30872: Hermantin(News) Language of Healing (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: leonie hermantin <lhermantin@hotmail.com>



LANGUAGE OF HEALING
With a growing Hispanic and Haitian population, words are becoming a barrier 
between doctors and patients
By Maria Herrera and Patty Pensa
South Florida Sun-Sentinel
12:27 AM EDT, July 22, 2007




William Arias knows he'll find someone at the doctor's office to translate. 
Nurse, secretary, janitor. Anyone will do. Osmara Perez and Lorena Morales 
schedule their clinic appointments together. Neither knows English. Marisela 
Herrera uses hand gestures to describe what hurts.Every day in Palm Beach 
County, patients struggle to communicate with their doctors, instead entrusting 
family, friends and even strangers with the private details of their conditions 
and medical history. Because of language barriers, these patients often do not 
follow doctors' orders, misuse prescription drugs or avoid care altogether. The 
problem, which some say contributes to higher hospital costs for all, has 
catalyzed a movement to bring trained interpreters into doctors' offices and 
hospitals."We cannot wait for [immigrants] to learn English," said Yanick 
Abellard, executive director of the Intercultural Family Health Education 
Center, a West Palm Beach nonprofit group that works with Haitians. "They won't 
go to the doctor for minor problems. Then they go to the ER and sometimes it's 
too late. ... They are invisible."For years, hospitals and doctors have 
depended on bilingual employees and paid for telephone interpretation. The cost 
of hiring interpreters is prohibitive, they say, and perhaps unnecessary. None 
of Palm Beach County's 14 hospitals has a trained interpreter on 
staff.Considering the area's growing Hispanic and Haitian populations, 
advocates and experts are pushing for change. So far, more than 130 medical 
interpreters have been trained in Palm Beach County in the past year. The 
nonprofit Glades Initiative, which seeks to improve the county's western 
communities, has undertaken the effort with $600,000 in grant money.The local 
effort is part of a new national focus on the connections between language and 
health care. The emphasis has been on hospitals, where health care is most 
concentrated, yet clinics and doctors' offices confront similar challenges. 
While hospitals routinely look to improve patient safety and reduce medical 
errors, the role of language was largely ignored, said Amy Wilson-Stronks, lead 
author of The Joint Commission study Hospitals, Language and Culture: A 
Snapshot of the Nation, released this year.A quarter of Palm Beach County's 1.2 
million residents speaks a foreign language, according to the U.S. Census 
Bureau. Spanish, Haitian-Creole and Portuguese are among the languages spoken. 
The county's Hispanic population alone grew about 40 percent between 2000 and 
2005, the Census Bureau showed.Hospitals routinely use bilingual staff as 
intermediaries between doctors and patients. But advocates say much can be lost 
in translation."Spanish may be your primary language but that doesn't mean you 
know the word for spleen," said Corinne Danielson, of the Glades 
Initiative.What's more, a sizable part of the Hispanic community speaks little 
or no Spanish, instead communicating in at least one of 22 indigenous tongues. 
One in five Hispanics are among the estimated 40,000 Guatemalans who live in 
Palm Beach County. They often feel helpless when they don't understand 
English-speaking doctors.Enter Elisa Tomas, trained Mayan interpreter. Three 
times a week, she heads to the county clinic in Lantana to guide patients 
through the health-care system."You can't just translate," said Tomas, of the 
Guatemalan-Maya Center in Lake Worth. "You got to work around a word until the 
message gets through somehow."Maria Domingo only spoke the Mayan language Mam 
when she emigrated from Guatemala almost a decade ago, so she stayed away from 
doctors."There were so many things I wanted to ask," said Domingo, who later 
learned Spanish but not English. "In the end, I just kept my mouth 
shut."Patients who don't speak English are more often injured during treatment 
or given the wrong medicine, according to a report by The Commonwealth Fund, a 
health care advocate. Hospitals should rely on trained interpreters, the report 
concludes.But hospital officials and doctors say they are generally satisfied 
using bilingual employees, people that patients bring with them to translate or 
telephone-based translators.Dr. Paco Arrascue, a kidney specialist, asks his 
Haitian Creole-speaking patients to come to appointments with someone who can 
translate. It usually works, he said, and most doctors are able to get by."We 
cannot afford to hire an interpreter," said Arrascue, president of the county's 
medical society. "It would be nice, it would be ideal [but] you're not asking 
anyone to do any medicine."At Palms West Hospital in Loxahatchee, bilingual 
employees are first in line to translate. If no one's available, the hospital 
will use the Language Line Services, a phone service that costs about $2 per 
minute.The telephone system, with dual handsets for doctor and patient, is used 
at least once a week in the surgery department where nurse Jean Smith works.The 
hospital has used the service for about four years, and Smith said there's 
little reason to change. "At this point, I don't think it's going to make much 
of a difference because [telephone] interpreters are readily available," she 
said. "I've never had to be put on hold."The Language Line Services, begun 25 
years ago, is itself expanding. It will double its crew of interpreters to 
6,000 in the next two years, said company President Louis Provenzano. The 
company, though, does not employ interpreters who speak the Mayan languages 
because there is no demand, a spokeswoman said.The service also offers video 
and in-house interpreters but telephone interpretation is used most widely. 
Face-to-face interpretation is best for scheduled appointments, Provenzano 
said, but in an emergency, the telephone is best.Boca Raton Community Hospital 
recently bought 20 dual-handset phones, with about six placed in the emergency 
department. Last year, the hospital made 142 calls, using interpreters for 18 
languages. Spanish, Creole, Cantonese and Portuguese were among the most 
requested.As with other hospitals, employees and family members still 
translate. But as more attention is paid to the issue hospitals may have to 
change their practices in favor of trained interpreters, said Amy Wellington, 
director of patient and guest relations."There's a huge need for it," she said. 
"The services they offer now are very expensive and it's hard for health care 
facilities to see the benefit of doing it pro-actively. In the future, all 
hospitals will need to do something."
Copyright © 2007, South Florida Sun-Sentinel
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