“I’m sitting here and all of a sudden I feel ‘Chik!’ in my foot. And then another ‘Chik!’ in my hand. ‘Chik!’ here and ‘Chik!’ there and everywhere.” She pauses, and then for good measure adds, “Chik!” With each “Chik!” she jumps in the chair and quivers slightly, acting out her reaction to the sharp electrical pain she feels in her hands and feet as a result of diabetes. In the hospital in Haiti, the patients demonstrate a colorful reliance on tone, gestures and onomatopoeia to accentuate their feelings.
Haitian Creole is a pidgin language based on altered French vocabulary and aspects of West African grammar, and has been used on this island for 200 years. Spoken mostly by impoverished subsistence farmers, Creole wasn’t a written language until recently, and nearly half of Haitians are still illiterate. Like most languages, Creole mirrors the culture and people from which it is born. Haitian culture is vibrant and boisterous, and Haitians communicate with large gesticulations as much as my Italian family members. It makes sense that the Creole language is colorful, playful and onomatopoeic.
I remember learning the word “onomatopoeia” in fifth grade English class. We studied a special and bizarre word every week. Mrs. Mulaney snuck the valuable word in among the more esoteric ones such as “lagniappe” and “agape.” Don’t ask me why, but I memorized how to spell onomatopoeia by singing it syllable by syllable to the verses of “All I Ask of You” from the musical Phantom of the Opera. After that, the word never signified much more than a literary tool used to dress up an otherwise boring paragraph. SPLAT! (See, it works!). In Haitian Creole, however, onomatopoeia is not used in writing as much as it is used in speech.
The word for earthquake reflects the nature of the phenomenon, providing the most striking example of Haitian onomatopoeia. Earthquakes strike Haiti with relative frequency, a fact of life for a mountainous country located on two tectonic fault lines. In English, the sound of an earthquake has been described as a low-rumbling, like a freight train passing. The Creole word goudou-goudou reflects the sound that the ground makes as it shifts from side to side, and the harsh consonants combined with the long vowels evoke images of the ground rumbling beneath your feet in the past and small wooden shacks swaying in the countryside. After January 12, 2010, when the 7.0 magnitude earthquake ravished much of the country, a new respect for the power of the earthquake was born. Most of the urban denizens of Port-au-Prince who witnessed the concrete structures of the modern city crumble now reverentially refer to earthquakes as tranbleman te a, a modified version of the French term — tremblement de terre.
Mrs. Mulaney’s definition of onomatopoeia was the formation of a word by imitation of a sound made by or associated with its referent (meow, honk, boom). In Haiti, onomatopoeia is not always used as Mrs. Mulaney taught us, but the other dictionary definition: the use of imitative and naturally suggestive words for rhetorical, dramatic or poetic effect. Haitians are nothing if not dramatic and poetic. When a Creole speaker can’t find words to express the emotions, the concepts, the extreme sensations that they wish to convey, onomatopoeia fills the gaps.
Another common practice is to use hand gestures with word repetition to emphasize the meaning. Wo or gwo — meaning tall or big — can be repeated to accentuate the extreme height or large girth of an object or person. “Li wo wo wo” or even “Li wooooooo” both mean it’s very high, reinforced by the hand raised as high above the head as the arm will stretch.
“Li fe mal aannnpiiiiiiiiiiil!” a patient cries out, throwing her head back, lips contorted in a grimace while a high-pitched squealing sound emanates from within. She’s not in pain at the moment but is merely illustrating the pain that wrenched her flank as a kidney stone traversed her kidney, descending to the bladder. She elevates the pitch in her voice to convey agony without using many words.
“Woy. Woy. Wooiiiiyy,” the woman in labor wails out in quick succession, a natural and antique method of Lamaze breathing. Haitian women have embraced that same “Woooy!” to express any painful experience, especially those associated with medical care in a hospital such as sticks with a needle or knife. Children of both sexes have adopted the “Woy!” as well. Situated next to the pediatric ward during my clinic days, I hear the rapid fire “Woy! Woy! Woy!” of the children as the nurses draw their blood or inject medications. Only grown men do not use the familiar cry to bear pain in the hospital.
Since I’m limited by a small vocabulary in Creole, I’m grateful that patients communicate with me so passionately. In the United States, I often receive the answer of “11” when I ask patients to rate their pain on a scale of 1 to 10. In Haiti, I can follow their hands or the pitch of their voice to feel their pain and experience their feelings.
Vincent DeGennaro is an internal medicine doctor and a global public health specialist at the University of Florida’s Division of Infectious Diseases and Global Medicine and works half time in Haiti with the nonprofit Project Medishare. See his An American Doctor in Haiti blogs.