and part of an orientalist preservationism was at least as significant as the use of English. The spread of English has been driven by postwar changes, the rise of the US, changing economic and political conditions and so forth. One of the other effects of continuing colonial relations is the construction and maintenance of languages, what Makoni and I (Makoni and Pennycook, in press), following Foucault, have called the ‘language effects’ of missionary and colonial activity. Finally I will consider various new directions for thinking about language in the world.
So how do we start to make sense of these interrelationships between English and the local and global? Writers from different ends of the political spectrum are often united in their agreement that English and globalisation go hand in hand. Where they differ is in terms of the effects of such globalisation. Thus, reviewing David Crystal’s (1997) book on the global spread of English, Sir John Hanson, the former Director-General of the British Council is able to proclaim: “On it still strides: we can argue about what globalisation is till the cows come - but that globalisation exists is beyond question, with English its accompanist. The accompanist is indispensable to the performance" (Hanson, 1997, p.22). Phillipson (1999), by contrast, in his review of the same book, opts for a critical rather than a triumphalist evaluation: “Crystal’s celebration of the growth of English fits squarely into what the Japanese scholar, Yukio Tsuda, terms the Diffusion of English Paradigm, an uncritical endorsement of capitalism, its science and technology, a modernisation ideology, monolingualism as a norm, ideological globalisation and internationalization, transnationalization, the Americanization and homogenisation of world culture, linguistic, culture and media imperialism (Tsuda, 1994) ” (p.274).
One view of English and globalization, then, views English as part of a process of global homogenization. Whether or not we wish to adhere to this particular version of imperialism, there are important concerns here about the relations between English and other cultural, political and economic relations. As Tollefson (2000) explains, “at a time when English is widely seen as a key to the economic success of nations and the economic well-being of individuals, the spread of English also contributes to significant social, political, and economic inequalities. ” (p.8). On the one hand, then, some see English as fulfilling “the perceived need for one language of international communication. Through English, people worldwide gain access to science, technology, education, employment, and mass culture, while the chance of political conflict is also reduced. ” Yet on the other hand, amongst other things, “the spread of English presents a formidable obstacle to education, employment, and other activities requiring English proficiency" (p.9). Phillipson’s (1992) book, Linguistic Imperialism, remains the clearest articulation of this position. As Tollefson (2000, p.13) explains “Phillipson’s analysis places English squarely in the center of the fundamental sociopolitical processes of imperialism, neo-colonialism, and global economic restructuring. In this view, the spread of English can never be neutral but is always implicated in global inequality. Thus Phillipson, in contrast to Kachru, argues that the spread of English is a positive development for some people (primarily in core countries) and harmful to others (primarily in the periphery). The spread of English, in this view, is a result of policies adopted by core countries to bring about the worldwide hegemony of English, for the benefit of core country institutions and individuals".
What Phillipson (1992) is arguing, then, is that English is interlinked with the continuing neocolonial patterns of global inequality. He explains:
We live in a world characterised by inequality - of gender, nationality, race, class, income, and language. To trace and understand the linkages between English linguistic imperialism and inequality in the political and economic spheres will require us to look at the rhetoric and legitimation of ELT (for instance, at protestations that it is a ‘neutral’, 'non-political’ activity) and relate what ELT claims to be doing to its structural functions. (1992, pp46-7)
According to Phillipson, therefore, English plays an important role in the structure of global inequality. The notion of imperialism in ‘linguistic imperialism’ thus refers not only to the imperialism of English (the ways in which English has spread around the world) but also to imperialism more generally (the ways in which some parts of the world are dominated politically, economically, and culturally, by other parts of the world). It is not a coincidence, therefore, that English is the language of the great imperial power of the 19th century (Great Britain) and also of the great imperial (or neocolonial) power of the 20th century (and probably the 21st) (USA).
Phillipson convincingly shows how, for example, “A vast amount of the aid effort has…gone into teacher education and curriculum development in and through English, and other languages have been neglected. A Western-inspired monolingual approach was adopted that ognored the multilingual reality and cultural specificity of learners in diverse ‘Third World’ contexts” (1994, p. 19). As he goes on to argue, “In the current global economy, English is dominant in many domains, which creates a huge instrumental demand for English. There has therefore already been a penetration of the language into most cultures and education systems" (1994, pp. 20-21). But the challenge here is to show not only that the global spread of English can be seen as a form of imperialism which is particularly threatening to other languages and cultures, nor only that this spread of English correlates with other forms of political and economic domination and thus reflects global inequality, but rather that there is also a causative relationship between the promotion of English and forms of global inequality, that English helps produce and maintain inequitable global power relationships. While it is indeed crucial to understand the political context of the spread of English, we need to be cautious of assuming that the effects of the spread of English are easily understood, that language is simply spread rather than learned, adopted, adapted and appropriated.
While this homogeny position views English as a reflex of global capitalism and commercialization, the alternative heterogeny position, as epitomised by the notion of world Englishes, views the global spread of English in terms of increasing differentiation. The interest from this perspective is on the ‘implications of pluricentricity…, the new and emerging norms of performance, and the bilingual’s creativity as a manifestation of the contextual and formal hybridity of Englishes’ (Kachru, 1997: 66). And yet, while Kachru’s world Englishes framework opens up questions of hybridity and appropriation, at the same time it all too often loses sight of the broader political context. As Canagarajah (1999a, p180) points out, Kachru “does not go far enough, since he is not fully alert to the ideological implications of periphery Englishes. In his attempt to systematize the periphery variants, he has to standardize the language himself, leaving out many eccentric, hybrid forms of local Englishes as too unsystematic. In this, the Kachruvian paradigm follows the logic of the prescriptive and elitist tendencies of the center linguists."