Translators Necessary in Hospitals

By TOM WEBER

An analysis released this week by the New England Journal of Medicine indicated that many hospital patients with a limited ability to speak English are not getting the translators they may need to navigate safely through medical crises.

From 1990 to 2000, according to U.S. Census figures, the number of residents with poor English skills grew by 7 million to 21 million, or more than 8 percent of the population. Despite the increase, the journal study found that no interpreter was used in 46 percent of the emergency room cases involving such patients.

“Lack of interpreters translates into impaired health status, lower likelihood of being given a follow-up appointment, greater risk of hospital admissions and more drug complications,” one of the study’s authors told USA Today.

The need for translators is being felt most keenly in rural areas of the country that until recently may have been almost entirely English-speaking and unaccustomed to a diversity of foreign languages and cultures.

All of which makes the Bangor Interpreting Agency a unique and valuable resource in our midst, not only for new non-English- speaking residents and visitors who might require emergency services but also for those professionals who provide them.

Catherine Munch, an American Sign Language interpreter and spokeswoman for the agency formerly known as Hands On, said the resource has been around for about 11 years now. For most of that time, its mission was to provide interpreters for people who communicated through ASL, signed English and cued-speech transliteration, which is not a language but a series of symbols made with the hand next to the mouth to support lip-reading.

“But then two years ago, we very quickly started getting calls from doctors and hospitals in the area that needed foreign-language interpreters,” said Munch, one of the agency’s 20 ASL interpreters.

In response, the service has retained more than 30 foreign- language speakers from the area who, as trained freelance subcontractors working on call, act as interpreters in about 15 languages.

There are interpreters for Spanish, French, Portuguese, Italian, Creole, Punjabi, Urdu, Arabic, Japanese, Cantonese and Mandarin Chinese, Vietnamese, Cambodian, Thai, Russian, German, Bulgarian, Hungarian and Romanian.

The array of languages might not span the entire globe, but it covers a large chunk of it – even Turkmenistan, a language spoken in central Asia, north of Iraq.

The agency uses only interpreters for whom the foreign language is native, Munch said.

“Knowledge of the cultural aspects are as important as the language in stressful situations like hospitals and law-enforcement settings,” she explained. “And we find interpreters in a variety of ways. I was once in a dance class, and was chatting with a woman who spoke English with a lovely accent. It turned out she is Russian and has a degree in linguistics. She’s now on our list.”

Because the agency’s answering service operates 24 hours a day, seven days a week, Munch said, a doctor’s or hospital’s request for an interpreter usually can be filled promptly. Fees for the service range from about $50 to $75 an hour. While certain users may be eligible for insurance reimbursements in some cases, Munch said, disability laws require that hospitals and other large institutions absorb the cost themselves.

“Health care is a huge part of our business,” said Munch. “Our interpreters work in emergency rooms, inpatient services, therapies and surgeries. We go right into the operating room to be there as the patients go under anesthesia, and are there for them when they wake up in the recovery room. It can really help a patient’s stress level a lot.”

Health care workers recognize that a patient’s family members, especially children, are not the best people to act as interpreters in medical situations. Not only might they be unfamiliar with the terminology of hospital care, and could translate critical information inaccurately, their troubled emotional states often can confuse their thinking.

“Hospitals want the emotional aspect out of the communication,” said Munch. “With an interpreter there, the relatives don’t have to deal with that aspect of the crisis and can just be there as family members. It can be a great relief to them.”

Doctors at both St. Joseph Hospital and Eastern Maine Medical Center, Munch said, have expressed their gratitude about having such a resource at their disposal. Before the agency added its foreign- language component, she said, a local doctor treating a non-English- speaking patient was forced to seek out the person’s family members or to hunt for an interpreter at the university.

The presence of an interpreter in a hospital can help reduce the risk of potentially harmful mistakes, said Munch, who used an example from ASL to show how things can go wrong. A doctor treating a deaf person who is distraught and perhaps mentally ill, for instance, might touch his index finger to his thumb and raise his remaining fingers – as in the familiar gesture meaning OK – to indicate that the patient should take three pills.

“But to a deaf person, that says nine, not three,” said Munch.

Although the interpreters work mostly in the health care field, she said, the agency also provides language assistance for a broad variety of other situations.

“Foreign-language interpreters can be used for students attending the university, let’s say, who need help during tutoring,” she said. “They can be used in businesses with deaf or foreign-speaking employees. There are migrant workers, too, who might need interpreters for health care, law enforcement or legal issues. We were called to a wedding on the coast, and regularly do funerals all over the state. Basically, any situation in which you might need to communicate by more than pointing at a menu.”

The agency also provides interpreters for regional cultural events, such as storytelling performances and crafts and cooking demonstrations. Munch’s favorite interpreting gig is the annual folk festival in Bangor, which she happily has been a part of from the start.

“I mostly do medical interpretation and trauma,” she said, “but I have to say that getting up on that stage each year and interpreting music is especially exciting.”

(c) 2006 Bangor Daily News. Provided by ProQuest Information and Learning. All rights Reserved.