The Blessingway: A New Language for Cancer in Navajo

by Translation Guy on March 1, 2010

In old age wandering on a trail of beauty, lively, may I walk.
In old age wandering on a trail of beauty, living again, may I walk.
My words will be beautiful.

Among the Navajo, the Blessingway [Hózhójí] is used to bless the “one sung over,” to ensure good luck, good health and blessings for all that pertains to them. It is sometimes described by English-speaking Diné (the term members of the Navajo Nation call themselves, meaning “The People”) as being “for good hope.”

But the beautiful tongue is stilled when talk turns to death. Discussion of death is forbidden in the language of the Navajo people. This creates problems for health care givers when cancer is the diagnosis.

Martha Austin-Garrison, Navajo language instructor at Diné College, says, “We all know from way back that people would talk about cancer as the sore that does not heal. When you hear that, it’s such a fear. People don’t want to hear about death or dying.”

The moment a doctor diagnoses a patient with cancer, the conversation ends. The old terms, translated from English years ago, are not only technically inaccurate, but culturally misleading and inappropriate, causing emotional distress and defeating the goals of early screening and detection.

So a new initiative, with Austin-Garrison as head translator, has lead to a new way to discuss cancer within Navajo communities.  By providing literal translations, editors of the glossary can ensure terms meet National Cancer Institute expectations and regulated language used by medical professionals across the Navajo Nation.

“Federal officials will know what is being said in Navajo,” says Austin-Garrison. “They can use this to assess the accuracy and appropriateness of the words. There never has been a standardization. Different patients got different translations from different doctors. That’s emotionally and psychologically inappropriate.”

In Indian Health Service hospitals and clinics across the 27,000-square-mile reservation, doctors rely on bilingual, English-Navajo translators to relay diagnoses to patients. Austin-Garrison believes a glossary will help translators communicate a positive and hopeful message.

“As clinicians, we need to learn the terminology,” she continues. “We’re not going to learn the language, but if we know the terminology, the translators can relate that.”

New translations focus on understanding and respecting the Navajo language, as well as native views of disease and illness. Interpretations of medical conditions have been changed to reflect positive thinking, hope and compassion, starting with the definition of cancer and covering topics from prevention and diagnosis to treatment and recovery.

“The ultimate goal of the glossary is the education of the Navajo people,” Austin-Garrison says. “We need to enhance the quality of communication between medical providers and Navajo, particularly when the patient is Navajo and the provider is not. The bottom line is that language affects the survival rate of patients.”

While Navajo is my favorite language, I am personally and professionally committed to the support of any initiatives for terminology standardization and shared translation memory resources that can help cancer patients receive the care they need, regardless of the language they speak.


  1. Bugga-aba says:

    Every patient with cancer has the right to get clear information about the diagnosis and treatment so he or she can take full part in making decisions. Most medical centers have trained interpreters or have other ways to help with language differences.

    • Ken says:

      Its those “most medical centers” with their “other ways to help with language differences” that gives me the heebie jeebies.

  2. Nancy says:

    If cultural beliefs will affect decisions about treatment and care, the health care team needs to be made aware of this beliefs, is that also a role an interpreter would play? That’s knowing more than a language, but understanding an entire culture and all of its intricacies

    • Ken says:

      Nancy, interpreters are often put in the role of cultural broker in a health care setting. It is a difficult role to balance. Professionals manage better than amateurs. Trained professionals the best of all. (Not all professional translators are trained, especially in less-commonly translated languages.)

  3. This has been more studied in Hispanics. In patient-level analyses, evidence of socio-economic disparities in breast cancer decision-making and treatment were found in Hispanics:

    • Ken says:

      Heather, I’ve only gotten as far as the abstract on your citation before I found something I thought was very interesting…

      “4) Treating more limited English-proficient patients was associated with decreased physician satisfaction with time spent with patients; 5) Greater intensity of interpreter service use ameliorated some of this dissatisfaction.”

      This gets to the problem that doctors have with patients who don’t share their language. It cramps their style. And unhappy campers are likely to avoid camping, or with working with people who don’t speak their language. Language barriers will do that.

  4. Uka says:

    The Intercultural Cancer Council (ICC) is a great resource and often helps with such issues.

  5. That’s ridiculous, poor Navajo’s who want to have something treated but are peer pressured to go the natural route..

  6. Ty J. says:

    This is definatley a huge barrier in cancer care and I applaud you for taking the time to bring it to the masses Ken 😉

  7. Willy Wong says:

    Reducing Barriers to Cancer Care is a dedicated cancer outreach effort for Chinese immigrants living in New York City. Do the Navajo have any representation such as this?

  8. Peevo Swally says:

    There is no doubt that lack of cultural competency increases disparities in cancer care …

  9. Delicisou says:

    Interesting read. I’ve always considered that decisions about treating cancer have been based largely on clinical factors such as efficacy, safety, and patient quality of life, but what about cultural beliefs, nice spin.

  10. Amanda Ray says:

    Cancer resources for languages other than English can be found here: I hope this helps someone.

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