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A healthy demand for English

With an influx of British settlers in southwestern France, local doctors are having to learn English in order to communicate with their patients. Astrid Deroost meets the doctors struggling to learn phrases such as "Where does it hurt?" If more and more country doctors in southwestern France are learning English, it is not to prepare for the holidays but to cope with an influx of British settlers who often speak only a few words of French.

He's fine, but I'm damned if I can remember how to say 'coeur' in English "Reading English is one thing, but finding yourself face-to-face with an Englishspeaking patient -- that's totally different," said Christine Paulien, a doctor in Chazelles, 150 kilometres (90 miles) north of Bordeaux. Some 2,500 Britons are now living in the district, compared with 1,500 two years ago, local authorities say. They include retired couples, but those still working as well, along with their children, attracted by low housing prices and cheap air fares between Britain and southern France. That means they need health care for problems extending far beyond the sunburns and minor accidents that typically befall tourists. Communication problems But doctors, who need to be precise, struggle to find the right English word, and often have problems understanding the patients, Paulien said.

"The realisation can be brutal," said Genevieve Sevestre, a doctor in nearby Angouleme, the chief town in the Charente region.

Doctors struggle to find the right English word and often have problems understanding patients.

She used to answer the telephone for the emergency medical service. "Sometimes I was confronted with somebody who could only speak English," she said. "We had to ask a lot of questions, and suddenly you got the feeling you couldn't do your job." Learning English with Mr Brown The local doctors have called for help from an Angouleme teacher, Francy Brethenoux-Seguin, who produced a bilingual guide for health workers late last year. "My job as a teacher at the Angouleme Nursing School made me realise that health workers were coming more and more into contact with Britons," she said.

It's so hard for us GPs to find time for our English homework these days Her guide, written in collaboration with a nurse, stars 'Mr. Brown', from the time he arrives in the casualty department -- or emergency room, as the Americans call it -- to his return home after complications. The 12-chapter guide, which comes with an audio CD and labelled anatomical designs, provides such phrases as "Where does it hurt?", "Are your vaccinations up to date?", and "Breathe deeply".

One aim, Brethenoux-Seguin said, is to avoid having to seek out 'the' person in the establishment who speaks English. Shifting demographics The initiative comes as French doctors are deserting some of the countryside regions Britons find so appealing.

Brethenoux-Seguin's guide provides such phrases as "Where does it hurt?", "Are your vaccinations up to date?", and "Breathe deeply". In all, according to 2004 census figures, some 200,000 Britons have settled in France -- a huge increase of 45 percent in just five years, and some 20,000 have houses in the southwest. These are often old farmhouses they have done up, or houses in small villages. France has more doctors now than ever before -- 203,000 for a population of 61 million, or one doctor for 300 people -- but general practice has fallen out of favour. Final-year medical students last year left 500 GP posts vacant, with many preferring to continue their studies to qualify as specialists, the statistics show. Most general practitioners -- family physicians, as they are known in the United States -- say they prefer to work as part of a team, rather than in isolation in a rural area, to be able to have free time. The government has now set up regional health missions to pinpoint imbalances and propose solutions. July 2005