The effectiveness of a prescription depends on the patient's comprehension, which cannot be presumed in multilingual communities. This article investigates language barriers and communication strategies in medical consultations in Mamfe, Manyu Division, South West Region of Cameroon. Mamfe's linguistic landscape encompasses Kenyang, Ejagham, Cameroon Pidgin English, English, French, Igbo, and other local languages, with increasing diversity due to the Anglophone crisis and resulting displacement. The study was conducted across four health facilities (Mamfe Urban Integrated Health Centre, Mamfe District Hospital, Presbyterian Health Centre Besongabang, and Full Gospel Mission Health Centre), using a qualitative-dominant mixed methods design. Data were collected over three months from 70 participants (50 patients and 20 healthcare workers, including 3 doctors, 12 nurses, 3 laboratory staff, and 2 pharmacy staff) through questionnaires, interviews, and observation. Language barriers were most prominent during symptom description, diagnosis explanation, and prescription comprehension. Both patients and healthcare workers addressed these challenges by negotiating meaning through code-switching, use of Cameroon Pidgin English, simplified explanations, repetition, gestures, demonstrations, and informal interpretation by relatives or bilingual staff. While these strategies facilitate communication, they remain improvised rather than institutionalized, posing risks to accuracy and confidentiality. The article contends that multilingualism in Mamfe’s health facilities serves as both a barrier and a resource. It concludes that effective and equitable healthcare in linguistically diverse settings requires interpreter support, simplified multilingual prescription guidance, communication training for healthcare workers, and institutional recognition of local languages as integral to quality care.

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