Multi-lingual and multi-cultural information systems

Multi-electronic publishing will provide information to various audiences, helping them to select from options using information in respective languages (Ghonaimy 2000). The languages of different communities in South Africa are part of cultural diversity. Language has an intrinsic value closely connected with the cultural identity, knowledge and understanding. Information technology has a potential of shaping the future of cultures and languages. It is important to discuss how technology will affect the identity, culture and creative diversity amongst the communities in the country.

Currently health information and services, both paper-based and electronic, are dominated by the English language, and medical terms and health concepts have been derived from English. The domination of English in health service environment creates divisions in health literacy (high and low health-literacy levels). A pertinent question is: Can culture and language diversity be preserved in health information development and health service delivery without losing the essence of these aspects? How much does it cost to do this preservation? These are the questions to be grappled with towards e-health in South Africa.

Within societies there are health professionals and theses are leading the way in the area of health service delivery and development. Their social positions, values and expectations differ fundamentally from the target group (Mbananga forthcoming).

These health professional groups take a dominant position and define what knowledge mix is required for whom, what quality is good or bad, who is educated or not. The consequence is to overvalue professional knowledge versus the understanding of the importance of fundamentals and wisdom imbued in other information. There will be an increasing conflict between the minority of knowers and the majority who only understand living in traditional ways (Mbananga forthcoming). Likewise, Drucker (1994) suggests that poor communities with less knowers will turn into poor and ignorant countries. How this problem can be averted in South Africa centres on the issue of the development of health concepts and terminology in the eleven languages.

A significant step to be taken would be to find ways of preventing the clash between health professionals and consumers (Mbananga forthcoming). The clash is not only promoted by the difference between professional knowledge and consumer

knowledge only, but also by the lack of equivalent health concepts or terms in African languages in South Africa. The potential of a cultural clash might increase with the influx of different information. How to divert this cultural clash is going to be a challenge for information technology (e-health) in South Africa. There are notions that cultural information, through records, reports, maps and charts, discloses reality more widely than professional knowledge (Eysenbach et al. 2001). In situations where health records, and other general health information materials, do not include cultural information, reality is obscured. Socio-cultural information provides for reordering and enriching reality (Mbananga forthcoming). Information technology potentially lifts both the illumination and the transformation of reality to another level of power while it is also providing a new kind of information for easy access to consumers. Health information and services through the power of technology is supposed to be received as the arrival of reality. This can be realised if the language of consumers is used.

Clearly electronic health information will need to be tailored to the socio-cultural and linguistic landscape of the South African population if it is to be useful and developmental. If this approach is neglected, information technology (e-health) will create a new division between haves and have-nots or deepen the old division.

7. Conclusion

There is a need to focus energies on devising uses for new technology that will enhance people’s lives, improve health status and serve the values that people hold in common. How e-health will enhance the health status of ordinary people in South Africa depends on how the language and cultural diversity is incorporated in its conceptualisation and development. Central to this process is the development of health concepts and medical terms in the eleven languages of health consumers. This is posing a question: How far has South Africa moved towards the development of medical terminology and health concepts in African languages?

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