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There can be little dispute that English is currently the world’s leading scientific and medical language. Such linguistic dominance is not without challenge, of course, but until recent events its privileged status has not been seriously jeopardised. Interestingly, the threat to its dominance has not emerged as one might have anticipated from rival languages with significant populations, such as Mandarin, Hindi, Russian, or even Spanish, but through internal factors.

On the 23rd of June, 2016, 51.9 per cent of UK voters opted to leave the EU. The implications of this have largely been examined in terms of economic and social factors, such as customs borders, free movement of workers, and the UK’s potential liability for penalty exit payments. However, the wider and longer-term implications of this development should not be ignored.

The “Brexit” vote dramatically alters official linguistic patterns in the EU. At present, within the EU, English is the official language of the UK, Ireland and Malta. Thus, English is an official language of approximately 14 per cent of the European Union, at 69.1 million people. However, the forthcoming exit of the UK will see this figure drop dramatically to just 4.5 million, representing less than one percent of the population of the European Union.

Ireland will shortly become one of only two countries in the EU with English as an official language. It is noteworthy that both countries also have their own official languages and that Malta has a population of just 437,000.

The situation in Ireland is interesting, as although English is used by almost all Irish people on a daily basis, the official first language of Ireland is Gaelic (Irish), with English officially relegated to second position.

Ireland was offered the option of Gaelic becoming an official language when it joined the European Economic Community (EEC; a forerunner of the current EU) in 1973, but declined the offer at the time. However, in 2004, Ireland changed tack and formally requested that Gaelic be recognised as an official language of the EU, which was subsequently accepted and came into force in 2007. At present, the EU is training a cohort of interpreters in readiness for Gaelic officially becoming a working language of the EU in 2022.

The status of English in the EU is therefore under significant threat. The Brexit vote jeopardises the continuing dominance of this language in a bloc with a current population of 508 million. Even putting aside such quantitative metrics, at an emotional level the dominance of English is also under threat. The withdrawal of the UK from the EU has all the hallmarks of an ugly divorce, and there may well be a backlash against its dominance. Jean-Claude Juncker, President of the European Commission, recently conspicuously opted to speak French rather than English at a public event and drew attention to his decision, stating that, “English is losing importance in Europe”.

At present English will undoubtedly continue to perform its role as an international lingua franca. However, its status longer-term has been irrevocably damaged. The implications for publishing in the sciences, and in particular in the medical sciences, may be significant.

In response to the declining position of English, and to put aside nationalist rivalries, prejudice and favoritism, it may be opportune to explore the future potential of a language such as Esperanto, created in 1887 by Polish physician Ludovic Zamenho, to fulfil this role in the health sciences. His aim was to create an international auxiliary language or “common tongue” that would facilitate communication across stark linguistic barriers that divide communities and countries.

Being both Polish and Jewish, Zamenhof witnessed the divisive nature of linguistic differences himself as can be seen in his own words: “In Białystok the inhabitants were divided into four distinct elements: Russians, Poles, Germans and Jews; each of these spoke their own language and looked on all the others as enemies”.

It should be noted that although historically persecuted by Hitler, Stalin, Franco and Imperial Japan, Esperanto has also been the subject of high-level support. In 1954, UNESCO passed the Montevideo Resolution (Resolution IV.4.422-4224) supporting its development, while in 1985, UNESCO passed another resolution supporting the teaching of Esperanto. Esperanto has also found support in emerging and influential countries, such as China and may currently be understood by approximately two million speakers.

Recently added into the repertoire of Google Translate, Esperanto was deliberately constructed to be relatively easy to learn, having a standard format and lacking the idiosyncrasies that beset so many languages. It would be naive to consider the future potential development of Esperanto without acknowledging that it faces significant challenges if it is to move beyond its current niche status. Nevertheless, it has significant potential to develop as a non-partisan lingua franca that may help to overcome nationalist linguistic rivalries. As such, it holds certain attractions to multi-lingual countries and international trading blocs such as the EU, which currently includes 28 separate countries.

As a constructed language, Esperanto is not the first language of any country and is a non-colonial and non- nationalist language, lacking the historical and current cultural baggage associated with many mainstream international languages.

The proposal to examine Esperanto may seem far-fetched to many but don’t forget that within Europe, the history of medicine is dominated by the use of Latin as the medium of instruction and nomenclature. In fact, the development of Esperanto and the field of medicine are intrinsically linked.

A series of articles in The Lancet from 1905 to 1907 discuss various issues on this topic, including the concept and pronunciation of Esperanto, as well as the formation of “An Esperanto Society for Medical Men”. Such a society, the World Medical Esperantist Association (Tutmonda Esperantista Kuracista Asocio in Esperanto), was duly founded in 1908 in the city of Dresden in Germany. In 1923 this group established the Medicina Internacia Revuo (International Medical Review), an international peer-reviewed journal featuring articles and abstracts in Esperanto. This journal is the official forum of the Universala Medicina Esperanto Asocio for communicating results and ideas in medical science, and is still publishes medical articles today.

In 1964 the World Medical Esperantist Association changed its name to the Universal Medical Esperanto Association (Universala Medicina Esperanto-Asocio [UMEA] in Esperanto), although this group is also known as the International Association of Medical Esperantists.

Not only was Ludovic Zamenhof, or ‘Dr Esperanto’ as he has been referred to, an ophthalmologist himself, but three of his four brothers were physicians, while the fourth was a pharmacist. A significant number of his family were crucially involved in both medicine and developing Esperanto: many members of the Zamenhof family published in Esperanto or supported work in this field. For example Ludovic’s brother, laryngologist Leon Zamenhof wrote poetry in Esperanto and edited the journal Pola Esperantisto, in addition to co-editing the journal Medicina Internacia Revuo, mentioned above.

Looking forward to the decades ahead, the dominance of English as an international lingua franca in the realm of science and medicine has dramatically been cast into doubt. Librarians and library/ information science educators need to be cognisant of this fact and begin developing skills and training in response to and in anticipation of subtle but profound linguistic changes that may occur in the field. As a non-partisan auxiliary language specifically designed with ease of use in mind, the potential of Esperanto should be explored and exploited.