Dr. Christian El-Hadad, left, and Shaan Bhambra have developed a visual acuity chart in Indigenous syllabics, which would allow Inuit and other Indigenous people to have their eyes tested in a familiar language. (Photo courtesy of Shaan Bhambra)
Professor, med student design Inuktitut-based eye test chart
Visual acuity chart can be used in Inuktitut and other Indigenous languages
It was a trip to Puvirnituq last year that inspired Shaan Bhambra and Dr. Christian El-Hadad to develop a way to test eyesight using Indigenous-language charts.
Bhambra, a recent medical graduate, travelled to the Nunavik community for a rural medical placement. He was paired with El-Hadad, a McGill University faculty ophthalmologist.
The pair met several patients during the placement who could only read or write fluently in Inuktitut.
“We have these patients who are fully literate adults, but because we’re not providing them with a chart in their alphabet, it brings on this pejorative notion that they might be illiterate or that they are unable to read,” Bhambra said.
So they brainstormed the idea of creating a visual acuity chart using Canadian Aboriginal Syllabics, which can be recognized by Inuktitut, Ojibwe and Cree speakers.
Visual acuity charts are ubiquitous in the office of any eye doctor: Letters line the top in a very large font and each line down gets progressively smaller. Doctors use these charts to assess patients’ eyesight.
El-Hadad, who routinely provides eye care to people in Nunavik, said the Indigenous-language charts are helping his Indigenous patients.
“This chart actually allows them [to move from feeling illiterate] to feeling literate in their own language, and feel empowered to kind of feel free to use their own language to express and be tested and receive medical reports,” El-Hadad said.
“It allows us to test several First Nations and Inuit patients using the same tools.”
A lot of research went into deciding how to develop the chart.
Bhambra and El-Hadad only used characters that are used in written Inuktutit, Cree and Ojibwe syllabics.
“These seven letters that we use, we’re able to cover the languages of, I believe, 85 per cent of the 260,000 Indigenous Canadians who speak an Indigenous language in Canada,” Bhambra said.
“So we really try to use this as a testing ground to start developing a visual acuity chart in Indigenous scripts, but try to make it as broad as possible as well.”
So far, the rollout of the chart has been a success, said El-Hadad.
Printed copies of the chart are available to use at clinics in the 14 Nunavik villages, the Ullivik lodging facility for medical patients in Dorval, and El-Hadad’s clinic on the McGill campus.
“It makes me very, very happy to know that we are providing something that patients are really appreciative of,” Bhambra said.
“It’s been really inspiring, I would say, to be able to provide care in a patient’s native language and to respect their culture and language in a way that hasn’t been done before.”
The chart is open-source material, meaning anyone can access it.
El-Hadad and Bhambra are trying to spread the word about it in many forums.
Bhambra, however, said he hopes people can look at the chart and come up with their own ideas to improve the relationships doctors have with their Indigenous patients.
“We’re just in a small aspect here, but we hope that it inspires other people to look for solutions in other specialties, or in ophthalmology or in medicine more broadly: How can we make sure that we’re serving our patients as effectively and in a way that’s culturally respectful as possible?” Bhambra said.
“We really do owe the patients the right to use their language and to follow their customs and to respect the culture that they share with us.”
This is great in practice, however in Nunavut the Department of Education has not prepared a lot of students to be able to use this. There are so many kids even in Grade 12 that do not know their syllabics. Let alone be literate in Inuktitut.
there are a lot of people who are unilingual, this would be useful for those people
You are correct there are some unilingual Inuit that are literate (mostly over 60 or 70 now, and i think that is generous), though unfortunately every year there are less, and the young that might be “unilingual” are not literate (not learning enough written Inuktitut to be able to use this chart).
Though I really hope that changes.
There are already eye charts that don’t use roman letters, and they have existed for decades, probably as long as eye charts themselves have existed (since illiteracy and language barriers exist in all cultures). As the above poster notes, the number of people who would prefer syllabics is steadily declining. As well, the person testing the patient would also need to be fluent in syllabics for this new chart to be effective.
So, a nice feel-good gesture, but one that is of little consequence and is mostly a virtue signal. Health care is so stretched already, it’s amazing how much money and energy is spent solving problems that have already been fixed, or don’t really exist.
You’re absolutely right about the kinks in our health care, and something like this gets out to reconfirm. Why do the government, health care allow this to happen. Another joke that too many won’t get comprehensive of.
But will they know how a syllabic is pronounced or which one it is?
He said…”Good idea.”
Either your a settler or colonized Inuk that Inuit have a basic understanding of syllabics so it won’t be too difficult to use it.
Oh Ima,
I meant the eye doctors or the eye team, there isn’t any Inuit eye doctors that I know of.
When ever an Inuktitut speaking patient is being served, there is an interpreter provided so they will be able to tell them what they see and will be able to communicate to the optometrist
Good way to fluff up the resume. “Created eye test chart in inuktitut”
Would be a funny T.V. skit.
Person giving test has no clue what the symbols are…
Older person taking test, not wanting glasses, makes any sound he/she likes and…. passes test.??
Thank you for featuring our work! To respond to some of the comments, please note that the individuals testing the patients are provided with a list of the letter sounds so that they will know what the correct letters are even if they do not know syllabics. We hope that more Inuit youth become familiar with Syllabics, and that our project can help them.
Hablad Anglais?
This clinic would serve Inuit on Nunavik better by learning some bedside medical matters, and stop charging Inuit a fee to fill out forms for being off work to come down from Nunavik to get eye surgery, plus don’t make people feel small for having the forms filled out. And Inuit be careful, always someone trying to impress on Inuit expense.
I had a few visits there as an escort, I didnt find them friendly at all. And I can relate to filling out the absent work form, the doctor was rude asking for a fee as though, the patient would then not bother to ask again.
I’m getting eye surgery soon and I’m wondering what you’re talking about.. what should I have ready?
I was escorting a family member to this clinic, and the doctor said he was too busy to sign the form, that’s needs to be signed by the doctor, in order for employees to be paid sick time, for the time in Montreal getting treatment. The patient was not paid by the employer, because the form was not signed by the doctor. That’s what people need to be aware of. To this day , no pay was ever issued, it’s a year ago now. The employer refused to pay, and the patient tried several times via liaison nurse to get the doctors signature, still no response.
In the mobile eye clinic we#ve developed, we solved the problem with the e-hook method. The person whose eye acuity is to be tested is given an E made of Styrofoam in his hand and turns it in the same way as the E-sign on the board. But it’s certainly better if you can use the familiar written language for the eyesight test. Could I order one or more sign boards from you? We also work abroad. Thank you and great Job!
Does KI have enough school days for kids to be literate enough to understand this?
Honest question. I frustrated with the lack of education my kids are getting. Finally my son has school this morning and now they’re dismissing him for the afternoon.
My kids are Inuk and are not able to be homeschooled with the school board we have because, they are INUK. Look it up. It’s so unfair. KI teachers contribute a huge portion to the poverty levels of nunavik with their lack of attendance. To a point where our kids learn nothing and now it’s already Final Examination Season.
Good job on the eye docs, though. If only we were allowed to and can implement it into everyday life. Efforts are near futile with the lack of education our children get.
Bring the Three “R'”s back.
Reading, ‘riting and ‘Rithmetic.
Period.
Mr Miyagi, I hear you. It’s truth you write. But the reality is as it is, and I’m not confident that it’ll be any better for a generation or so yet. Many have to move for the kid’s education, and I’m telling you now, it’s the only way your kids are going to learn on par with the rest of Quebec and canada. I know, it’s not easy to move, but it’s your kid’s education or it’s not moving, period. It’s really bad, I know.
I did that in 2020. Little to no help when covid happens. Maybe I’ll try to convince the wife again. Only time will tell what happens then. I really would do it again.