Careful Words: Nursing, Language, and Emotion in Papua New Guinea

ABSTRACT

Papua New Guinean nurses work in a sociomedical system in which cultural and linguistic diversity are matters of pressing concern. Using data drawn from ethnographic research with PNG nursing students, I show how nursing education socializes nurses to take stances toward language and communication that impact their care practices. I argue that nurses’ use of language is shaped by their ethical commitments as educated Christians and indigenous concerns about the links between language, emotion, and health. In a resource-poor setting where health workers risk blame for structural inequalities, this “ethical metapragmatics” is an important but neglected facet of care work.

KEYWORDS:

• Papua New Guinea
• care
• emotion
• language ideology
• professional nursing
• sexually transmitted diseases

Acknowledgments

Approval for this research was granted by the PNG Medical Research Advisory Committee (MRAC) and New York University’s University Committee on Activities Involving Human Subjects (UCAIHS). Many thanks to the staff and students of the college who kindly welcomed me into their workplace. All names are pseudonyms.

Funding

This research was funded by a National Science Foundation Doctoral Dissertation Improvement Grant (no. 1025306), a Wenner-Gren Foundation Dissertation Fieldwork Grant, and a Dean’s Dissertation Fellowship from New York University.

Notes

1. Though koap is the preferred term for sex in HIV/AIDS prevention materials, it is much less neutral than “to have sex” is in English, and is obscene in most contexts (Lepani 2012:27). Sik koap is an accepted medical term for venereal disease, but many health workers at the clinic used the euphemisms sik bilong ol marit lain (sicknesses of married people) or sik marit (married sickness).

2. Sister Gameharo’s interpretation of the HIV/AIDS Management and Prevention Act (2003) is quite liberal: Section 14.4(b) permits testing without informed consent if “the medical practitioner believes that the test is clinically necessary or desirable (i) in the interests of that person; and (ii) for the purposes of treatment of that person” (Independent State of Papua New Guinea 2003:11). Thus, while the legality of testing a pregnant woman without consent is questionable, because prevention of parent-to-child transmission is considered morally unambiguous, the nurse may have thought it in the best interest of the fetus.

3. All patients carry a Health Department-issued patient book. These books are intended to facilitate communication between health workers, who record their observations, diagnoses, and treatment plans in English.

4. Lewa and bel are not isomorphic with the anatomical liver and stomach; they are also the seats of emotion, where loss, sorrow, anger, and love are felt. It is unclear whether Sister Gameharo is speaking of physical or emotional pain.

5. Tok bokis and tok piksa have been extensively described by Schieffelin (2008a) in the context of missionary translation and teaching activities in PNG. Tok bokis, or “hidden talk,” refers to various forms of circumlocutory language meant to exclude outsiders—ways of speaking that tend to be marked as “indigenous” or “heathen.” On the other hand, tok piksa is more often used as a gloss for the English word “parable,” with the associated Christian resonances.

6. The Tok Pisin terms for uterus and placenta are both bilum bilong bebi (baby’s string bag).

Additional information

Funding

This research was funded by a National Science Foundation Doctoral Dissertation Improvement Grant (no. 1025306), a Wenner-Gren Foundation Dissertation Fieldwork Grant, and a Dean’s Dissertation Fellowship from New York University.

Notes on contributors

Barbara Andersen

Barbara Andersen is Lecturer in Social Anthropology at Massey University, Auckland.