Saturday, April 13, 2013

Medical Language Brokering: A Testimonial

Let me make it clear from the start that I share the concerns of Professional Expert medical interpreters and many other people about letting immigrant children translate between family members and health care staff. The litany of objections includes the following:
  • The possibility of dangerous mistranslations, omissions and additions, especially in a field that uses a lot of technical terms
  • Placing on children a responsibility for which they are too young
  • Putting the children under stress from their relations with their family members and with the medical staff in addition to the difficulties of the translating itself
  • Exposing children to situations, knowledge, private and intimate data that it’s inappropriate for them to be acquainted with at their age.

An additional concern   rarely mentioned but one that I’m conscious of myself as a translator for a professional college of physicians and surgeons: the vulnerability of the interpretations and the interpreters to challenge in the event of litigation.
Nevertheless, this blog aims to describe things as they are and not as they ought to be; to use the terminology of linguistics, it’s descriptive and not prescriptive. And the reality is that a great deal of ad hoc medical interpreting for immigrants is still done by their children. The following recollection helps to explain why, as well as describing the experience from a child’s viewpoint. The author was brought up in California and is now in her early twenties.
"California lawmakers are currently [2005] considering legislation that would prevent children from providing language interpretation at hospitals, doctor’s offices and clinics. This made me think back to all the times I translated for my mother at the doctor’s office or hospital.

"I disagree with this law because a lot of the time the only accessible interpreter is a patient’s child. The proposal says that hospitals may have to provide their own translators, but due to the estimated $15 million price tag, many health experts say the state may fall short in trying to provide translation service. Some have even warned that doctors may turn away immigrant patients if they are forced to provide translators.
"In the case of my mother and her doctor’s appointments, if I had not been there my mom would not have had anyone to translate for her. Professional interpreters are expensive and a lot of times, my mother was expected to be able to provide her own translator when it came to understanding documents or speaking with someone about medical business.
"I come from a family of Vietnamese immigrants. I am the first generation from my mother’s side to be born here. Even when I was a small child, my mother assumed that I knew all the English there is to know. My mother figures that language is language; you just need to know basics. She was wrong.
"From fourth grade on, I have been my mother’s translator. Whenever she had an appointment with a doctor, I came along to help her with translating. When it came to just naming body parts and symptoms, I was usually good at that, but there were a lot of terms that I did not understand in either Vietnamese or English.
"I learned a lot of things during those visits. I learned as a fourth grader that women have eggs inside of them. I learned that many conditions have the same symptoms, so that regardless of the illness, a patient, like my mother, would often repeat words such as hurt, nausea, and dizziness.
"That was when the doctor would have to explain his side of the conversation. He would tell me what the issue was in English, and I would try my best to regurgitate the explanation in Vietnamese.
"There was often trouble when I had to translate the documents that my mom brought home from her doctor. There were times when even a Viet-English Dictionary did not help me because the terms in the documents were too technical to be found in my dictionary. I felt bad about not being able to decipher the words, but I just went ahead and helplessly extrapolated what I could. I didn’t know what else to do.
"I would feel bad because I knew my mother came to me only because she needed me and couldn’t afford a professional interpreter. We come from a low-income family and money is hard to come by. Therefore, it was made clear to me that going to an American school even if it was an elementary school qualified me for the job of being the go-between for my mom and the outside world.
"This job wasn’t always easy, but it was an important part of family life in my immigrant family. Banning this interaction between child and parent especially when the family has no other choice  seems wrong to me. When I was interpreting for my family, I felt I was fulfilling my filial duty. I was contributing to the family.
"I hope that the state could get to a point where every non-English speaking person can have access to a professional translator when they need one as they seek health care. If that happened, children like me wouldn’t have to learn a third language  medical talk  that they may or may not fully understand. But until California feels it can definitely give us the translators we need, sons and daughters should not be barred from helping their parents in times of need."
Considered together with the immediately preceding posts on school interpreters and the other mentions of child interpreters in this blog, the above is one more pointer to the universality of translating by children. There seems to be no restriction on place or language, and nor is it limited to exceptionally gifted children.

It also provides a little insight into how this language broker translates. This is an aspect that's not well covered in the literature on language brokering, where ability to translate is generally accepted as an a priori. Here we may note two techniques. One is that the Vietnamese girl used a dictionary, even if not always successfully. Ability to use dictionaries is not something that comes naturally; she must have learnt it somehow, and it immediately classes her as a Native rather than a fully Natural translator. (For these terms, enter essential definitions in the Search box.) The other is extrapolating, something that even Expert Interpreters have recourse to when they can't hear or can't understand the speaker. In the jargon of the trade, it's called winging it. It may perhaps be intuitive.

Thuy Ngo. Translation Trouble — Children May Be Barred from Interpreting for Parents. Youth Commentary, 2005. Posted by imd in Asian inShare, October 20, 2012. The full article is here.


  1. Although I do understand those who say that their children were their only hope in certain situations, I strongly believe that in such cases only trained medical interpreters should be used. In the field of medical care, where one wrong word can lead to disasters, it is essesntial to use qualified interpreters.

  2. Thank you for commenting, Alina. I was careful give reasons, at the beginning of the post, why Expert Medical Interpreters should be called in whenever possible. Failing that, then Expert Interpreters even if they aren’t medical specialists; read about my own experience of such a situation by entering "cullera" in the Search box. But the fact remains that, for one reason or another, Expert Interpreters are NOT always available or affordable even in this era of telephone interpreting, or there are cultural impediments. That’s what this ‘testimonial’ is about.

  3. Then school or college can arrange a short course for interpreter. Well experience interpreter can share his idea and experience. May be i am wrong but it should be start.

  4. The information is very useful!Thank you for sharing the information!Keep up the great works !
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  5. I agree it would be a good thing for schools to give a short course on interpreting, adapted of course to the age of the pupils. In fact there is already a short video on the EAMTS website made by a professional interpreter, but much more is needed. However, any such course must contain a high proportion of practice IMHO and not consist only of listening to somebody else’s experience.

  6. I strongly believe that in such cases only trained medical interpreters should be used. In the field of medical care, where one wrong word can lead to disasters, it is essesntial to use qualified interpreters.

  7. A translator may also add a certification statement on the document which certifies that the translation is a true and accurate reflection of the source document to the best of their abilities.

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