## No word for normal parts of early childhood?

Ian Preston wrote to draw my attention to this new item for our No Word for X archive — Thomas Brewer, "Giving Childhood Diarrhea a Name", Bill & Melinda Gates Foundation, 7/20/2013:

Over the course of my career I’ve spent over thirty years working in various developing countries trying to better understand and fight infectious diseases. One of the things that alarmed me most was that in many places, parents and caretakers didn’t even have a word for diarrhea. Sadly, this wasn’t because diarrhea was rare. On the contrary, diarrhea was so common that it was seen as a normal part of early childhood, and thus didn’t need a name.

No doubt Dr. Brewer has been doing a wonderful job bringing public-health research and services to the third world. But he himself is suffering from an acute case of the highly-infectious "no word for X" trope, and our generic advice about metaphorical hygiene applies: If someone tells you that one or more languages have no word for X, or if you find yourself using this figure of speech to make a social or cultural point, you should seek metaphysical treatment immediately.

It's hard to know exactly what languages Dr. Brewer has in mind, but he mentions Mali, and an online English-Bambara dictionary has

diarrhoea      kɔnɔboli

He also mentions Mozambique, where according to Ethnologue one of the major languages is Tsonga, for which an online dictionary gives

Chuluka ~ Diarrhoea ( have diarrhoea )

Swahili is a sort of lingua franca in the area, I believe, and Charles Rechenbach's 1967 Swahili-English Dictionary has

harisho (ma-) 1. med. diarrhea.

The strangest thing here is Dr. Brewer's logic: among the many things that are a normal part of early childhood, and for which many languages including English nevertheless have words or phrases, are babbling, crawling, diaper rash, burping, suckling, smiling,

I'll leave it to readers to find the words for diarrhea in various other African languages.

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1. ### Howard Oakley said,

July 23, 2013 @ 2:06 pm

He seems to expound an 'inverse Eskimo snow' law, that the more common and everyday something is, the less likely we are to have a word for it – as (not) exemplified by air, water, earth, and so on.
Howard.

2. ### Matthew Heberger said,

July 23, 2013 @ 2:34 pm

Dr. Brewer's logic doesn't hold water, as far as Mali is concerned. The lack of good epidemiological evidence on the causes of illness are due to a lack of surveillance and public health infrastructure in a poor country, not because of any linguistic limitations. Indeed, every Bambara speaker knows the word "kɔnɔboli," or running stomach, and the country's other major languages have words for diarrhea (an online Peulh dictionary shows two). And yes, while diarrhea is common, no one thinks its normal or desirable. While they may not understand the concept of microbes and transmission pathways, it IS regarded as an illness.

3. ### JB said,

July 23, 2013 @ 2:48 pm

That's interesting. He's not saying he's encountered languages without these words though, is he? He's saying parents and caretakers – not doctors – don't use them (or don't report and categorise diarrhoea as a symptom of illness?)

"Cholera was the only form of diarrhea with a name" does sound as if the vaccination clinic had some form of communication problem, though. Is there an issue here with differing taxonomies for illness in different languages, as with the French crise de foie?

4. ### GeorgeW said,

July 23, 2013 @ 3:59 pm

Arabic children (and adults) occasionally suffer 'ishaal.'

George

5. ### Matthew Stuckwisch said,

July 23, 2013 @ 5:32 pm

From my time working in poor rural areas in the States, I found often I'd come across random words that I'd've thought were in very common use across the English-speaking world that were not understood by many. I'd agree with JB that it's not an issue of the language not having a word, but perhaps simply the idiolects not having them or perhaps even not make meaningful (to care providers) distinctions in their use.

One can imagine something like strep throat not needing to be differentiated from a viral sore throat if it's common and medical care isn't sufficient such that treatment would otherwise be different. Maybe not the best parallel, but, meh.

6. ### markonsea said,

July 23, 2013 @ 5:47 pm

Matthew Heberger: "Indeed, every Bambara speaker knows the word "kɔnɔboli," or running stomach …"

Maybe Brewer thought people were telling him "kids get runny stomachs" because they didn't have a word for diarrhoea?

7. ### Steve said,

July 23, 2013 @ 7:16 pm

I don't think the analogy to English (and other languages) having words for many "normal" aspects of childhood (crawling, babbling, diaper rash, etc.) is apt. We have words for "normal" activities (crawling, babbling), but the relevant "normal activity" here is pooping, and, presumably, nobody would claim that the African cultures discussed here don't have a word for "pooping": what Dr. Brewer is alleging (apparently falsely) is that they don't have a word for a very characteristic form of pooping that is regarded as medically significant by our culture (and many others).

A more apt analogy would involve a word (or phrase) that is used to describe a very specific form of a generally "normal" behavior or phemonon, that, when it manifests in that particular way, is or can be a marker of one or more serious medical conditions.

I can't think of a great analogy off hand, but, broadly speaking, ISTM that neither a word-for nor a no-word-for finding would tell us much about the relative incidence of that disease in that culture. Nor would the presence or absence of a word for that particular form of behavior, in and of itself, tell us (at least with any reliability) whether the medical significance of that finding was well-understood. Put simply, it seems to me that there is a vast range of factors that could all impact whether a culture does or does not have a word for a particular manifestation of a general phenomonon, and, thus, that fact alone doesn't tell us very much.

July 23, 2013 @ 10:27 pm

"I'd've"

cool – double contraction

9. ### Uly said,

July 23, 2013 @ 11:55 pm

Maybe what he meant is that they only bother to use a word for it if it is cholera, but most of the time what WE would consider "the runs" THEY consider "normal sort of poop for a kid", so they don't bother naming it or bringing it up with a doctor?

10. ### Milan said,

July 24, 2013 @ 4:19 am

My guess would have been that, if the claim had any foundation, the culture in question would lack the concept childhood diarrhea as an illness. What would be translated as "childhood diarrhea" would then refer to the same phenomenon, but through a very different concept — the one of a normal, not a pathological condition, and there would indeed be no word to refer to our concept of diarrhea.
But all this is moot given that Matthew Herberger unambiguously made clear that diarrhea is regarded an illness in at least one of the cultures in question. And he most probably knows better than I.

11. ### Breffni said,

July 24, 2013 @ 4:29 am

Matthew Stuckwisch:

One can imagine something like strep throat not needing to be differentiated from a viral sore throat if it's common and medical care isn't sufficient such that treatment would otherwise be different.

That's an interesting example, because my impression is that Irish (and British?) people "don't have a word for" strep throat, in the sense that the term is not common currency outside medical circles, or maybe even within them (US vs GB "strep throat" in Google ngram viewer). I think I've only heard the term in American contexts, and I can't think of a simply synonym ("bacterial pharyngitis" isn't really a thing either).

If that's the case, it doesn't seem likely that this difference has to do with different standards of medical care: presumably Irish/UK doctors can distinguish between bacterial and viral throat infections and treat them accordingly. And note that even in the US, the graph I linked to suggests that "strep throat" only really started to take off around 1950, with a big and fairly continuous rise starting around 1970. That hardly reflects mid-century advances in medical science.

12. ### Nick said,

July 24, 2013 @ 8:12 am

We Brits don't have a word for Strep throat because our doctors don't bother with taking a swab and charging big \$ to grow a culture for a condition they know will resolve itself in a matter of days.

All a matter of profits for US physicians.

13. ### J.W. Brewer said,

July 24, 2013 @ 9:35 am

Atul Gawande has a relevant story in the current (7/29 cover date) New Yorker which includes the inspiring tale of how Bangladesh was able to reduce childhood deaths from diarrhea over 80% from 1980 to 2005 (via the nationwide implementation of a very low-tech treatment that could successfully be carried out in the absence of trained medical personnel by illiterate village parents using ingredients already at hand if but only if the numerous practical and cultural barriers to teaching millions of illiterate village parents what to do in a fashion that ensured they would in practice be likely to really do it once the well-meaning educators left town could be overcome). The same approach has worked equally well wherever else adopted in the 3d World, but level of successful adoption has apparently been quite variable. Presumably Dr. Brewer (no relation afaik) has worked in countries where it hasn't gone so well. Gawande attributes the failure in other countries to attempts to take a top-down light-touch approach that was not as labor-intensive in terms of "sandals on the ground" as the approach (with a lot of trial-and-error adjustment as it went forward) that worked in Bangladesh. That may not be the whole story, but what's relevant here is that Gawande does NOT attribute the stunning success of the initiative in Bangladesh to any special/magical properties of the Bengali language, lexical or otherwise.

14. ### Brian Hillcoat said,

July 24, 2013 @ 11:21 am

What the heck kind of English is the word "diarrhea" (or "diarrhoea" as I learned it) anyway? In Scotland we used to call it "skitter".

15. ### R McElreath said,

July 24, 2013 @ 11:32 am

Re the Swahili, the common term when I was working in Tanzania in the late 90's and early 00's was "tumbo la kuendesha", which seems much like the Bambara "kɔnɔboli" as it means "driving (causative) stomach". That is, it isn't the stomach that is driving, but the person being driven by their stomach.

I wonder if this is a common metaphor in Bantu languages?

Many of the languages in Tanzania will be perhaps contaminated by Swahili, but I'd be curious to hear from other Africanists about languages in other regions.

16. ### Pete said,

July 24, 2013 @ 11:34 am

In Northern Ireland it's called "skitters" or "the shites".

17. ### Jerry Friedman said,

July 24, 2013 @ 11:53 am

Milan: We don't know that the cultures Matthew Heberger provided information about are the relevant ones.

18. ### blagio said,

July 24, 2013 @ 12:47 pm

In the part of Italy I live in is called "cacarella", but "diarrea" is the word of choice, because the former has a slightly humorous connotation.

19. ### Theophylact said,

July 24, 2013 @ 2:15 pm

In the wonderful film A Private Function the term "the squits" is used.

20. ### J.W. Brewer said,

July 24, 2013 @ 2:15 pm

The Gawande piece I referenced above re how to communicate apparently successfully in Bengali re saving children from diarrhea-related death is here http://www.newyorker.com/reporting/2013/07/29/130729fa_fact_gawande?currentPage=all. I would have provided the link in my earlier comment had I not (falsely but reasonably . . .) assumed it was behind a paywall.

21. ### John said,

July 24, 2013 @ 2:35 pm

It seems unlikely for any language to not have a word for it, if only because English has so many. The squits, the shits, the runs, the trots…

I wonder if he meant there's no word in the technical register? I.e, ordinary people are perfectly content to say they have a "runny stomach", but (whether in Brewer's opinion or their own) that's not a term worthy of use by a trained doctor, yet they have no suitable alternative to describe that particular symptom?

22. ### Xmun said,

July 24, 2013 @ 3:00 pm

When my (adult) son told me he had been suffering from a "24-hour indisposition", it took a few minutes and a few more clues from the conversation before I understood what he meant.

23. ### Daniel Barkalow said,

July 24, 2013 @ 3:13 pm

It might be worth considering the term "stomach flu", which often leads English-speakers to believe that it has some relationship to the influenza virus. There's an awful lot of ambiguity between symptom-based descriptions and cause-based descriptions of diseases in that area in English, which means that it's often hard to communicate good treatment, detection, and prevention information to patients. I could imagine that such an issue, presented by a non-speaker of the language in question, might end up as a "no word for" claim.

24. ### Bruce said,

July 24, 2013 @ 3:17 pm

Apart from getting into the "no word for xxxx" business, there is the question of whether there is a COMMON word for it, and still more restrictively how commonly it is accurately applied. In the case of certain medical conditions, social norms hinder accurate identification.

Case in point: piano students are taught that Robert Schumann injured his hands by use of weights and pulleys for individual fingers. Other sources say he was suffering from side effects of mercury treatment for syphilis, which of course you can't possibly mention to a 10-year-old piano student.

25. ### Jeffry House said,

July 24, 2013 @ 4:09 pm

I think John may be right that a technical word, one that adequately differentiates the symptoms from other defecation from the doctor's point of view, may be missing. Where I grew up, we pooped, or we had rumbly tummy. The latter required a lengthy trip to the loo.
At the hospital, maybe they had diarrhea, but we didn't.

When I was young, there was no technical word for Alzheimers'; there was only "senile", which seemed to be a natural attribute of "seniors". Similarly, no one was autistic; they were dumb, or self-involved, or maybe narrow-minded.

26. ### Alex Bollinger said,

July 24, 2013 @ 6:03 pm

Wait, I thought it was "More common ==> more words," but here it's "so common ==> no words." Does the "no word for X" trope loop around when something becomes more common than snow is for eskimos? (That creates a terrible mental image in this context.)

27. ### Matthew Heberger said,

July 24, 2013 @ 6:58 pm

In reply to Jerry Friedman: the Bambara and closely-related Mande ethnic groups make up over half the population of Mali, and 80% of the population speaks the Bambara language, making it the countries lingua franca. But Dr. Brewer could have been referring to the Songhai, Tuareg, or any of the many other minority ethnic groups.

I am part of a group that is leading an effort to translate the book, "Where There is No Doctor" into Bambara, hence my interest. We do come across the problem of "no name for that" a lot. Usually, our translators just transliterate a word from French. But I understand that the Chichewa translators coined a number of new terms while adapting the book for Malawi.

28. ### Jerry Friedman said,

July 24, 2013 @ 7:34 pm

Matthew Heberger: Dr. Brewer didn't say that there was no word for "diarrhea" in some places in Mali, only that he had worked in many places where there was no such word and Mali was one country he had worked in.

I wish your group the best of success!

29. ### Ben said,

July 25, 2013 @ 8:33 am

Nick: Do you also not have a word for rheumatic fever?

Best not to leave strep throat untreated…

30. ### Metaphorical Hygiene | The Library Basement said,

July 25, 2013 @ 8:54 am

[...] a recent Language Log post: If someone tells you that one or more languages have no word for X, or if you find yourself using [...]

31. ### Michael Briggs said,

July 26, 2013 @ 2:53 am

My grandparents (English speakers, UK) didn't have a word for "teenager" even though their children didn't somehow skip from 12 to 20 overnight.

32. ### Nick Lamb said,

July 26, 2013 @ 10:28 am

"so common that it was seen as a normal part of early childhood"

Note that for Rotavirus, one of the pathogens mentioned in this article, that's true in plenty of the developed world too because Rotavirus is still endemic. Young children contract rotavirus, gastroenteritis follows, they experience diarrhoea or vomiting or both, and then usually the symptoms subside. Parents rarely report this, unless the disease was unusually severe, and arguably they are right not to, just as many of us get flu each winter, self-medicate with pain killers and feel better after a few days, why waste a doctor's time getting a diagnosis, there's nothing they can do but offer sympathy anyway.

But we do now have a vaccine for Rotavirus, in a generation or two a child with diarrhoea might constitute an exceptional occurrence in the developed world, something to urgently speak with a doctor about, because it is no longer a "normal part of early childhood" in the same way that you'd go to a doctor if your child had a strange rash now. Vaccination was scheduled to begin in the UK this month, it has been under way for some time in the US.

33. ### hanmeng said,

July 26, 2013 @ 11:13 pm

I saw "the squitters" in some novel. Probably not African.