“Ngiyashisha, ngiyajuluka

ebusuku” A YOUNG MAN WITH

FEVER & NIGHT SWEATS
Initiating the session
Doctor: Sawubona mnumzane.
(Hello, sir)
Patient: Yebo, sawubona, dokotela.
(Hello doctor.)
Doctor: Igama lami ngingudokotela …….
(My name is Doctor ……)
Doctor: Ngubani igama lakho?
(What is your name?)
Patient: Igama lami ngingu……….
(My name is…………)
Doctor: Ngubani isibongo sakho?
Initiating the session continued
(What is your surname?)
Patient: Isibongo sami ngingu……….
(My surname is………...)
Doctor: Uneminyaka emingaki?
(How old are you?)
Patient: Ngineminyaka ewu-25 dokotela.
(I am 25 years old.)
Doctor: Uhlalaphi?
(Where do you live?)
Patient: Ngihlala eMlazi.
(I live in Umlazi.)
Identifying the reasons for consultation

Doctor: Uphethwe yini namhlanje Wandile?

(What is troubling you today Wandile?)
Patient: Dokotela angiphilile kahle, Ngiyancipha emzimbeni futhi
ngiyashisa.
(I’m not well doctor. I’m losing weight and my body is hot)
Background information: Biomedical
perspective
Doctor: Kuqale nini ukugula?
(When did you become ill?)
Patient: Senginenyanga dokotela ngigula.
(It has been a month doctor)
Doctor: Futhi uyancipha?
(And you losing weight as well?)
Patient: Yebo ngiyancipha kakhulu emzimbeni.
(Yes I’m losing weight)
Doctor: Uyakhathala?
(Are you feeling tired?)
Patient: Yebo uyakhathala umzimba wami wonke dokotela
(Yes my whole body feels so tired)
Biomedical perspective continued
Doctor: Uyajuluka ebusuku?
(Do you sweat at night?)
Patient: Yebo, ngiyajuluka kakhulu ebusuku dokotela.
(Yes I sweat a lot at night doctor)
Doctor: Kukhona yini futhi okuhambisana nalokhu kugula kwakho?
(Anything else that goes with your illness?)
Patient: Yebo dokotela isifuba sami sibuhlungu.
(Yes doctor, my chest is painful.)
Biomedical perspective continued
Doctor: Sibuhlungu?
(Is it painful?)
Patient: Yebo, dokotela.
(Yes doctor)
Doctor: Kuba buhlungu kakhulu uma uphefumula?
(Is it worsened by breathing?)
Patient: Yebo, kubuhlungu kakhulu uma ngiphefumula noma ngikhwehlela futhi sibabuhlungu.
(Yes, it is very painful when breathing and coughing.)
Doctor: Ukhwehlela nini?
(When do you cough?)
Patient: Ngikhwehlela zonke izinsuku dokotela emini nasebusuku ngiyakhwehlela
(I cough everyday doctor, day and night)
Biomedical perspective continued
Doctor: Siyaphuma yini isikhwehlela?
(Is there sputum?)
Patient: Yebo, siyaphuma dokotela.
(Yes, there is doctor)
Doctor: Sinjani?
(What is the sputum like?)
Patient: Simhlophe.
(It is white.)
Doctor: Kulungile siyaphuma yini igazi?
(Do you cough blood?)
Patient: Yebo dokotela liyaphuma kodwa hhayi njalo.
(Yes Dr but not every time)
Background information
Past medical/surgical history
Doctor: Wake waba nesifo sesifuba?
(Did you have TB before?)
Patient: Cha, dokotela kodwa umama wami welashelwa sona isifo sesifuba.
(No, doctor. My mother is on TB treatment.)
Doctor: iTB?
Patient: Yebo dokotela.
(Yes, doctor)
Doctor: Wake walaliswa/noma wahlinzwa esibhedlela?
(Have you ever been admitted to hospital or undergone any surgical operation?)
Patient: Cha. (No)
Drug and allergy
Doctor: Umama uphuza amaphilisi esifuba(TB)?
(Is your mother taking pills for TB?)
Patient: Yebo dokotela, akhona awathathayo amaphilisi mina ngiphuza
umuthi wokukhwehlela.
(Yes doctor, she is taking pills, I am using cough syrup/medicine)
Doctor: Wena uphuza umuthi wokukhwehlela. Umuphi umuthi ongezwani
nawe?
(You are taking cough mixture. Any medication you are allergic to?)
Patient: Ayi awukho dokotela umuthi ongezwani nami
(No there is none doctor that I know of)
Family history
Doctor: Basaphila abazali bakho?
(Are your parents still alive?)
Patient: Ubaba angimazi washona ngisemncane. Umama ulashelwa isifo sesifuba.
(I don’t know my father he died when I was very young. My mother is alive and she is on TB
treatment)
Doctor: Unabo obhuti noma osisi?
(Do you have brothers and sisters?)
Patient: Yebo dokotela nginabo obhuti ababili.
(Yes doctor, I have two brothers)
Doctor:Sinjani isimo sabo sempilo?
(How are their lives back home?)
Patient: Baphila kahle ekhaya
(They are well at home)
Personal and social history
Doctor: Ushadile? (Are you married?).
Patient: Cha (No)
Doctor: Unazo izingane? (Do you have children?)
Patient: Cha (No)
Doctor: Wenza msebenzi muni?
(What work do you do?)
Patient: Hayi cha Dokotela angisebenzi. Ngihlala ekhaya.
(No Dr I’m not working. I stay at home)
Doctor: Ngitshele kabanzi ngendlu ohlala kuyo
(Tell me more about the type of house you living in)
Patient: Indlu enekamelo elilodwa nekhishi, sikhanyisa amakhandlela amanzi siwakha kude.

(One bedroom house and a kitchen without electricity, and we fetch water from far away)
Personal and social history continued
Doctor: Kulungile. Uyabhema noma uyaphuza utshwala?
(Do you smoke or drink?)
Patient: Yebo, dokotela, kodwa hhayi njalo mangabe ngithole imali ngiye ngiphuze ngibheme.
(Yes doctor but occasionally, I drink and smoke only if I get money)
Doctor: Ngitshele ngenhlobo yokudla okudlayo. (Tell me about your diet).
Patient: Ekuseni ngidla isinkwa netiye, bese ngidla ntambama ilayisi/noma uphuthu
okunenyama izaqathi angizithandi.
(I eat bread and tea in the morning, and eat rice/maizemeal with curry in the afternoon. I
don’t like vegetables)
Doctor: Uyaxivocavoca? (Do you exercise?)
Patient: Cha, anginawo amandla
(No, I don’t have strength)
Patient’s perspectives
Ideas and thoughts
Doctor: Ucabanga ukuthi yini imbangela yalokhu kugula kwakho?
(What did you think might have caused your problem?)
Patient: Ngicabanga ukuthi umama njengoba enesifo sesifuba nje, usengithelelile nami.
(I think as my mother has TB, I have caught it from her).

Concerns
Doctor: Yini ekuphatha kabi?
(What are your concerns?)
Patient: Dokotela ngiyesaba, njengoba ngikhwehlela nje Dokotela ngicabanga ukuthi
nginesifo sesifuba manje ngithuke kakhulu
(Doctor I am scared, as I am coughing I think I have TB so now I am scared)
Patient perspectives continued
Expectations
Doctor:Ufisa ukuba ngikwenzeleni ngalokhu kugula kwakho?
(What are you hoping for?)
Patient: Ngifisa ukuthola usizo namaphilisi.
(I hope to get help and treatment)

Feelings
Doctor: Uzizwa kanjani ngalokhukugula kwakho?
(How are you feeling about it all?)
Patient: Ngizizwa ngikhathazekile ngoba angilali kahle ebusuku, ngiyakhwehlela kakhulu,
ngiyajuluka isimo sami sempilo asikho kkahle.
(I am feeling worried because I don’t sleep properly at night, I am coughing a lot, sweating
and my health condition is not good)
Patient perspectives continued
Effects on life
Doctor: Lokhu kugula kwakho kunamiphi imiphumela empilweni
yakho?
(What effects is this having in your life?)
Patient: Angisakwazi nokuhamba ngiyozifunela amatoho njengoba
ngigula futhi angisebenzi.
(I am not able to go and look for temporal jobs as I am ill and
unemployed)
Preliminary explanation
Doctor: Ungakhathazeki ngizokusiza
(Don’t worry, I will help you)
Doctor: Ngicela ushaye isithombe. Ngabe kulungile?
(Please go to Xray. Is it fine?)
Patient: Yebo kulungile
(Okay it’s fine)
Doctor: Ngizokunika amaphilisi, kufanele uthathe lamaphilisi ekuseni
nasebusuku
(I will give you medication. You must take these pills morning and evening)
Patient: Ngiyabonga kakhulu
(Thank you very much)
Closing the session
Doctor: Unawo umbuzo?
(Do you have any question?)
Patient: Cha dokotela anginawo umbuzo.
(No doctor I don’t have a question)
Doctor: Ngicela ubuye mhlaka ………
(Please come back on……..)
Patient: Ngiyabonga dokotela
(Thank you, doctor)
Doctor: Ngiyabonga. Uhambe kahle
(Thank you. Goodbye)