Posted August 18, 2006 to GDN Headlines | Section Home | Print

Speaking Their Language: Problems with Medical Translation

Nguoi Viet, News Analysis, Josie Cabiglio
Linked

(PNS) -- Doctors tell a 15-year-old girl that her father has a cancerous tumor and must start radiation treatments right away.

As she tries to find the words to tell her non-English-speaking parent, the frightened child finds herself incapable of relating the whole story, partly because she is reeling from the news that she can’t comprehend fully and partly because she doesn’t want to have to tell him the verdict that he has a deadly cancer.

It’s a tough situation, and one that people who aren’t medically trained find themselves in too often when language is a barrier.

Enter the medical interpreter, someone whose health know-how, language skills and objectivity when talking to a patient can help doctors to explain sometimes life-and-death situations.

Patients “need to know what the doctors are saying,” said Lan Phuong On, who immigrated from Viet Nam in 1982 and has worked in such a job for 15 years. When a trained medical interpreter does the explaining to a patient, “you know it’s being translated accurately,” she said.

These professionals can be lifesavers, literally. Medical personnel say that when the individual translating is the patient’s child, an adult relative or friend, the message usually gets lost in the translation because it usually is weakened — or even lost entirely — because of the interpreter’s lack of knowledge of medical terms, concepts and technology.

When dealing with a non-English speaking patient who has a relative or friend do the interpreting, “I speak sentences and the person translating speaks one sentence,” said Dr. Nilam Ramsinghani, who specializes in radiation oncology at UCI Medical Center in Orange, Calif.

Such individuals “are not medically oriented to technology” and so are unable to accurately deliver the doctor’s message to the person who is ill, she said.

“We have lots of Vietnamese patients where children translate and I don’t know if they are translating right. I don’t know the language. They like to protect their parents, so they don’t tell them all (that the doctor says), but it’s not a good thing,” she said.

Unlike many other hospitals that contract out for medical interpretation services, UCI Medical Center has on staff one Vietnamese speaker and 11 Spanish speakers, Ramsinghani said. In addition, the hospital has one Spanish interpreter at its Anaheim clinic and two at a clinic in Santa Ana. For other languages, or if no staff interpreter is available, hospital personnel rely on the services of medical interpreters available by telephone, she said.

On got her medical knowledge starting early in her college days.

Partway through school, she switched gears and decided to study social work and psychology, hoping for a post in a hospital psychiatric or counseling unit after graduation, said On, who earned a dual bachelor’s degree from Trinity Christ College in Chicago.

When she applied for a job at UCI Medical Center, she found out by chance about an opening for a medical interpreter.

The qualifications were language fluency and knowledge of medical terminology.

“To be a medical interpreter you need to have knowledge of medical terms, interpreter skills, language skills and know the code of ethics where you work,” she noted, adding that one also must be culturally aware.

Moreover, “a face-to-face interpreter knows body language and has to understand regional languages. They use different words for the same thing” in different areas of Viet Nam.

Sometimes even those who have the medical knowledge, the language and the cultural understanding still need a medical interpreter. Recently, she said, she helped a Vietnamese doctor who asked her to detail matters to his patient because he was not very confident of his knowledge of medical terms in his native language.

In certain cases, Viet Nam natives who speak English also desire the help of an interpreter, for the opposite reason, she said. “Most of the family, even though they are totally fluent in English, still want to have a translator there because they don’t understand the medical terminology” in that language, she said.

“When talking to the patient, I talk directly,” Ramsinghani said. “ ‘You need radiation, these are the side effects and we’ll be seeing you daily for three weeks.’ I tell them how the radiation is delivered,” and this information must be translated accurately, word for word, she stressed.

“The bottom line is that our responsibility is to the patient. We don’t feel we can function to our best without translators.”

Patients flourish emotionally if they understand exactly what is happening to them, even if it is bad news. At issue is their “peace of mind,” she added. “They are able to handle the situation much better.”

“If a patient notices side effects from a medication or treatment, he doesn’t have to go back to talk to the doctor, because the interpreter has translated the medical professional’s directions as well as answers from the patient regarding these possibilities word for word,” OÂn said.

To be effective in her job, she constantly updates her knowledge, something that, thanks to the Internet, she can do aided by doctors she will never know or meet.

“I learn from doctor discussions on the Web in Viet Nam,” she said. This is crucial for so many reasons, including because “the language, before Viet Nam fell in 1975, was different than it is now.”

On finds that relatives of the patients for whom she interprets usually are grateful for her services because they realize they could not have translated all the information accurately, she said. “After I translate, they come over and say, wow, they could not translate like I do.”

A medical interpreter “is a bridge over a wide gap, present in an unobtrusive way. Not coming between people,” she notes, but working as a “supporting gap between them. As a medical interpreter, I am a conduit” of information.