According to one local bilingual healthcare professional, simple translation and healthcare interpreting are two vastly different skills that can literally mean the difference between life and death.
Northern Inyo Hospital Language Services Manager Jose Garcia knows that difference and was recently honored for it, NIH Director of Community Development, Marketing and Grant Writing Angie Aukee said.
On Jan. 23, Garcia was voted president-elect of the California Healthcare Interpreting Association. It is the organization that sets the standards for healthcare interpreting throughout California, Garcia said.
Garcia, with nine years experience in this specialized field, earned CHIA presidency because he “is committed to educating healthcare providers and our community about healthcare interpreting,” Aukee said.
This specialized type of interpreting is not “just about speaking two languages, Garcia explained. “It can be very challenging but that is why I like it.” Healthcare interpreting incorporates medical terminology proficiency, competency in the syntax, grammar and pronunciation of both languages and bridging the cultural gaps that exist between patient, provider and healthcare system, he said.
According to the Oxford English Dictionary website, there are approximately 750,000 words in the English language, including technical jargon such as medical terms. By comparison, there are about 200,000 words in Spanish, combining all regionalisms, Garcia said. Consequently, it typically requires more Spanish words to express the same thought as it does in English. Straight word-for-word interpreting, taken out of context, can be completely meaningless, he explained.
Healthcare interpreters must comprehend and make providers aware of cultural cues, Garcia said – attitudes and beliefs regarding screenings or taking medications can be the difference between life and death for patients.
To illustrate his point, Garcia cited an incident. A Spanish-speaking mother brought her adult son in to a Florida ER several years ago. An interpreter was not utilized. When the mother said “intoxicado,” it was assumed that her son was intoxicated. In fact, intoxicado means food poisoning.
The resulting “egregious medical error” resulted in the son being left with permanent brain damage and quadriplegia and a $71 million lawsuit for the hospital.
It also resulted in a group of interpreters and program managers creating CHIA in 1996. Prior to that, hospitals used any bilingual employee to translate for patients and healthcare providers. CHIA’s diverse membership includes interpreters, healthcare providers, language-service companies, educators and government policymakers.
In 2004, Garcia was an interpreter for Mammoth Hospital. As a native Spanish speaker and dentist familiar with medical terminology, Garcia said he thought healthcare interpreting would be simple. He soon realized he needed specific training and enrolled in healthcare interpreting courses at NIH offered by local CHIA Board Member Katharine Allen.
Within six months he was promoted to Supervisor of Interpreter Services, Aukee said. He wrote healthcare interpreting policy and hired five full-time interpreters and 10 dual-role interpreters – 50 percent of Mammoth’s population is Spanish-speaking. “Dual-role interpreters have primary jobs but they have language skills and have completed healthcare interpreting training” required by NIH.
In 2007, Garcia joined NIH’s staff, took a CHIA-standards-based, 60-hour, basic healthcare interpreting trainer course at Healthy House in Merced and became a CHIA board member, participating in its education and membership committees and conference calls.
Last month, Garcia said he took the written portion of the National Board of Certification for Medical Interpreters, which requires intimate knowledge of three different sets of standards – the California Standards for Healthcare Interpreters, the International Medical Interpreters Association Standards of Practice and the National Standards of Practice for Interpreters in Health Care, and “sit for the oral portion in March.”
Garcia is dedicated to “providing interpreting services for NIH that focus on the health, confidentiality and wellbeing of the patients we serve,” Aukee said.
NIH’s trained 13 dual-role interpreters have learned impartiality, ethics, professional conduct, cultural awareness, paraphrasing and the very crucial element of confidentiality. “We must assure the patient that everything will be kept confidential. Once you say ‘I have to tell the doctor everything you say,’ there is immediate trust,” Garcia said.
His staff of trained healthcare interpreters also utilize resources such as Language Line, a telephonic interpreting service, and Health Care Interpreter Network, a video interpreting service, to provide healthcare interpretation in more than 170 languages, she said.
Healthcare interpreting is a service that residents, tourist-patients and healthcare providers all find invaluable, Aukee said.