Monday, October 11, 2010

My Night As Medical Interpreter – 1

Before I was laid low by the flu, I read a very interesting article about Medical Interpreting – the Professional Expert kind. It’s a paper from The Critical Link 5 conference (see References). The Critical Link is the premier international conference series on Community Interpreting (or as the British call it, Public Service Interpreting). Critical Link 5 was held in 2007 in Sydney. It was an appropriate venue because Australia was a pioneer in the provision of high-quality Community Interpreting. Indeed, when we organised the first Critical Link conference, which took place in Canada in 1995, I was amazed to learn that Australia was way ahead of my own country both in the provision of services and in the setting of standards.

The reason for all this activity is made clear in the article. There are still people who still think of Australia as an outpost of England and of English. But the reality is, as the article says, that
Australia is one of the most culturally and linguistically diverse countries in the world. In the 2006 census it was possible to code up to 282 countries of birth, 364 languages and 115 religious groups.
The change began immediately after WW2, in the late 1940s, with the arrival of large numbers of non-English speaking refugees and other immigrants from Europe. Later waves of newcomers have come from Latin America, Asia, the Middle East and more recently Africa. By 1973, in the face of this ‘new look’, the Australian government adopted a ‘multiculturalism’ policy and there was the political will to implement it by substantial increases in government expenditure on immigrant welfare and assistance.

The first part of the article relates the history of these services in the state of New South Wales (NSW) from 1972 onwards, and makes it very clear with a timeline graphic. In 1973, the government Telephone Interpreting Service was organised – a world first and a decade ahead of North America – to cope with the problem of delivering interpretation in such a vast country.
In 1977, the Health Care Interpreter Service (HCIS) of NSW was set up, initially providing a workforce of twenty-seven interpreters to serve seventeen Sydney hospitals. Today, the HCIS has a workforce of over 1,000 full and part-time interpreters… generally free of charge, in more than seventy languages (including Auslan or Australian Sign Language)… In rural and remote regions, HCIS interpreters are able to facilitate consultations using videoconferencing.
In the same year, 1977, the National Authority for the Accreditation of Translators and Interpreters (NAATI) was established to act as a uniform standards-setter. Guidelines were drawn up, then reissued and revised over the years.

The rest of the article is mainly taken up with case studies in the form of accounts of their experiences by some of the interpreters. They dwell more on the problems of cultural differences than of language differences that the interpreters encounter. Here’s an example.
Vietnamese families try to protect old patients with terminal illnesses by not telling them the diagnosis or that their time is nearly up.
Many families often approached me outside the [hospital] cubicle and told me not to break the bad news to the patient. I could only say: ‘I have to interpret what the doctor says but, if you like, I can interpret for you with the doctor. You can make the request and it’s up to the doctor to decide.’
The general conclusion is that “in all the case studies collected… the effectiveness of the interpreter’s intervention was a source of great job satisfaction.”

Yet in spite of the wealth of experiences in these real-life case studies, nothing in them prepared me for my own initiation willy-nilly into medical interpreting. This was because all the accounts treated of patients with physical injuries and illnesses, whereas I found myself up against the perplexities of mental illness, where language – or rather the discourse in the language – itself constitutes a major symptom of the disease.

To be continued.

Ilse Blignault (U. of New South Wales), Maria Stephanou and Cassandra Barnett (NSW Transcultural Aged Care Service). Achieving quality in health care interpreting: Insights from interpreters. In The Critical Link 5, ch. 14, pp. 221-234, 2009.

The Critical Link 5: Quality in interpreting – a shared responsibility. Edited by Sandra Hale (U. of Western Sydney), Uldis Ozolins (Royal Melbourne Institute of Technology U.) and Ludmilla Stern (U of New South Wales). Amsterdam: Benjamins, 2009. 255 p.

New South Wales Department of Health. Standard Procedures for Working with Health Care Interpreters. (Doc. No. PD2006_053). Sydney: NSW Health, 2006.,



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