May 5, 2005 | Imagine falling ill and going to the hospital, only to find that you cannot explain your pain or understand the doctor’s instructions.

This is a very real scenario for the nearly 11 million people in the United States, including more than 57,000 in Arkansas, who speak English “less than very well” according to the U.S. Census Bureau. For them, having access to a trained medical interpreter is not just a convenience; in some cases it could mean the difference between life and death.

On April 8, the University of Arkansas for Medical Sciences (UAMS) certified its first class of medical interpreters. The week-long course, taught by Angelina Levitskaya, the UAMS Regional Programs medical interpreter and training program director, focuses on privacy issues, cultural differences and even positioning between the patient and physician so the interpreter does not become the center of attention. Interpreting only involves the spoken word; translating involves the written word.

“We speak more than 70 languages here at UAMS,” Levitskaya said. “Many of our staff members who speak more than one language could be invaluable as certified medical interpreters.”

The need for medical interpreters is not only vital for good doctor-patient relations – it is the law. Title VI of the Civil Rights Act prohibits discrimination, including unintentional discrimination by limiting the availability of services to someone. Several cases across the country accentuate the need for certified medical interpreters, including:

·       A woman whose baby was still-born because the doctor could not communicate that she needed a cesarean section.

·       A 16-year-old boy who was used to interpret for a woman seeing a gynecologist.

·       A 10-year-old girl who had to interpret for her mother at a public health clinic concerning the use of birth control pills.

“Medical interpreting is very different than other types of interpreting; it requires many special skills,” Levitskaya said, comparing it to the political and industrial interpreting she did for years in Russia and the United States.

“Interpreters build a bridge over the language gap that allows people who do not speak the same language to communicate with each other. However, the worlds on each side of that bridge – the world of the provider and the world of the patient – may look very different.”

Levitskaya said that not only must interpreters find ways to express words, ideas and processes that may have no equivalent in the target language, they must also account for the divergent world views that give those ideas their particular meaning. In addition, interpreters must be concerned with whether the listener understood the message, because misunderstanding in health care can be dangerous, even fatal.

There are also times when a patient’s lack of experience in the complex health care system of the United States makes it necessary for the interpreter to intervene to ensure the patient gets the care to which he is entitled. In fulfilling these roles, it would be easy for the interpreter to become a focus of the interaction.

“On one hand, you have a doctor who may be explaining things in very technical terms, and on the other you have a patient who may be very emotional,” she said. “Interpreters, then, must facilitate accurate communication between patient and provider, but not take control of it.”

Levitskaya said the position of the interpreter during the medical interview is a delicate balance, requiring sensitivity and proper attitude, a willingness to intervene when necessary and yet stay in the background the rest of the time. Medical interpreters must be very clear about their role so that, far from obstructing communication, they succeed in helping patients and providers connect with each other and clearly understand each other.

The new UAMS certified medical interpreters are: Chris Dickens, management project analyst for the Area Health Education Center (AHEC) in Fort Smith (Spanish); Socorro Duke, nursing assistant at the AHEC Southwest in Texarkana (Spanish); Bernadeta Kreft, business officer for the central office AHEC (Polish); Mary Lou Louviere, patient account specialist, Arkansas CARES (Spanish); Sonia Monroy, licensed practical nurse at the AHEC Southwest (Spanish); and Luis Navidad, a future student in the UAMS College of Nursing(Spanish).

The medical interpreters, along with Levitskaya, represent the countries of Columbia, Mexico, Poland, Russia and Salvador,

As UAMS expands its base of medical interpreters, Levitskaya said, it may be able to use the latest technology to expand their availability. She said future workshops may focus on phone interpretation and the use of telemedicine.

The next medical interpreter’s course will be June 27 through July 1 in the UAMS Regional Programs conference room. The course is eight hours a day. For more information, or to register, contact Levitskaya at (501) 686-6556.

Links on This Page

UAMS Regional Programs: http://rpweb.uams.edu/

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