Training Announcement: Introduction to Cultural Brokering for the Medical Interpreter

"Introduction to Cultural Brokering for the Medical Interpreter"

Thursday, June 30, 9:30am-12:30pm

Catholic Charities Maine

250 Anderson Street Portland

Trainers: Malvina Gregory, Director - CCME Language Partners

Jessica Goldhirsch, MPH

Interpreting textbooks & trainings often state that interpreters need to notice when cultural differences arise, and intervene when necessary to make sure that communication is clear.  Unfortunately, very few models explain exactly how an interpreter is supposed to do that.  Just as not all bilingual people make for good interpreters because they lack training, likewise not all bi-cultural people make good cultural brokers.  It takes a special mix of skills and experience to identify cultural differences and explain the dynamics to an outsider.  The skills must be learned, and hopefully as our profession advances, they will be taught.

Next Thursday, June 30th, we at Catholic Charities Language Partners will start a discussion with Maine interpreters about how to do this complex part of their work.  We are offering this training in alongside the Interpreter Services program at Children's Hospital in Boston, MA, and our joint reflections on the training and lessons learned will be shared at the 2011 International Medical Interpreters Association conference this fall.  We hope that our training will lead the way for more discussions nationwide.  The truth is that without effective cultural brokering good health outcomes are much less likely to occur.  Doctors and patients will misunderstand each other.  For the sake of our patients, we need to start developing ways to teach our interpreters.

If you are an interpreter and interested in attending, you can call 523-2726 or e-mail mgregory@ccmaine.org.  Registration is limited to 25 students.  Training will be free for all CCME interpreters. Registration fee for non-CCME interpreters: $50.00.  Interpreters must have already completed a 12hr Basic Interpreter Training to attend this course.

Resource Review: 10 Tips for Working with Language Interpreters

We just have to share one of the cutest provider tutorial videos we've ever seen: 



By the way, see the notebook in this video?  An interpreter with a notepad will jot down dosages so that numbers don't get confused in the translation process or annotate long statements so that they can allow speakers to speak in longer, more natural paragraphs.  Notepads are a sign of a trained, professional interpreter.

Thanks to the authors for creating such a fun, approachable teaching tool (and to the colleague who passed this along to me!).  This definitely beats our usual written list of "Tips for Using Interpreters".  We'll be sure to integrate this into some of our future trainings.

Man vs. Machine

In Spanish: "The hand washes itself, don't whiten don't fall, lovely iron" 
via WTF? Microservios

We've recently heard some providers say that they no longer send translations out professional translation services because online tools such as GoogleTranslate have become so effective.  We thought in the interest of scientific discovery, we'd put this theory to the test.

This great website puts your simple phrase through a series of machine translations, back and forth to English so that you can see the linguistic distortions.  For more giggles, the program will allow you to run something through 30 or even 50 translations.  In no short time the simplest text goes awry: "How many apples did you buy?" in just 10 machine translations becomes "How Apple Store?". 

This is fun enough, but let's really illustrate the importance of a human interpreter and/or translator.  What happens when we do some medical and legal texts?  Even the simple "Take one pill in the morning and one in the evening" becomes "Morning and evening sleeping pills."  Very different!  The classic "You have the right to remain silent.  Anything you say can be used against you in a court of law." becomes "You have the right to remain silent. You can say that in court." in just 10 iterations. 

All this is very relevant given that recently a murder case in Ohio was thrown out due to a human interpreter's error in interpreting the Miranda warning.  If humans can get it wrong sometimes, and we have yet to build a computer that can even come close to what the human brain does, imagine the danger in using machine translation for anything beyond the simplest of phrases. 

Our review: machine translations are useful in a pinch, and perhaps good for basic phrases (what time is the bus?), should never be used when someone's life or liberty is on the line.  For that, the old-fashioned human being is probably still your most reliable option.

Language in the Labor Force

This week we're at the 2011 Maine HR Conference.   The 2011 Census indicates that Maine's population is rapidly diversifying; both Portland and Lewiston's minority populations doubled over the past decade (no time to crunch the numbers? for a good recap of all the data see Downeast Denizen's blog post).  In a time where Maine's overall labor force is shrinking, that means that more and more employers are working with staff from different backgrounds and who might speak different languages.

Sadly, many times employers only realize that they need an interpreter after a problem has developed.  This week, CCME Language Partners can be found at the 2011 Maine HR Conference talking to employers about how to proactively respond to the new workforce.  Employers today are using translations to explain safety procedures beyond a shadow of a doubt, staff training to head off workplace tensions, and interpreters to clear up misunderstandings and pave the way to good communication between management and personnel.  See a glimpse of our talks here:

What if Einstein had to pass the TOEFL?

Today I watched a brilliant talk by Patricia Ryan, an English teacher in Dubai:




She asks a great question: "If I knew a monolingual Dutch speaker who knew the cure for cancer, would I stop him from entering my British university? I don't think so, but that is exactly what we do!"  She asks, how many skills are we overlooking because this genius does not speak English?  What if Einstein had to pass the TOEFL?

In some cases scientists have failed to reach the correct answer because their languages and ideas didn't and couldn't help them visualize the question in the right way.  Any interpreter can tell you that we think about some ideas in one language, some ideas in another.  Why?  Because it's just easier, that particular language lends itself to the discussion at hand.

There are currently 6,000 languages in the world, and in 90 years we will have only 600.  That means that a language dies every 14 days.  Imagine!  That means that in a year the world loses 26 different ways of describing the human experience. 

As an interpreter, I cannot count the number of brilliant people I know who have struggled to learn English.  Brilliant people who may speak more than one non-English language, but who are unable to figure out our grammar and syntax.  Does that make them less intelligent than we who have spoken English since birth (and, incidentally, can only speak one language)?  Furthermore, what happens when the elder generations can no longer communicate their wisdom to their grandchildren who no longer speak their language?

Ryan points out that the price of even taking the TOEFL are sometimes cost-prohibitive.  The reality is that even for those who will never attend college, learning even basic English is sometimes economically unfeasible.  Many drop out of basic ESL classes because they need to work.  It is ironic that when you are working two or three jobs to support your family and guarantee that your children can someday attend college, that you might not have time or energy at the end of the day to learn English yourself. 

Every interpreter has been asked, "But why can't this person just learn English?"  This is a question that we all struggle to answer.  "They are learning."  "It's hard for them."  "I'm here because they want to express themselves fully."  -- all are quick, pat answers that we offer.  However, as Ryan points out, the question is larger--yes, we all can learn English, but what will we lose if we do?

Tips from the trenches

I'm going to let you in on a dirty little department secret: you don't always need an interpreter.  That's right, even sitting on our pile of golden interpreters, the proverbial Midas of language services, we don't always immediately run to the language line.

It's ironic, right?  We're supposed to be in the business of selling interpreters.   

As we discussed this odd phenomenon and compared notes over the refugee-services water cooler, we came up with these "how-to" tips for confident cross-cultural communication.  We realized that we all do the same things when working with limited-English proficient clients. It's not rocket science, but it is powerful stuff:

• Assess your statement - what are the implications if they don't understand?  Use these steps below for simple, concrete communication.  For complex issues, run--don't walk--to your nearest intepreter service.
• Slow down (speaking louder doesn't help, slower does).
• Shorten your statements
• Avoid compound sentences
• Explain processes and don't assume they'll know how systems work
• Draw a picture
• Watch body language for furrowed brows or glazed eyes
• Ask open-ended questions to make sure they understood
• When you have to repeat something two different ways and it's clear that they still don't get it then reach for the interpreter. 

This last point is important.  It's a glorious victory for a client when they can explain their needs without having to use an interpreter; they are one step closer to independence.  But don't ever let a client continue to struggle or leave with questions.  Use a phone interpreter service for five minutes at the end of the appointment to make sure all was understood.  Your time--and theirs--is worth getting it right.