Translation and interpretation in hospitals and EDs

The first thing that comes to mind when thinking about the job of a translator is a person working
alone in their tiny office surrounded by shelves filled with a variety of books, monolingual and
multilingual dictionaries, sitting in an uncomfortable chair behind their desk, furiously typing on their
computer as their eyebrows furrow in concentration and they huff and puff in frustration.

And although this arduous task is indeed part of a translator’s life, translating is much more than
that. The translator's career is quickly evolving, developing and spreading to different new fields. In
the modern world where communication is key, the demand for translation and interpretation
services in various sectors is growing.

One of the fields that is currently undergoing significant change is medical translation, and more
specifically translation and interpretation in hospitals and emergency departments (EDs).


A civil rights issue 

Today, it is more and more expected of all health-providers to take steps to ensure that their
services are accessible to everyone, whether they speak the country’s language or not. In that way,
translation and interpretation in the hospital setting (or the lack of it) is also perceived as a civil rights issue as all citizens, regardless of their age, their race, their color, or their national origin, have equal rights to health care.


Language barriers and other issues

In the U.S. nearly 9 % of the population age 5 or older has limited English proficiency, and this
figure is increasing. People with this proficiency cannot speak or write English well enough to
communicate effectively in the language.

Repeated problems caused by language barriers between patients and hospital staff show that better
solutions to deal more effectively with multilingualism on the hospital floor need to be found. It is
proved that 80% of the diagnosis depends solely on oral communication, and medical mishaps in
the ED often result from poor communication and misunderstandings. Therefore, the lack of
interpreters and translators in hospitals and EDs is a serious matter.

Translating from one language to another isn’t always an easy task, and when it comes to
interpreting a conversation between a doctor and a patient, the stakes are even higher.

Up until recently, clinicians often used (and still do in some cases) any available person as an
interpreter – a family member, a member of staff that happens to speak the patient’s mother tongue.
Family members are put in a tough situation and end up under a lot of pressure as it is not easy for
them to translate and share the doctor’s not always positive news to their loved ones. A good
example of that is the story of a young child who had to interpret their parent’s cancer diagnosis.

But the task isn’t only hard and emotionally draining. A translation provided by a non-professional
translator is often simply wrong.

A bad translation can destroy a life

There are thousands of examples to support this statement. One among many others is the story of a 18-year-old baseball player, Willie Ramirez, who was taken to a hospital in coma and whose family used the Spanish word ‘intoxicado’ to explain that he might have ingested something that had made him sick. However, the word was wrongly translated into ‘intoxicated’ and the doctor immediately diagnosed him with a drug overdose. In reality, Ramirez's problem was actually bleeding in his brain, but by the time the health team had figured it out he'd suffered lasting damage and ended up quadriplegic.

With time hospitals came to realize that family members and even hospital staff are not trained for
medical translation as they do not always know the right medical terms in both languages. It is now
clear that it’s more appropriate and reasonable to use professional interpretation and translation
services in the hospital setting.

However, hospitals are in a tough spot as the law prohibits them from asking patients to pay for
translation services, yet they do not always receive reimbursement. At the same time, facilities realize
that offering competent interpreter services will help avoid misdiagnoses that result in serious injury
or death, and know that trained interpreters can also help them save money in the long run by
avoiding unnecessary tests and procedures. This is why today hospitals are taking that step, and
translation and interpretation in this area is growing strongly.

Written by Paulina Rachwalak

This article is based on information from the following articles:

• https://www.npr.org/sections/health-shots/2014/10/27/358055673/in-the-hospital-a-bad-translationcan-destroy-a-life?t=1570956812426

• https://www.annemergmed.com/article/S0196-0644(18)30431-1/fulltext

• https://www.washingtonpost.com/national/health-science/hospitals-struggle-to-provide-translatorsfor-patients-who-dont-speak-english/2012/05/21/gIQA2ETxfU_story.html

• https://www.researchgate.net/publication/270791405_Interpreting_in_the_Emergency_Department_Challenges_for_Practice_and_Training