How do you talk to the doctor when you don’t know the words?

Lisa Owad/Medill

By Lisa Owad
March 11, 2010
Medill News Service

Every day thousands of Chicagoans visit a doctor – but can’t explain what’s wrong.

It’s not because they don’t know their symptoms, they just don’t speak the same language.

Radhika Sharma Gordon deals with this constantly as coordinator for a health organization in one of the most diverse areas in the country, Chicago’s Albany Park neighborhood.

“One problem [we face] is the language gap in health communications,” said Gordon, the coordinator of Healthy Albany Park, a community coalition of health care workers. “We’ve steadily had an increasing Spanish-speaking population, but we need free or low-cost translation into Arabic for the sizable Arabic-speaking community here.”

Lisa Owad/Medill

With dozens of languages spoken in Chicago, health care organizations can find it challenging to meet all of their patients’ needs.

Speaking their language

Small, community-based organizations like Healthy Albany Park struggle to find funding for translation services and often have to rely on the language skills of their staff.

“We’re forced to be very creative, because we get so little money,” Gordon said. “Unfortunately, people who are bilingual often have this foisted on them as another job duty. You don’t want to overburden any bilingual colleague.”

Lisa Owad/Medill

Organizations that are larger and better-funded have more options.

Cook County’s Community and Economic Development Association has a Women, Infants and Children Program office in Albany Park. WIC is a nonprofit, national organization funded by the United States Department of Agriculture that focuses on nutrition counseling and services for moms and kids.

“We run the largest WIC program in Illinois,” said Sarah Sullivan, program coordinator. “Monthly we serve over 46,000 clients in Cook County.”

Lisa Owad/Medill

With federal funding and national support, the WIC offices find it easier to fulfill their clients’ translation and interpretation needs.

“I think we do a very good job meeting the language need within [Albany Park],” Sullivan said. “We have four languages that are spoken on site, full time: Arabic, Hindi, Spanish and English. All of our clerks that are hired speak another language. That is part of the job requirement.”

With so many different languages spoken in Chicago, it’s impossible to represent every language with an on-site interpreter. Using outside agencies to assist with translation and interpretation is a necessity.

“We use AT&T’s Language Line,” Sullivan said. “We have a standing contract with them, so translation help is just a phone call away. We also partner with the Illinois Coalition for Immigrant and Refugee Rights for translation help as needed.”

Video or phone interpreter services are commonly used by hospitals to communicate with non-English speaking patients.

“We have access to 170 languages through a combination of staff interpreters, agency interpreters, phone interpreters and video interpreters,” said Omar Torres-Knight, manager of interpreting services at Chicago’s Children’s Memorial Hospital.

However, speaking to an interpreter over a phone or video connection can have its limitations.

“Usually in person is much better,” said Kyung Yu, a Korean interpreter at Swedish Covenant Hospital. “A lot of times our patients are seniors, and a lot of them have hearing problems. And having a rapport with patients is very helpful.”

Swedish Covenant Hospital serves many patients from the diverse Albany Park area.

“The staff has interpreters in house for a few different languages: Korean, Spanish and Russian,” Yu said. “We also use Language Line for other languages.”

When a patient can’t speak English, one of the interpreters is summoned by pager or cell phone. Sometimes their services aren’t even necessary, one of the advantages of working in a diverse community.

“We have many staff [members] that speak other languages,” Yu said. “It depends though, because their primary job isn’t interpretation.”

Immigration trends

Events on the other side of the world can affect translation needs in Chicago. For example, unrest in the Middle East is driving a need for Arabic language services.

“The reality is that anything that’s going on in the world, we pick up in Cook County,” said Magali Rodriguez, the director of interpreter services at the Circuit Court of Cook County.

The number of Arabic speakers in Illinois increased 12.9 percent between 2000 and 2005, according to data from the U.S. Census Bureau. Between 1990 and 2000, the nation’s Arab population increased by nearly 40 percent.

“We have an Arabic population that seems to be growing,” said Yu. “We get requests often for that language [at Swedish Covenant Hospital].”

When immigration organizations foresee a change in the incoming population, news travels to health organizations, so they can prepare to meet the changing needs.

“In 2008, our local refugee settlement program, World Relief, received word to expect more Iraqi refugees,” Gordon said.

“[WIC has] been at Albany Park for 16 years, and I think we’ve seen some of those trends, and we’ve met them very well,” Sullivan said. “We just purchased an Arabic keyboard a few years ago.”

Effective health care communication

A 2002 Institute of Medicine study revealed that “racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities.” A major factor in this disparity is the patient’s ability to communicate with their doctor.

And the difficulty doesn’t end with the doctor-patient relationship. Hospitals and clinics might have to provide translation for consent forms, educational materials and medication information, according to “One Size Does Not Fit All,” a study by The Joint Commission, an organization that helps facilitate health care communication between providers and patients.

The often immediate nature of health issues can make the need critical. While court dates are usually scheduled ahead of time, health care, by nature, is often unexpected.

“In the health care system it’s really a greater challenge,” Rodriguez said “because we get sick without prior notice.”

However, health organizations like Albany Park find themselves doing the best they can with what they have in order to serve their clients.

“If we can get English, Spanish and Arabic [translation], then we can cover most of the parents [in the area],” said Gordon.

A parallel system: Interpreting in the judicial system
In 2006, interpreters were used 120, 412 times in Circuit Court of Cook County proceedings.

“Interpreters are requested by the court or a court order,” said Magali Rodriguez, director of interpreter services in the Circuit Court of Cook County.

Spanish, Polish and sign language interpreters are the most frequently requested, but the court is prepared to provide for everyone.

“We have three tiers of staff,” Rodriguez said. “We have full-time staff in the most often used languages: Spanish, Polish and sign language. We have a second tier that is called ‘session employees.’ They are reimbursed by how many sessions they work. We also have a variety of what we refer to as ‘exotic languages.’ So they are just languages of lesser use.”

However, in a diverse city like Chicago, Rodriguez finds that more help is needed.

“We contract out with a language services provider,” she said. “Our full-time interpreters work every single day and the others are as needed. The contract agency is for when we can’t provide a language.”

Time is the major difference between interpreter services in health care and the courts.

“If there is an impromptu need, the court will call our office,” Rodriguez said. “We welcome the call from any language, even though we normally request 48 hours in advance to request an interpreter.”

However, the two systems aren’t completely unrelated.

“Some medical interpreters do in fact come work for us,” Rodriguez said. “They are a plus because some of our cases use that specialized terminology. So we have very good luck when they have that experience.”

See this article at the Medill News Service

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