Note from the Editors:
Whether this month's edition of CHIA Insider finds you on vacation, at work, or helping your kids gear up for a new school year, it is next to impossible to ignore the healthcare debate that has taken front stage and center this summer. Of course, those of us involved in healthcare interpreting are all too aware of the challenges faced by patients and providers in our current system, whether it be something as simple as trying to make an appointment in a language unfamiliar to you, or the more complex challenge faced by a hospital working to provide quality care to all its patients, regardless of nationality, insurance status, and languages spoken. In this edition, we offer the reader a broad glimpse of trends in our field from different perspectives. Freek Lankhof, owner of Intrans Books, provides us with insight gleaned from two decades of attending industry conferences across the country and Beverly Treu mann recaps the recent Healthcare Interpreter Conference in Oakland, CA. Arlene Narváez gives a compelling description of the trilingual interpreter, who works in ASL, English and a third language. And Christopher O'Roark examines cultural competency for the healthcare interpreter as it relates to religion. Finally, we are pleased to announce information about CHIA's 2010 Annual Conference and ongoing developments with the CHIA Standards Training targeting healthcare administrators. The healthcare reform debate may rage on nationally with no clear end in sight. In the meantime, we want to highlight how healthcare interpreting is bringing needed reform to the field, quietly, and without as much hoopla, but real change nonetheless.
Katharine Allen and Nick Arce
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CHIA Conference Set for March 18-20, 2010
CHIA is pleased to announce that it will partner on its next annual conference with the Health Care Interpreter Network, a non-profit cooperative of California hospitals and healthcare systems that uses video-conferencing technology to share trained healthcare interpreters. The conference, From Face-to-Face to Cyberspace, is scheduled for Thursday through Saturday, March 18-20, at The Westin South Coast Plaza in Costa Mesa, CA.
CHIA and HCIN are coordinating three full days of programming that will feature a wide range of topics, including the growth and appropriate use of technology in providing language assistance in healthcare. The joint conference is expected to draw interpreters, trainers, managers, hospital administrators, and health plan representatives from across the country.
Registration and programming information will appear in the coming weeks. For now, please mark your calendars! |
A Bookseller's Tour of Our Profession
By Katharine Allen
Freek Lankhof, Friend of CHIA 2007, owner of InTrans Book Service and a familiar face to many, sat down with the CHIA Insider this month to discuss his take on the industry. Freek travels to over 20 events a year and brings a unique perspective as someone who has witnessed the growth of our field up close and personal.
Insider: First of all, what is InTrans Book Service?
Lankhof: We are a prime source for specialized language dictionaries, other reference material and study books for professional interpreters and translators.
Insider: What kinds of events do you attend?
Lankhof: Over the past 20 years, I have been traveling to all kinds of conferences and regional meetings. I regularly sell books at the ATA annual conference and their regional meetings. I go to TAPIT, NATI, AAIT, CHIA, CFI, CCIA and MICATA, to name a few.
Insider: What kinds of trends are you seeing in the T&I professions?
Lankhof: Overall, I see increased attention paid to medical interpreting. There are more conferences just for this area and other conferences are building it into their programs. There used to be more emphasis on court interpreting and recently I have also seen more emphasis placed on community interpreting. Another trend I see is less demand for dictionaries and more requests for self-learning materials, such as Holly Mikkelson's ACEBO products or those put out by the Berkana Learning Center. These are books that help people self-train in the fundamentals of translation and interpretation, running a business, anatomy and physiology, etc. There is a lot of focus on prepping to take entry-level tests. Also, more and more, I see print dictionaries being pushed into the background. People don't think they need them as much as before. There is a definite trend among younger buyers who believe they can find all their terminology online. Many buy a basic bilingual dictionary and it takes a while before they realize they can't find everything they need through a Web search. Fortunately, those with more time in the field come to realize the importance of print dictionaries and specialized reference materials.
Insider: How has the bad economy affected your business?
Lankhof: This year I have sold more books at conferences, and fewer on the web. There is a frugal mindset right now linked to this economic downturn. People are obviously more careful about what they are buying. But no matter where I go, typically 60% of what I sell is to new customers, and 40% to returning clients. Overall, T&I does not seem be as hard hit by the economic downturn as other fields, I am selling more at conferences this year and they have been well attended.
Insider: What kind of regional differences do you see in the field?
Lankhof: There are some regional differences in terms of what kind of language materials I get asked for. In the Midwest people ask about African languages, such as Somali, and there is a large Hmong population in Minneapolis. Out West I get more requests for materials in Asian languages. Spanish is always in highest demand and most of my materials are for that market. Other Romance languages have good distribution infrastructures, but Spanish-language materials printed outside of the US are much harder to obtain, so I try to be a one-stop access point for those books. I have seen a lot of growth in professional associations and ATA chapters particularly in the Midwest. There are a lot of new associations that have begun to hold meetings over the past five years. You can really see the impact of recent immigration in those markets. And always, there is a big emphasis on medical interpreting.
Insider: Is it really worth it to attend all of these events?
Lankhof: It's not always about the money. At some conferences I make a profit, at others I don't, but I think I have an obligation to be there. As long as I can come and invest in a conference to begin with, I will do so, even if I take some losses initially. My presence benefits both the individual conference and my business down the road. I fill an important niche as a specialty bookseller and I carry books that are not available in big warehouse stores such as Amazon and Borders. I do what I can to support the professionalization of the field. |
Cultural and Religious Diversity in Healthcare
By Christopher O'Roark
Because culture is everything that we consider to be normal and natural, it can be difficult to evaluate our own culture without experiencing another. One of the most defining aspects of a culture is religion, due to its far-reaching effects on many other customs and traditions. As interpreters, we also function as cultural liaisons, and as such it is important that we understand cultural differences with respect to religion. Consider how American culture generally views religion. Although we enjoy the freedom to choose our own religion and beliefs, we largely expect ourselves and others not to discuss them. Our religious beliefs tend to be left at church on Sunday morning. However, in many other cultures a person's entire life can be defined by the religion that they practice. These practices and beliefs, then, will certainly not be laid aside when a patient enters a medical facility. It is important, then, for the interpreter to be aware of a patient's religious background, as the practices and beliefs that stem from that religion can have profound effects on the quality of care that the patient receives. First, we simply cannot assume a religious preference based solely on a patient's language or nationality. A patient should be offered the opportunity to voice their preference for themselves. Second, the interpreter should be prepared to advise health care staff of possible cultural considerations based on religion that could affect a patient's care; these can include dietary restrictions, blood transfusion issues, modesty and gender concerns, and the use of alternative medicine. Additionally, the interpreter must be prepared to interpret for a chaplain or other spiritual care provider. This includes becoming familiar with religious terminology that can often be difficult because of the poetic structu res and archaic vocabulary involved. Most religious texts can be found in bilingual versions to aid in familiarizing yourself with specialized vocabulary. So although our culture may prefer to lay religion aside, acting in the best interest of the patient means being willing to address the subject especially when their beliefs may cause conflict with standard health care practices. A patient's religious beliefs can be extremely influential over questions of blood transfusions, brain death, abortion and many other aspects of health care. As interpreters, we are in a unique position to promote cultural sensitivity, avoid conflict, and help improve overall patient care in our medical facilities.
Christopher O'Roark is a health care interpreter at Long Beach Memorial/Miller Children's Hospital and Director of Youth Ministries at the Carson Bible Church. He has a B.A. in Translation and Interpretation from California State University, Long Beach. Chris recently presented to CHIA Los Angeles Chapter and provided the following handout on Christian Terminology.
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What is Trilingual Interpreting?
By Arlene Narváez
We hear the term, trilingual interpreter, but what does it mean? In relation to the field of American Sign Language (ASL) interpreting, a trilingual interpreter is an interpreter who is working in ASL, English, and a third language, like Spanish. The kind of work that we see can vary from working with deaf professionals, Spanish speaking parents, and deaf children, working in assignments such as Education, Medical, Immigration, to the ever popular Video Relay Service in which a Trilingual Video Interpreter (TVI), using video technology, can interpret any number of calls connecting a deaf consumer to a hearing consumer, switching from a Spoken English call to a Spoken Spanish call in a matter of seconds.
It is said that TVI's go around the world in a day, interpreting telephone calls that connect consumers anywhere in the United States or any country. This exposes interpreters to dialectical differences, varying accents, and varying speeds of conversation. The TVI's responsibility is to facilitate the communication between the consumers, to remain neutral, and to manage the amount of stress in front of them; doing all of this successfully makes the task seem easy.
Many factors are involved in this specialization, such as, the variety of signing styles that range from ASL, ASL with Latino cultural gestures and/or home signs, Signed English, and Signed English with mouthing in Spanish. Adjusting to the signing style of the deaf consumer is only one part of the job. Understanding culturally appropriate gestures that may not fit the culture are also important. An exampl e is the ASL sign for child, used to denote height, is only used to refer to animals in Latino cultures, an index finger would be the more appropriate match.
Trilingual interpreters take what they know as trained Sign Language interpreters, following the Code of Professional Conduct of the Registry of Interpreters for the Deaf (RID) and apply it to the Spanish component of the work that they do. Additionally, trilingual interpreters are held to the same standards as bilingual interpreters, in terms of breaks, teaming, and professional development. It is time to reconsider the standard, research the work that we have been doing, identify the differences and the nuances of the work, and move forward as informed interpreters and informed consumers about the amazingly complicated work that we do.
Arlene Narváez has been interpreting for 10 years and holds both RID CI and CT certifications. She is currently the Co-Chair of the Southern California RID Trilingual Committee and the Region V Representative for Mano a Mano, an organization that supports interpreters working in Spanish influenced communities. |
Healthcare Interpreter Network Conference in Oakland, CA
By Beverly Treumann
Patients who speak limited English are often very appreciative when someone helps them communicate with a provider in a healthcare setting in the United States. "Thank you, so much. God bless you. God will pay you," is what they might say to the bilingual employee or the trained interpreter who makes all the difference in the world in a given moment to bridge a communication gap.
Despite the patient's right to an interpreter and despite the progress that has been made to develop a profession of healthcare interpreting, patients in many settings still find that getting help is a matter of chance. And when they say thank you, part of the message is, thank you for being here this time.
The recent Healthcare Interpreter Conference that took place in Oakland, CA on July 16 and 17, 2009 provided an opportunity for managers, administrators and providers to come together to exchange information about how to improve language access for patients. Interpreters (including more than a dozen ASL interpreters), educators, researchers and IT specialists also attended, making for a total of 182 participants. The theme, "From Ad-Hoc to Best Practices in Healthcare Interpreting," was chosen to mark the movement away from how it all began not so long ago with: "Hey, you speak Spanish. Can you help me?"
The conference was convened by organizations that are bringing new resources and leadership to the challenge of providing equal language access to all patients: Health Care Interpreter Network, Kaiser Permanente, California HealthCare Foundation, California Hospital Association, National Association of Public Hospitals and Health Systems, and the California Association of Public Hospitals and Health Systems/California Health Care Safety Net Institute.
Conference highlights included: Wendy Jameson of the California Health Care Safety Net Institute (SNI) noted the progress made on language access among California hospitals since 2002. Public hospitals, which comprise only 6% of California hospitals but provide 45% of the hospital care to the uninsured, have demonstrated leadership in establishing effective language services. This has occurred because of their mission, their patient population, (over half of whom are Limited-English Proficient), SNI's efforts to develop and spread models and best practices, foundation support, and the emergence of remote technology solutions. Jameson provided data showing a steady increase in the use of qualified interpreters at California public hospital systems.
Cindy Roat, a national leader in our field, presented on "Best Practices in Health Care Interpreting 2009," in which she reviewed the growth of healthcare interpreting from its roots as an ad-hoc service provided by family members to the nascent profession that it is today. One point that she made that was echoed throughout the conference was that progress today is driven more by concerns for patient safety rather than simply by fear of regulatory consequences. Gayle Tang, Director, National Linguistic & Cultural Programs, National Diversity for Kaiser Permanente, spoke on the need for a multi-pronged strategy to ensure meaningful and effective language access. This form of comprehensive strategy highlights the need for qualified interpreters, as well as for bilingual employees and providers who have been assessed for language skills, translation of materials through a process that ensures quality, and for identification of language needs in the medical record.
Finally, Marjory Bancroft, Director of Cross-Cultural Communications, spoke on the National Council on Interpreting in Health Care and its plans to develop standards for training for all who assist with language access. |
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