Gloria and Juan share a small Manchester apartment with another family. Neither speaks English. Juan says he can understand some, but that�s it. Gloria says last July she took her almost two-year old daughter to the hospital with a fever of 105. Doctors assured her, with medicine, the baby would be fine.
Track 1
2:31 Spanish
The situation didn�t improve over night. Juan and Gloria say they took the baby back to the hospital around 2 o�clock in the afternoon. Juan says a woman in the waiting room spoke some Spanish. Even though she wasn�t a hospital employee, she helped them fill out paperwork. The parents didn�t get any language help again until 5, that afternoon. Gloria tells the story through an interpreter.
Track 2
:29 Spanish
:56 they never provided an interpreter they just had her laying in the bed, they were checking her and testing, but I did not have an interpreter, I could not tell what they were doing, I could not explain what I was thinking, feeling�
:54 Spanish
1:30 �They took her to an MRI, I did not know what was going on, people were doing any test they wanted, and I was totally lost. When they finally could no longer dela with me, around 5 in the afternoon, they put the phone line with the interpreter.
And for the first time, says Gloria, that phone line meant she and her husband could understand what was happening to their daughter.
But by then, Gloria says her child�s fever had reached 110, and her body had swollen. The language line interpreter explained that the baby would have to be helicoptered to Boston.
Juan and Gloria had to drive to the Boston hospital and arrived around ten that evening. And they waited. Again Gloria.
1:03 Spanish
1:49 around three in the moring they came out and said it was a good operation, it was probably going ot come out fine. And around 5 they said no, it�s gotten worse, there�s not much hope.
The baby stayed in the Boston hospital for a week before she died.
Track 11
:10 we get calls quite often from people in the community telling us of their horror stories
Sienna Larson works at the New Hampshire Minority Health Coalition.
�they are challenges that our clients face. We may not hear about them on a daily basis but they happen very often.
Stories like Juan and Gloria�s have attracted the attention of federal officials. The Office of Civil Rights, at the US Department of Health and Human Service has been reviewing four NH medical providers. The reason for the review is this, if a hospital or health center, receives any federal dollars it must provide equal services to everyone. Whether patients speak English or not. If a hospital does not provide interpreters a non-English speaking patient may not understand what is happening and the quality of health care suffers. In legal jargon it�s a violation of Title 6 of the Civil Rights Act. Robinsue Forbose, acting director of the Office of Civil Rights, says her office responds when someone calls in a complaint. But the OCR also performs what are called compliance reviews.
:58 � Information in the public domain, info that comes from professional associations, or info from consumer groups, at times even staff within the facility. This info triggers a determination that we need to look at the practices, procedures, and policies of a particular health care facility to determine if there are any problems, violations of law.
Frobose is quick to point out that a review doesn�t necessarily mean laws have been broken. As for the facilities in New Hampshire, the acting director says the office has a long-standing policy of not discussing on-going cases. But the Manchester Department of Health, Concord Hospital and Catholic Medical Center of Manchester openly admit they met with the OCR last May. But all three facilities say they have services in place that meet the needs of patients.
Track 5
:00 �welcome. CMC will provide interpreter services for patients and families who speak limited English.
Catholic Medical Center�s Paul Mertzick reads the sign that�s posted at the hospital�s front door and its emergency room entrance.
�There is no charge for this service. Patients do not have to provide their own interpreters. Please present this request for interpreter services card to any of our employees. Thank you.
That sign has been translated into six languages. It�s a relatively new effort by the hospital to serve all its patients. Staff have also created an identification card they call a �passport.� When showing the �passport,� a patient points to the language they speak, helping doctors and nurses know what kind of language assistance is needed.
Mertizick says he is not personally aware of any particular civil rights violation at CMC. But he admits finding qualified interpreters is hard. Especially given the hospital�s round the clock operation. CMC isn�t alone in this problem. And so many area hospitals have come to rely on interpretation through a telephone language line. This enables a medical provider to call into the line, request the language they need, and within a matter of seconds, a trained medical interpreter is there.
Sometimes though, even the language line isn�t sufficient. And that, says Nancy Hacking with Concord Hospital, is when hospitals have to get creative. She remembered the woman who arrived a few years ago in a comma. With no id, the hospital worked with the police to determine she was an out of state student.
Track 11
:28 �This woman was from China, what part of China, we were unable to find anybody with that particular dialect.
1:04 but were able to use someone through the Franklin Pierce Law Center some professor who was there from China, was able to work with the American Consulate in China to get in touch with people who could talk to this young woman�s parents. And explain to them what was happening, get some information from them.
Director of patient and family services at Concord Hospital, Patti Nichols says her goal is two-fold. Communicate with the patient, but also help make them feel comfortable. She says people heal when they feel safe. But she says even though the hospital only sees 3-4 non-English speakers a week; it�s a constant challenge to provide service she would call adequate.
Track 19
:00are we complying with regulations, do we have policies and procedures in place that provide interpretation services for anyone who needs them when they come in the hospital. Yes, and we are providing them. Is it adequate? I think that to say we do it 100% perfect everyday would not be an accurate statement. Everyday we are learning something new about what we are not doing well enough. And can do better.
Ann Dancy works for Lutheran Social Services. She runs the state�s only language bank. And she has seen a change in the state.
Track 6
:19 even just a few years ago there were places in the community that were very unsure what to do when someone showed up who didn�t speak English�and I think people were even turned away from services or told to come back and bring somebody with them. Now, I think that administrators clearly understand, they understand what the law is under Title 6, and they are very interested in compliying with that law.
Dancy doesn�t kid herself. She says she knows that front line personnel at hospitals and social service agencies are not always as well informed about laws. But she points out that health providers have joined non-profits and the state to provide an on-going medical interpreter training course. And many of the parties believe the situation in the Granite State has improved. But even with the changes, stories persist of patients in New Hampshire hospitals receiving inadequate health care because they don�t speak English. Ava Castillo is a Manchester-area interpreter.
Track 4
:28 but these doctors, they are getting away with whatever they want, b/c they tell the patient, unless you bring your interpreter, too bad.
For NHPR News, I�m DG.
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