Crossing Idiomas: Negotiating Translingual Rhetoric within Global Health Publics

Abstract

Increasing numbers of U.S. students and practitioners in the health professions travel annually to developing countries with global health programs. In these programs, visiting practitioners and local residents often work side-by-side to serve marginalized communities in need of better access to medical and dental care. This transnational public engagement in global health requires collaborative work among individuals with varied backgrounds of language, culture, class, and status. Health teams must develop communicative strategies to negotiate these differences and connect with their patients. This qualitative study examines these strategies for cross-cultural communication with two groups of volunteers that ran temporary health clinics in the Dominican Republic. Drawing from ethnographic methods (interviews and participant observation) and a methodology of rhetorical engagement, I examine how Dominican volunteers and visiting health practitioners assembled to form "emergent collectives" that collaborated across linguistic and cultural differences. I also analyze how individuals developed translingual rhetorical strategies that negotiated languages, dialects, and non-verbal gestures to support performances in the clinics. Using grounded practical theory, this study analyzes the communicative problems that volunteers encountered with varied proficiencies in English, varieties of Spanish, and medical terminology. It then examines the rhetorical strategies participants developed in response to those problems to interpret across English-Spanish, Spanish-Spanish, and non-verbal tactics. Although U.S. participants noted that the rural, Dominican dialect of Spanish of the local community was stigmatized, globally, I argue that it was considered the most "useful" form of Spanish to connect with patients and support performances in these clinics. By recognizing the integral support of the local volunteers' use of Spanish-Spanish interpretation and how U.S. participants performed language in ways to "sound more Dominican," I assert that vernacular language use was crucial to assembling as a collective and effectively caring for patients. This dissertation demonstrates how a situated health context outside of the U.S. can illuminate the complex "messiness" of translingual rhetoric in practice for transnational publics. Ultimately, this project encourages a collective approach to translingual rhetoric and advocates for more narratives that incorporate the vernacular voices of local volunteers working "on the ground" of global health.