For several days this winter I was in a French hospital, in a small clinic on the southern edge of Paris. Like most of Paris's outer neighbourhoods it is home to many immigrants.
As I sat waiting to meet the anaesthesiologist who would put me to sleep, a few days later, a man came in. I think he had an appointment to see the anaesthesiologist also. I can only guess because neither the receptionist nor I was sure what he wanted as he spoke almost no French. I gathered that Spanish was his native language.
None of us, including him, was certain that the receptionist had directed him to the right place but as he couldn't make himself understood further he sat down and began to look at the sheet she gave him to fill out. I had just filled out that sheet. It required to list the medicines take regularly, any allergies, all the things the anaesthesiologist should know to try to prevent you from harm during the process. I don't know if he ever made any marks, for as I went in for my appointment, the man was still looking at the sheet with a confused expression. If I were the anaesthesiologist I wouldn't have wanted to anaesthetise him, since it was impossible to take his medical history accurately without a translator. I worried that the patient would leave, and not get the help he needed, but I also worried that he would stay and not get the help he needed.
In the tunnel
In the United States, activist groups have recently filed cases to force pharmacies, hospitals, nursing homes and clinics to provide language translations for people who cannot speak English. They contend that medical care must be provided in a language the patient understands. If not, they argue that medical services are discriminating based on national origin and thus violating federal civil-rights law. An article in the New York Times described one of the complainants in the litigating group's dossier - a 47-year-old woman who spoke only Spanish, she could not understand the printed instructions for her anti-depressant medicine, took too much and ended in the hospital.
Her story was touching and sad, but I wondered why an adult woman hadn't taken out a Spanish-English dictionary and figured out what the label said. It's possible that even with the dictionary, she would not have understood it, but if she couldn't work through that simple problem do how can she accomplish basic day-to-day tasks in an English-speaking country and what effect that had on her sense of self, well-being and security.
The United States has no national language although that is likely to change soon, and there are many programmes in place to accommodate people who don't speak English. A friend of mine in New York told me that his handyman, a refugee from the Bosnian war, had travelled from Manhattan in New York City to Staten Island where it was possible to take the test for a driver's license in Serbo-Croatian. After six years in the country the man's English is still rudimentary although his wife who works in an English-language office has mastered the language. She has to perform basic tasks.
But that gender split is an anomaly, more often it seems to be women who are trapped in the house and lack basic language skills, like Hawa Gréou, the Malian resident of France whom I wrote about in May 2007. After almost thirty years in France she still speaks only Bambara, a prominent language in her native Mali. As a result she was not able to obtain citizenship or any other legal protections because she relied on her husband to fill out forms and explain France's laws to her. Over the years he had acquired other non-legal wives who he preferred and didn't want her to stay. Because she can't speak French, she's been at his mercy. I've met many people who have lived in France for long periods of time without learning the language. Most of them are women and they are trapped in a community of their countrymen. Often they work in the home while their husbands work outside of it and acquire language skills.
Or there is the story I heard over brunch in London from a mother who would desperately like to set up a time for her son to play with his best friend at school. But the son's mother who picks him up is Bengali, speaks no English and - according to one of the teaching assistants at school, who is also Bengali - has a controlling husband.
From enclave to public square
I've travelled in countries where I couldn't speak the language at all and I hated it. It's infantilising to rely on someone to help you perform basic tasks and to be unable to express your wants and needs. After two years living in France, my French is good but not fluent. I'm much less likely to challenge a bill that's wrong or to call and demand better service for something. It makes me meek and keeps me vulnerable.
In France, lawsuits like the one proceeding in the United States would not be possible. In the past few years France has begun to require that anyone requesting residency for more than one year, prove a a certain level of language proficiency or take classes. And in December 2007, the national assembly passed an immigration bill requiring that even those between the ages of 16 and 65 who settle in France under family-reunification policies must pass a test proving that they speak French and have adequate knowledge of French laws and culture. If they fail, they will be sent to classes given by the French government and then tested again.
I disagree with parts of the immigration bill - I think family members who fail the test should be allowed to enter with a provisional visa and receive a permanent visa to be awarded once they've passed the examination in France. There is little fear of people abandoning their studies. Legal residency in a country is precious to people and few will want to relinquish it if they can avoid it.
Nicolas Sarkozy sharpened his profile in 2006 when as interior minister he designed a law on immigration and integration which (inter alia) requires French proficiency for immigrants. People who run French-language classes in poor immigrant areas say that their classes are now full. The same men who once prevented their wives from attending now bring them, fearing that they will be deported if they don't learn French. A feminist writer in France and I discussed this trend. She's a staunch socialist who disagrees with most of Sarkozy's policies. "What do you think", I asked? "Isn't it positive that women will have the tools to make choices about their lives?" Even faced with the evidence it was difficult for her to agree. Forced language-training goes against the principles of most leftists.
But why? In France, it is usually poor, older immigrants who exist in these enclaves or prisons of language and culture. Young people go to school. Wealthy people refuse to accept marginalisation. Language classes are expensive and require time. If there is a way to get around it, some people will, but that's a short-term outlook. Yes, forcing people to go to school is also a form of paternalism and anyone who has tried to learn a language as an adult knows how infantilising it is to hobble along in simple sentences. But citizenship constitutes a civic agreement and being a member of a society includes knowing how to function in it.
I've lived in a country, the Netherlands, for seven months without ever learning the language. Most Dutch people speak English and in many countries, English speakers can usually get away with being monolingual by staying in wealthy educated circles where English is often the common language. Newspaper signs and the overheard conversations mean that random encounters are rare. But I knew that I would always be a visitor if I didn't learn Dutch and I knew that I would always be a visitor if I didn't learn French.
Because of my French abilities I was able to go through an operation and a six-day stay at the hospital. I joked that I might wake up without my appendix but it was that: only a joke. I wonder about the poor Latina woman overdosing on her depression medication in New York and the Latino man who was unable to make himself understood at my Parisian clinic. Soon he'll learn French because it is required of him.