Key encounter 1 : medical review with a 'pending patient'

This encounter revealed serious and pervasive communication failure at various levels:

• - the patient (a young man) and his family were not aware of his chronic renal failure (diagnosed 2 years earlier)
• - the family were therefore unaware that appropriate management could delay progression to end-stage
• - no medical reviews or monitoring occurred during this period
• - at the end of their consultation with an experienced physician (but no interpreter or healthworker) the Yol\u participants were still unclear about the patient's renal status and prognosis
• - an improved (but still incomplete) level of shared understanding was only achieved through further discussion with interpreting assistance

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