ESRC Seminar 6 Abstract
June 2006
Developing alternative communication strategies to facilitate communication
with Somali refugees in primary care
Authors: Marianne Johnson1, Zeinab Mohamed2, Gareth Evans2
School of Nursing1, School of Informatics2, The University of Manchester
Background: Significant numbers of Somali refugees and asylum seekers are still
entering the UK as a result of the continuing war in Somalia (Home Office, 2005).
Somali refugees tend to have very limited English and literacy skills as a result of
poor educational opportunities; consequently they experience communication
difficulties during healthcare consultations (Harris, 2004). Although communication
is deemed the single most important factor influencing the success of a consultation
(Hornberger et al., 1996; Fazil et al., 2002), many gaps and inadequacies pervade the
provision of language services for non-English speaking patients. Most studies
investigating language barriers still tend to recommend using professional
interpreters, link workers or Language Line (Gerrish, 2004, Rhodes & Nocon, 2003)
but no standardised alternative communication strategy exists in primary care when
these services are unavailable (Johnson, 2004).
Alternative communication strategy: This proof-of-principle study aimed to
develop and evaluate an alternative communication strategy to address this gap. This
strategy involves using a computer system containing pictographic symbols, bilingual
text labels and recorded Somali speech. It is designed as a tool to help Englishspeaking clinicians elicit information from Somali patients with limited English and
literacy. A live demonstration of how the system works will be given during the
poster presentation.
Evaluating this strategy: The success of the system was evaluated in simulated
asthma reviews with clinicians and Somali volunteers with asthma (Doss et al., 1991;
Dyches et al., 2002; Fried-Oken, Howard & Stewart, 1991). Preliminary findings
indicate that the communication aid enabled history taking between clinicians and
Somalis. A list of recommendations for improving the system for possible future
deployment within primary care is being compiled as a result of this proof-ofprinciple study.
References
Doss LS, Locke P, Johnston S, Reichle J, Sigafoos J, Charpentier P, Foster D. Initial
comparison of the efficiency of a variety of AAC systems for ordering meals in fast food
restaurants. AAC, 1991, 7: 256-265.
Dyches TT, Davis A, Lucido BR, Young JR. Generalization of skills using pictographic and
voice output communication devices. AAC, 2002, 18: 124-131.
Fried-Oken M, Howard JM, Stewart SR. Feedback on AAC intervention from adults who are
temporarily unable to speak. AAC, 1991, 7: 43-50.
Gerrish K, Chau R, Sobowale A, & Birks E. Bridging the language barrier: the use of
interpreters in primary care nursing. Health and Social Care in the Community, 2004, 12(5):
407-413.
ESRC Seminar 6 Abstract
June 2006
Harris H. The Somali Community in the UK: What we know and how we know it. King’s
College London, 2004.
Home Office. Home Office Asylum Statistics, 2nd Quarter, United Kingdom. 2005. [Website].
Available from: <http://www.homeoffice.gov.uk/rds/pdfs05/asylumq205.pdf> [Accessed
September 2005].
Johnson MJ. What can we learn from drawing parallels between people who use AAC and
people whose first language is not English? Communication Matters, 2004, 18(2): 15-17.
Rhodes P, & Nocon A. A problem of communication? Diabetes care among Bangladeshi
people in Bradford. Health and Social Care in the Community, 2003, 11(1): 45-54.