With the global economy looking healthier than ever before, travel to far-flung countries on business and pleasure continues to rise at a steady pace. The influx of foreign students into US and British universities, and of software and other professionals into European and American businesses, has been escalating over the past two decades. According to recent estimates ? there are about 45 million people residing in the US alone, who speak a language other than English in their homes, and among them, about 19 million have a limited ability to communicate in English.

Need for interpreter and translation services in hospitals and clinics

When non-English speaking patients seek medical help, the issue of proper communication by translation and interpretation of a patient's problem for physicians and other medical staff at the healthcare center assumes serious importance. Most patients take it for granted that once they approach a doctor or hospital and describe their specific ailment and its symptoms, a line of treatment that is appropriate to their condition would be prescribed. But in reality, things are not all that simple: communication is the key element here, as unexpected complications may arise if the patient or his family is unable to clearly explain the exact nature of the patient's condition and the accompanying symptoms. The situation could be even more precarious if it happens to be an emergency.

Although some hospitals and clinics have trained interpreters on board for translating the patient's conversation, many are not equipped with such translation services. In any event, miscommunication through faulty translation of a patient's condition can have serious implications on the treatment outcome.

Medical mistakes caused by errors in interpretation

In a recent study undertaken in the pediatrics department of the Boston Medical Center, 13 encounters between physicians, their patients (who were non-English speaking) and the interpreters were video-taped, and it was found that there were as many as 396 interpreter errors! The study specifically revealed that untrained interpreters were far more likely to make errors that had serious consequences on the patient's health than trained personnel.

The most common interpreter errors that were listed in the study were as follows:

Omission: (52%), in which the interpreter left out an important piece of information.

False fluency: (16%), in which the interpreter used words or phrases that didn't exist in a specific language.

Substitution: (13%), in which a word or phrase is replaced with another word or phrase of a different meaning.

Editorialization: (10%), in which the interpreter's opinion is added to the interpretation.

Addition: (8%), in which a word or phrase is added by the interpreter.

(Source: Language Barriers Lead to Medical Mistakes kyha.com/OCRLanguage/Language%20Barriers%20Lead%20to%20Medical%20Mistakes.pdf)

Availability of interpreter or translation services

Currently, the services of an interpreter are covered by insurance in five U.S. states: Hawaii, Maine, Minnesota, Vermont and Washington. Many large hospitals in Milwaukee have interpreters on their payroll, and the State-owned Children's Hospital employs both full-time and part-time Spanish-speaking interpreters. Many hospitals outsource their interpreter or translation services based on need. However, a number of healthcare establishments don't have adequate resources to cover the expense of hiring interpreters or translators.

On a more heartening note, the situation that prevails in the Lucile Packard Children's Hospital in the Bay Area is worth a mention. David Peschard, a Mexican native, together with his dedicated team of professional and volunteer translators help ease the problem faced by Spanish-speaking patients and their families who have difficulty communicating in English. Peschard not only offers interpretation and translation services to Spanish-speaking families, but also helps find interpreters for patients who speak many other languages including Russian, Cantonese and Japanese. He also coordinates interpreter training and the commissioning of volunteer services at short notice as needed for interpreting conversations between patients and their physicians. Vietnamese is the second-most commonly spoken language, followed by Mandarin and Cantonese.

With rapid advances in the field of medicine taking place concurrently with cross-border migration of people in large numbers either for education or for livelihood, the need for a high quality of interpretation and translation services in health care facilities is being felt with increasing intensity. Medical mistakes can prove expensive not only to patients and their care givers, but also to health care establishments. So it would be appropriate to adopt strategies similar to the one practised at the Lucile Packard Children's Hospital by health care facilities, in the best interests of all concerned.