Working with Interpreters

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Working with Interpreters

• Mary Phelan
• mary.phelan_at_dcu.ie

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What is Interpreting?

• Interpreting is spoken
• Translation is written
• Knowledge of two languages does not necessarily
  guarantee ability to translate or interpret well.

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Groups that may need interpreters

• Asylum seekers
• Refugees
• Tourists (5.9m in 2002, 1.4m from non English
  speaking countries)
• Deaf people - 4,500 in Ireland
• EEA workers
• Work permit holders
• Workers on student visas

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Asylum Seeker applications
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Countries of origin of asylum seekers in 2002
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Work Permits Issued
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Top ten countries of origin of Work Permit
holders in 2002
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Putting the Patient First (1)

• You have the right to be informed of the nature
  of your illness or condition in language which
  you can fully understand, and to be informed
  concerning
• the results of your tests and x-rays
• the purpose, method, likely duration and expected
  benefit of the proposed treatment.

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Putting the Patient First (2)

• Alternative forms of treatment
• possible pain or discomfort, risks and
  side-effects of the proposed treatment.

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When are Interpreters called?

• When a patient has ZERO English?
• When a patient has a little English?
• When a patient requests an Interpreter?
• For some procedures but not for others?
• All patients have the right to understand and to
  be understood.

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Communication Issues

• 80 of a doctors information comes from
  communication, 20 from examination/tests
• Patients normally speak for 18 seconds before
  doctor interrupts them
• 80 of patients complaints relate to
  communication

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Who is doing the interpreting?

• Friends
• Family members, including children
• Sometimes there is no interpreter
• Untrained paid interpreters - face to face or
  over the phone

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U.S. Office of Minority Health 1999

• The error rate of untrained interpreters
  (including family and friends) is sufficiently
  high as to make their use more dangerous in some
  circumstances than no interpreter at all. This is
  because it lends a false sense of security to
  both provider and client that accurate
  communication is actually taking place.

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Untrained interpreters may

• Add extra information
• Omit information
• Alter information
• Provide advice
• Not be familiar with medical terminology
• Not respect confidentiality
• Be embarrassed

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The hidden costs of using untrained interpreters

• Wasteful use of medical services
• Unnecessary tests or procedures
• Informed consent?
• Cheaper to provide a trained interpreter

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Eastern Regional Health Authority Annual Report
2001

• There were some reported difficulties making
  appointments with health professionals,
  explaining symptoms or situations and
  understanding the directions of health
  professionals. However, the most difficulty was
  experienced by persons who rated their English
  language proficiency as poor.

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Irish Journal of Psychological Medicine March 2002

• Language difficulties appeared to be a major
  hurdle to diagnosis and possibly treatment in a
  substantial minority. Trained interpreters were
  not readily available, leading to incomplete
  assessments and probably lack of empathy and
  treatment in many cases.
• (Noel Kennedy et al)

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University Hospital Galway

• Non-national children were also being
  inappropriately used as interpreters only 12 of
  asylum seeking parents had a basic grasp of
  English, leaving the difficult task of
  communicating with health professionals to their
  young offspring.
• The Sunday Times 25th May 2003

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Irish College of General Practitioners survey

• GPs have identified a lack of interpreters in the
  health system as the single biggest barrier to
  offering quality medical care to asylum seekers
  and ethnic minority patients.
• The Irish Times, 24th May 2003

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Who would want to be an Interpreter?

• Erratic demand. No pay structure
• Most interpreters spend more time travelling than
  interpreting
• Usually tied to an agency so they cant speak
  their mind
• Are expected to be professional even though they
  are not trained
• Isolation

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When working with an Interpreter
Service Provider
Interpreter
Patient
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Working with an Interpreter

• Background information is always welcome in
  advance
• Match the gender of interpreter and service user
  if appropriate
• Possible religious/political differences
• Allow extra time including time for introductions
• Consecutive Interpreting

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Working with an Interpreter

• Speak directly to service user, not to
  Interpreter
• The Interpreter will use I when speaking for
  service provider/service user
• Speak in clear sentences and pause often
• Let Interpreter interrupt you if necessary
• Avoid jargon and abbreviations

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The Core Problems
No policy on interpreting No training for
interpreters No guidelines for interpreters No
testing of interpreters No quality control No
records
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Solutions

• Training for Interpreters in interpreting
  techniques, terminology, ethics.
• Training for service providers.
• An accreditation system.
• Ongoing training.
• Quality control.