TRANSLATORS: FRIENDS OR STRANGERS?

PALS for Health, a non-profit language service program that strives to "increase access to meaningful and quality health care services for limited English proficient residents of Los Angeles County", is one organization that provides translation services that Chinese Americans can use to overcome the language barrier that they face in going to an American doctor.  The translators, as described in the video, undergo a careful selection process and must complete a comprehensive exam and a rigorous training program in order to best prepare themselves for clearly relaying information from doctor to patient.

One point that the video brings up is the use of relatives or friends as interpreters.  While the patient may be more comfortable with having someone they know well with them, the interpreter most likely lacks the skill and medical terminology needed to accurately translate information to the patient.  This, in turn, is detrimental to the patient because he or she does not get the clear description of what is happening to them simply because the interpreter does not know how to give the exact medical translation.  Another downside to using a relative or close friend is that, because they have a personal bond with the patient, they may choose to downplay the severity of the diagnosis in order to spare the feelings of the patient.  Because of the relationship they have, a family member or a friend might let emotions get in the way of the doctor truly helping the patient.

While an interpreter, in this sense, would be the ideal choice, especially since they are more trained and skilled in medical terminology and could give a clear translation, would the patient be completely comfortable with a stranger knowing what is wrong with them?  The question that is raised with using a stranger is the idea of privacy, something that would not be such an issue if someone close and trusted were with the patient.  Also, with the emotional bond the patient and interpreter have, wouldn't the interpreter be more likely to be trustworthy in relaying all the information simply because they care about the patient?

Thus, the issue is this: is it better to have a family member or friend translate because the emotional bond will push the translator to do the best they can to make the patient better, at the risk of not having the technical skill to accurately relay complex medical terminology, or is it safer to employ the use of a stranger who may have the medical translation abilities but not necessarily have the will to speak the whole truth?

A LOOK AT THE LANGUAGE BARRIER

In February of 2006, the Joslin Diabetes Center (an affiliate with Harvard Medical School) released an article discussing the language barrier experienced by Chinese Americans, which is preventing them from clearly understanding the issues regarding their health.

Although they acknowledge the fact that translators and bilingual staff are being used, Joslin states that that is simply not enough; according to a study conducted by researchers in the Joslin Diabetes Center:

"these patients also need comprehensive patient education materials written in Chinese and a medical staff thoroughly versed in the customs and cultural issues that may impede their diabetes care" (Joslin Diabetes Center)

The researchers at the Joslin Diabetes Center conducted surveys of 52 Chinese American immigrants from ages 18-70, all of whom had been diagnosed with type II diabetes for at least a year and were taking medication.  Those surveyed were divided between their preference towards speaking English and Chinese, and were then quizzed on their knowledge of diabetes.  Of the 52 people, the Chinese-speaking group scored a 63% understanding of diabetes, while the English group scored 85%.  

The subjects were then given books, written in English and Chinese to comply with their specific groups, explaining diabetes.  After reading the books, the Chinese group reported having an increased understanding of diabetes.  

The issue that this study explored is that translating information from English to Chinese is not enough.  Because the Chinese culture is different from American culture, translating text from English to Chinese does not necessarily provide Chinese Americans with material they can understand and relate to.  The article gives the example of diet; a dietitian who is unfamiliar with Asian American food could prescribe their patient to eat foods that are not normally consumed, such as pasta and cheese, without ever addressing foods that are more central to the Asian diet.  

Thus, more needs to be done in order to better aid the Chinese American population.  Rather than just translating English text to Chinese, the text needs to be written in Chinese specifically geared to Chinese Americans so that they can understand what they are going through and can take better care of themselves.