Diabetes pamphlet for Atiu
A health NGO asks you to review a 12-page draft pamphlet on diabetes prevention, translated into Cook Islands Māori for a community hall meeting on Atiu. The draft uses “maki suka” for diabetes and translates “body mass index” and “portion size” literally. A nurse says older readers will not understand “BMI,” and some will stop reading at page 3. A translator says changing the terms will make the pamphlet “not the same message.” The audience is about 60 people, many over 60, some with low literacy; 20 copies will be read aloud. The meeting will also discuss weight, and a community worker warns that public talk about individual weight may shame people. The NGO wants the pamphlet finished in 10 days and has a small budget for one community test.
1. Which terms would you change, and how would you decide?
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Decision: Keep ‘maki suka’ if local speakers use it, but gloss it once. Replace ‘body mass index’ and ‘portion size’ with everyday measures.
Reasoning:
- ‘Maki suka’ is widely used in Cook Islands health communication, so replacing it entirely could confuse people who already know it. The problem is not the term itself but assuming everyone knows it. Add one plain gloss at first use.
- ‘Body mass index’ has no everyday equivalent. A literal translation preserves the English concept but not the meaning. Replace it with a waist measurement and a simple explanation, or with a statement about healthy weight that a nurse can explain.
- ‘Portion size’ can be rendered with local food measures: a plate, a coconut shell, a handful, or a number of pieces. These are not exact, but they are usable. The nurse must check that the advice is still medically safe.
- Do not change medical facts to make the text simpler. Simplify the language, not the advice.
Test: Ask 5–6 elders and 2 younger readers to explain the terms back to you. If they cannot, the translation has failed even if it is literal.
2. How would you run the one community test?
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With one small test, I would focus on comprehension rather than politeness:
- Recruit 6–8 people at the community hall: mostly elders, plus two younger readers who will read aloud to others.
- Read the pamphlet aloud in short sections, stopping after pages 2, 5, and 8. Ask: ‘What would you do after hearing this?’ and ‘Which words are hard?’
- Mark stopping points. If people stop at page 3, find out whether the problem is the term, the sentence length, or the page design.
- Check the food examples. Ask what a ‘portion’ looks like in their kitchen. If they name local measures you did not use, adopt them.
- Have the nurse review the revised text for medical accuracy before printing.
Reasoning: A community test is not a popularity vote. It is a check on whether the intended action is clear. The budget is best spent on a small, structured test and a nurse review, not on a larger print run of an unreadable draft.
3. How would you handle the weight and shame issue in the text and at the meeting?
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I would separate the health message from public personal disclosure:
- In the text: avoid labels such as ‘fat’ or ‘overweight person’. Use ‘healthy weight’ and talk about family and community action: food at gatherings, walking groups, gardening, and shared meals. Say that weight is one part of health, not a moral judgement.
- At the meeting: do not ask individuals to state their weight or waist size in front of others. Offer a private check with the nurse. If a demonstration is needed, use a volunteer or a tape measure on an object, not on a person.
- Use respectful language. In Cook Islands Māori, direct public comment on someone’s body can shame the person and their family. The community worker should lead this part, not an outside translator.
- Give people a choice. Say clearly that no one has to be weighed or measured to attend.
Reasoning: A pamphlet that causes shame may be medically accurate but socially ineffective. The judgement is to protect dignity while keeping the health advice clear.