Care comes in all languages: Medical interpreters connect patient, provider

By Chelsea Boulrisse | Sep 21, 2018 | Originally published on

Going to the hospital or a doctor’s office can be nerve-wracking as is, but for people who struggle with the English language, that anxiety can increase tenfold. In order to help those people, specially trained medical interpreters are brought in to make sure the care doesn’t get lost in translation.

Data from a study recently carried out by the St. Joseph Community Health Foundation showed that just over 10 percent of the population in Allen County did not speak English at home. In addition, half of that group reported having difficulty with the language.

“I think some immigrants, some refugees, they don’t have enough time to go to English classes but they are willing to,” Ayman Trabulsi, a local professional medical interpreter, said. “They work hard or have longer hours, so they don’t have enough time. For someone coming from overseas who never had the chance to practice English, it’s not easy to explain himself properly and correctly.”

Bridging the gap

Organizations like Amani Services and St. Joseph Community Health Foundation have seen firsthand the importance of medical interpreters in the community to be the communicative bridge between foreign-born residents and their doctors or counselors. Without these licensed interpreters, patients may not be able to fully understand the care they are looking for or may avoid getting medical care altogether. Even simple instructions such as prescription dosages can become a challenge.

“Without an interpreter or if they have a child as an interpreter, what happens is the encounter doesn’t go typically as successfully as it would,” Irene Paxia, executive director at Amani, said. “The professional providing those services is not able to provide the same quality of service than if an interpreter was present. This can go all the way to a person risking their life.”

The need for medical interpreters became more apparent, according to St. Joseph executive director Meg Distler, around 2008 when Fort Wayne started taking in a large volume of refugees, most of whom spoke Burmese. Adding to the challenge, Distler explained, were the differences between the American health care system and the system most of their newest residents were familiar with.

In response to this need, agencies like St. Joseph and Amani helped build training programs to teach willing participants the best practices for being a medical interpreter. Oftentimes those trained interpreters are then paid for their services through grant monies awarded to local agencies.

Distler pointed out that medical interpreters are expected to demonstrate more than just the ability to speak another language, but to utilize it in a way that is effective in a health care environment.

“It’s more than being bilingual,” Distler said. “A trained interpreter is taught all of the research of best practices to accurately relay information orally from one person to another.”

Interpreters are stationed at hospitals and health care providers all over the county, but the ones that get called in the most, Distler pointed out, are at health clinics that serve people without health insurance. In the same population study, St. Joseph found that 32 percent of Allen County’s foreign-born population, many of whom do not have strong English skills, were uninsured. As a result, many foreign-born residents may seek out the care of facilities such as Matthew 25 or the local health department.

Meeting the demand

By Distler’s count, there are currently about 110 trained medical interpreters in the area, speaking around 18 different languages. The need, though, still outweighs the numbers.

“There is a tremendous need, particularly for Spanish in our community,” Distler said. “Following that is Burmese or different dialects of the Burmese language.”

A common reason for the continued shortage, Paxia pointed out, is the inconsistency of compensation between companies that hire or contract out interpreters. While interpreters at Amani receive a salary and benefits like any full-time worker, some other companies do not offer such benefits.

Also, as a precaution, Paxia said, the agency requires any interpreter, whether on the payroll or contracted out, to have liability insurance, in case important information gets lost in translation and leads to complications. Such insurance, as well as transportation and other expenses, can make it difficult for an interpreter to make a living.

“You need to have a certain number of hours to make it worth your time,” Paxia said. “If you don’t have enough hours, you have difficulty paying for the expenses related to being trained, insured and providing your own transportation. It’s a great profession, but it only works if you’re very well connected.”

One way that the problem can be assuaged, Paxia suggested, is encouraging more professionals, especially those working in medicine, counseling or case work, to pick up a second language, thus eliminating the need for a go-between.

“There’s not enough bilingual caseworkers and counselors, so we rely on interpreters to work with our licensed caseworkers and therapists,” Paxia said. “If we have a counselor that spoke Burmese, we wouldn’t need as many Burmese interpreters.”

Helping thy neighbor

It takes a special kind of person to serve as the middle man between patient and provider. A large portion of people who step up to the task are foreign-born residents themselves, looking to reach out a helping hand to those still struggling with the language.

“They have experienced for themselves the difficulties of relocating,” Paxia said. “They’re passionate about helping others. Oftentimes they start informally as an interpreter for their parents…Then over time they find out through training what it means to be a professional interpreter.”

Trabulsi is one such citizen who has taken it upon himself to utilize his previous translation experiences to serve the community as a medical interpreter.

“When I came here, I decided I would like to serve the community, serve other people,” Trabulsi said.

Originally from Damascus, Syria, Trabulsi worked as a mechanical engineer, primarily helping his company communicate with partners in India, Italy and several other foreign countries. Later on, Trabulsi took his language skills to the French embassy in Damascus to help people navigate the procedures of the embassy.

Today, he spends his time handling Arabic/English or French/English interpretations, bouncing around from one location to another depending on where the need is. While the added medical component was new for him, Trabulsi refuses to let it be a barrier for him, opting to continually review his skills daily.

“I keep the book always close to me so that I can start my day by reading something about the medical terminology so I can improve all the time to talk better and be more professional,” Trabulsi said. “The challenge is to always do your job as accurate as possible and to be on time and to make everybody comfortable that you present a service to.”

Even when navigating the various Arabic dialects or trying to put a complicated medical procedure into layman’s terms, Trabulsi finds joy in his work.

“At the end of interpreting, you feel that you’ve done something for others,” he said. “And that makes me satisfied with what I’m doing.”