Problems of communicative competence in multi-cultural medical encounters in South African health services

Research in health communication shows communicative competence to be an important aspect of successful health-care. Definitions of competence involve more than the participants, however; the position and status of these participants in terms of the medical hierarchy and accepted paradigm, the language of choice, educational levels and a host of other variables affect relationships and perceptions of competence. This article grapples with a number of issues that impact on communicative competence in the health-care professions, given the multi-lingual and -cultural society within South Africa as well as emerging shifts that foreground this debate. In particular, the thorny question around language use, the hegemonies of the past regarding a dominant lingua franca and subsequent issues involving translation and interpretation are discussed.