Category Archives: California Healthcare Interpreting Association (CHIA)

Lost In Translation: How Foreign-Speaking Patients Suffer Without Medical Interpreters –via WBUR

DIAZ RIVERA

** ADVANCE FOR TUESDAY, NOV. 16 ** Medical interpreter Carmen Diaz, right, interprets for Spanish-speaking patient Romualdo Rivera at Temple University Hospital in Philadelphia, Sept. 1, 2004. Temple University is among 10 sites in the Robert Wood Johnson Foundation’s Hablamos Juntos program that received grants to hire and train Spanish interpreters. (AP Photo/Bradley C. Bower)

Lost In Translation: How Foreign-Speaking Patients Suffer Without Medical Interpreters

By Dr. David Scales

When I met Mr. Y., he was sitting up in bed, sweating and breathing quickly. An elderly, Russian-speaking man, he was admitted to the cardiology ward at a large hospital where I was working. His blood pressure was dangerously high and he struggled to breathe. His fear was instantly apparent in his wide blue eyes. Panting, he told us that he had liver pain, pointing to just below the ribs on his right side.

It’s unusual for patients to complain about liver pain. In broken English, Mr. Y. explained that it began after starting new blood pressure medications a few months ago. But his chest X-ray told a different story. His lungs were drowning in fluid — the likely reason why he was so out of breath — and that couldn’t have been caused by the medications he was so worried about. Having already perused his laboratory results, his condition seemed like a straightforward case of heart failure, but I quickly realized admitting Mr. Y. would be linguistically and culturally complex.

I needed to understand what made him so short of breath, and why he thought his medications caused the problem. But no in-person interpreter was available for another hour and a half. The telephone interpreting service at this hospital was designed to be accessible — the interpreter can be paged from any hospital telephone and should call back. Yet, no one had called back after my two attempts. I imagined they were busy interpreting for other patients. In the meantime, Mr. Y. continued to pant and sweat, leaning forward in bed to help his breathing.

Reluctantly, I asked his adult daughter if she would interpret for me. She agreed, but was clearly reticent; her hesitance and discomfort apparent as she stumbled over questions about her father’s recent urinary and bowel habits. While I speak no Russian, I became suspicious of misunderstandings when she interpreted my question about previous “heart failure” as “infarkt,” which sounds like a medical term for a heart attack.

I know of studies showing patients suffer when clinicians do not use interpreters or use untrained, informal interpreters like family members. I learned this during medical interpreter training and in my own experience volunteering as an Arabic interpreter with Iraqi refugees in New Haven and Syrian refugees in Jordan. As was the case with Mr. Y.’s daughter, family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.

“Family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.”

I know of studies showing patients suffer when clinicians do not use interpreters or use untrained, informal interpreters like family members. I learned this during medical interpreter training and in my own experience volunteering as an Arabic interpreter with Iraqi refugees in New Haven and Syrian refugees in Jordan. As was the case with Mr. Y.’s daughter, family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.

As a trained interpreter myself, it is painful and frustrating when good interpreter services are not available. But it isn’t just a dearth of interpreters — it’s also a lack of time that presents challenges to providing good care to non-English speakers. If I had a leisurely day I could have waited or returned, but on an adrenaline-fueled day on call, waiting for the interpreter was not possible. I had to balance my limited time with Mr. Y. against preparing for the three other patients I expected to be admitted at any minute. Worried this would be my only chance to hear his story, I put my interpreter training aside.

To read more of this article courtesy of WPR Boston’s NPR—>click here

 

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Medical Interpreters Speak for New American Patients –via Seven Days

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A woman rushes to a hospital after taking her baby’s temperature. In English, she tells the nurse that her child has been crying nonstop and is burning up. She begs to see a doctor. The nurse turns to her colleagues and other patients and speaks in an unidentifiable language, presumably asking if anyone understands English. Most give blank stares. A patient speaks a few words to the mother but backs off when he reaches the limits of his English proficiency. By now, the mother is hysterical and desperate.

That’s the scenario depicted in a public service announcement video from the Texas Association of Healthcare Interpreters & Translators, produced in 2010. It concludes by telling viewers that 8 percent of U.S. citizens, or 25 million Americans, speak limited English. The video clip is one of an array of materials that Lynette Reep, interpreter coordinator at the University of Vermont Medical Center, uses to educate her colleagues about the challenges that deaf patients or those with limited English proficiency (LEP) face when accessing health care.

To drive home her message, Reep also cites famous cases of tragic outcomes that resulted from inadequate language access. One such incident took place in 1980 in South Florida. Eighteen-year-old baseball player Willie Ramirez became quadriplegic after a misunderstanding of a single word led to a misdiagnosis and erroneous treatment. A resultant lawsuit led to a settlement of $71 million.

Reep’s position at UVM Medical Center was created just a year ago; before that, technical training for the clinical staff revolved around use of phone interpreters or an app. “Burlington, historically, is not a community that necessarily had a huge need for interpreting services,” Reep said. “But over the last 20 years or so, we’ve had refugees resettled here.”

According to statistics provided by the medical center, the percentage of LEP patients has risen over the past three years from 1.25 to 1.38 percent. Each week, the medical center receives about 16 requests for ASL interpreters and 200 for spoken-language interpreters. The three languages for which interpretation is most often requested are Nepali, Bosnian and Arabic.

Reep, 55, said it is her mission to “provide language access in the interest of patient safety and to educate the organization as a whole about the link between language access and patient safety.” This means creating a culture in which trained medical interpreters are seen as part of the treatment team.

“It’s really important that patients and providers understand that,” Reep said. Even though the interpreters don’t provide care, she added, “they are the mechanism through which care is being provided.”

To read more of this article courtesy of Seven Days—->click here

For Some Filipino-Americans, Language Barriers Leave Culture Lost in Translation via KQED News

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When it came time for Dominic Lim to pick a language to study in high school, he chose French. He chose it not because he was particularly interested in the language, but because the only other option was Spanish.

“I consciously picked French because I didn’t want to learn Spanish and then feel bad that I was learning Spanish, which was so similar to Tagalog …” said Lim. “I know that’s very bizarre but it’s like, if I learned French then I wouldn’t feel so bad that I didn’t learn Tagalog.”

Lim, 41, is first-generation Filipino-American. He never learned to speak his family’s native language, Tagalog.

He loves adobo, sinigang and lumpia. He grew up surrounded by his large extended family, whom he regularly saw at gatherings.

“Going to all these family parties and weddings and everything, you know you hear the older cousins talking to aunts and uncles, but you can’t really join in,” said Lim. “I felt like they probably didn’t respect the kids as much because we couldn’t talk to them in their own language. That was, for me, the biggest, most emotional regret that I have. It’s the most emotional component, for me, of being Filipino.”

To read more of this article courtesy of KQED News —-> click here

An open letter to medical interpreters via Izabel Souza (Arocha)

Izabel and Louis

An open letter from my wonderful colleague and co-founder of the National Board for the Certification of Medical Interpreters, Izabel Souza (Arocha).

Click here to read Izabel’s letter ———-> Open letter Izabel Souza (Arocha)

Please join me in congratulating Izabel for her magnificent contributions to the medical interpretation field and wishing her well in her new endeavors.

Please feel free to forward to your networks.

With best regards,

Louis

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When You Can’t Understand Your Doctor –via East Bay Express

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When You Can’t Understand Your Doctor

Legislation in Sacramento would pave the way for hiring 7,000 medical interpreters statewide to help non-English speakers. But does it go far enough?

By

Gloria Estela Ortiz Ramos doesn’t speak English, so when she became ill in 2006 and needed medical care, she had to rely on her ten-year-old son for help. He translated a list of medication prescribed to her from the Eastmont Wellness Center, an East Oakland clinic that serves low-income people. But the El Salvadoran immigrant said she expressed concerns to her medical provider, because her son had just started to learn English himself.

“There was a video interpreter present when I requested the instructions in Spanish, but it didn’t really change the interaction — the doctor would still say, ‘We don’t have these in your language,'” Ramos told me through Jose Uribe, who works for Interpreting for California, a nonprofit dedicated to improving communication between medical providers and patients. Medical providers in California, like the one at Eastmont Wellness Center, often provide interpretation services via video-conferencing or phone — or sometimes not at all — a practice that can heighten the risk of miscommunication.

Ramos decided to leave Eastmont for La Clinica de la Raza, a medical clinic in the Fruitvale district, where her current doctor is fluent in Spanish and her medication labels are translated, too. But she said she still suffers from problems associated with being over-medicated for too long, including chronic pain, poor circulation, severe headaches, and muscular degeneration — symptoms she never experienced before the start of her care. “I’ve been on varying doses of pain medications for months,” Ramos said. “My condition has worsened since taking these medications at the start of my treatment.”

Under Title VI of the federal Civil Rights Act, patients like Ramos who are not fluent in English are supposed to have access to qualified interpreters. And in a diverse state like California, the number of non-English speakers is substantial. According to US Census data from 2010, nearly 20 percent of California residents over the age of five reported that they speak English “less than very well.” In addition, about 281,000 low-income patients in the state’s Medi-Cal program said they had difficulty understanding their medical practioners, while 135,000 parents of children in the program reported having the same problem, according to state officials. Yet in California, the medical interpreting system is disorganized and mismanaged, forcing many patients to rely on friends and family to translate when they require medical attention, thereby increasing the chances for misdiagnosis, injury, and unequal standards of care.

A bill — AB 1263, which is sponsored by Assembly Speaker John Pérez of Los Angeles, and is awaiting approval this week in Sacramento — hopes to address these problems before the state’s heath-care system becomes flooded with new patients when the federal Affordable Care Act takes effect in January. If enacted, AB 1263 would require the state to spend $1 million to $2 million on a statewide medical interpreter system in order to obtain nearly $270 million in federal funds from Obamacare. The legislation would create a state-certified Medi-Cal-patient-centered program known as CommuniCal.

To read more of this article courtesy of East Bay Express, click the link below.

http://www.eastbayexpress.com/oakland/when-you-cant-understand-your-doctor/Content?oid=3706984

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