Health care interpreters see an increasing need
When a child or other family member is sick and needs medical attention, a trip to the doctor is often required.
But what if that doctor speaks a language different from yours? How can you be assured she will understand the situation and administer appropriate care — and that you will understand her instructions?
That's a scenario that plays out every day in Oregon and across the country. More than 20 percent of the population in the United States speaks a language other than English at home, according to the U.S. Census, and 25 million Americans have limited English proficiency (LEP).
The 2017 Census report shows that 40.5 million Americans speak Spanish, nearly 3.4 million speak Chinese and 1.7 million speak Tagalog, a first language used by a quarter of the population of The Philippines. Ever heard of the tonal language Karen, spoken in parts of Myanmar? It is one of more than 100 languages spoken by citizens of the Portland metropolitan area.
Since 1975, 65,832 refugees have resettled in Oregon, Census figures show, and all of them — regardless of the languages they speak — are entitled to the services of an interpreter for health care appointments and other needs under Title VI of the landmark Civil Rights Act of 1964, which eliminates discrimination based on a person's national origin.
And that's where the Oregon Health Care Interpreters Association (OHCIA) comes in. Founded in April 2011, the organization's goal is to promote and further the advancement of the health care interpreter profession.
The nonprofit works in cooperation with federal, state and local agencies to offer education about the need to provide interpreting services to LEP patients and how to utilize health care interpreters in medical settings. The organization was founded by interpreters and is dedicated to creating positive changes for the Pacific Northwest's diverse population.
"Think of a swimming pool at open swim time," said OHCIA Executive Director and Lake Oswego resident Susy Molano. "Everybody is going every which way, swimming however they wish. What we aim to do is organize our interpreters like synchronized swimmers — our actions are organized and we are moving forward in the same direction."
Health care interpreters are the sole effective communication bridge between the health care professional and the LEP patient. Not only do interpreters understand the languages being spoken, but they also have been trained to be culturally sensitive, ethically conscious and able to explain medical terminology accurately. Their job exists to ensure LEP patients get the same quality of health care as everyone else.
Toward that end, OHCIA has launched a Pacific Northwest Interpreter HUB, a revolutionary model for health care that is providing better care, better health and building better communities.
The HUB includes a web-based interpreter portal, where interpreters can access agencies needing services and agencies and health care providers can view profiles of interpreters, matching needs to skills. By using the HUB, interpreters can more easily find clients needing services.
"Before the HUB, interpreters would have to go knock on doors to find clients needing interpreter services," said OHCIA Events and Development Manager Carola Ibanez. "Now they can more easily find the jobs and work more hours."
The HUB also gives interpreters access to a team of 20 master interpreters who act as mentors, sharing information to build their skills as cultural brokers. Through the HUB, interpreters also have access to services provided by partner agencies such as Goodwill Industries, which provide professional computer training, skill assessments and the free services of employment specialists.
The HUB also is a center for advocacy for better laws.
Recently, OHCIA launched the Diamond Project, a scholarship program to support individuals who would like to pursue a career as a health care interpreter. Recipients will receive all the necessary funding and support to complete the process to become a qualified or certified health care interpreter in Oregon and be ready to help refugees and immigrants build a community. The cost is approximately $1,200 per interpreter.
"We are investing in people," Molano said. "And in a bright future."
She said the name for the Diamond Project has special significance.
"Diamonds are the most resilient stone. It takes hard pressure to make them, and they don't look like anything special until you cut and polish them. Then you can see they are strong and precious," she said.
The refugees, she explains, are similar in nature; when they first arrive in the United States, they may be intimidated by the language, different customs and the American way of life.
"We are good at welcoming people to the U.S., but then what?" said Molano. "They still need help with schools, medicine, legal assistance, functioning in society and getting a job. Think about trying to use mass transit or learning to drive. Through the Diamond Project, we can train more interpreters and then help (the new residents) become self-sufficient."
Since the financial barrier for training is removed with funding from the Diamond Project, those wishing to become interpreters can do so more easily and begin working sooner as interpreters, building community and support for those who need it.
"The faster we can certify interpreters, the better outcomes we can achieve," Molano said. "We really are cultural brokers, helping medical professionals understand cultural norms of their patients that they may not otherwise know."
Another issue the HUB will address is standardization in accreditation and certification. Currently, there are no nationwide standards, so OHCIA aims to standardize training in Oregon first and then influence the standards set for the rest of the country.
"Oregon already requires the most training," said Ibanez. "Our training is 64 hours, and most other states require just 40 hours."
Elijah Voichishin, 23, is a nursing student who has been interpreting for Russian-speaking clients for about seven months. His nursing education has already proved valuable for other interpreters and his clients.
When Voichishin was going through the training program, an instructor was having difficulty explaining a medical procedure and asked Voichishin to explain it. He did, sharing in English so that the other interpreters could understand.
"There are some words, like 'tingle,' that don't necessarily translate," he said, so a lot of preparation is required before interpreters meet with a client. They must learn about the medical condition ahead of time so they can clearly explain what is discussed — a process that can be mentally exhausting.
"The people at OHCIA are so thorough, they make certain you have the information you need. They want you to succeed. I feel very confident I can help my clients," he said.
Alma Gomez is OHCIA's Master Interpreter Project Manager. At the age of 12, her family came to the U.S. from El Salvador. Her sister has cerebral palsy, and Gomez had to be the family's interpreter during trips to the doctor or hospital.
When she moved to West Linn in 2006, Gomez sought to rebuild community among the Spanish-speaking community by becoming an interpreter again. As a master interpreter, she now mentors interpreters in the nuances of the Spanish culture.
"As master interpreters, we keep in touch with the interpreters and give feedback (on what they are experiencing)," said Sandra Valdez who is another of OHCIA's master interpreters. "The providers learn from the interpreters, too."
Gomez said the interpreters are respected by the medical community for their professionalism and commitment.
"We are continually improving the conditions," she said, "but it's the lack of resources that slow us down."
The Diamond Project hopes to ease that situation by funding the training of more interpreters, who will then be able to meet an ever-growing need.
"Our role is crucial to the success and better health of the people we serve," Gomez said. "So we just 'keep on swimming,' as Susy says."
To learn more about OHCIA or donate funds to the Diamond Project visit ohcia.org.