How many languages are spoken in Manchester? 15. 30. 72. It's a question without just one answer. But whatever the actual number, with that increase in non-English speakers, the city's social services face a growing demand for language assistance.
And, as NHPR's Dan Gorenstein reports, health facilities, in particular, are finding that demand to be both costly and challenging.
Sfx: Health Clinic phone, five languages greeting the caller
The Manchester Community Health Center�s phone system us the front line in the front line in the Center�s struggle to provide health care to non-English speaker. Behind that phone message stands a full-time Spanish interpreter, ten multi-lingual staff members, and a language phone line. That line allows the doctor and patient to communicate with still more interpreters in a conference call.
Director Chris McCracken guesses the Center spends at least 40 thousand dollars a year on language services. If they didn�t she says, it would be like 30% of their patients not getting service at all.
6:00 95% of the visit there is no laying on of the hands. It is all verbal. It�s like sending someone to the counselor and saying grunt through the visit�how could you describe if it�s sharp, if it�s shooting, if it�s searing, if it�s throbbing� It is useless, unless it is a gaping wound in their chest. They might as well be unconscious.
The Center�s Medical Director Gavin Muir.
4:38 80-90% of a diagnosis is made in the history and the physical, if I can�t get a history from pointing at something, or making grunting sounds, I am not able to get a good history. A good history is so much better than sending someone for an expensive lab test or x-ray test.
Muir says language allows patient and doctor to bond. Even if it happens through a third person. The interpreter.
Sfx: Dr. Frank with Bosnian patient
Like in this fairly benign podiatrist visit between Doctor Frank and patient Jazminka. Frank could joke with his patient and try to create a rapport through the interpreter. But imagine trying to find an interpreter to come in any time of the day or night.
1:38 that has been a challenge in this community b/c even though we are very culturally diverse we don�t have a large pool of qualified interpreters to draw from on a 24/7 basis.
That�s Georgelynn Wisner with the Manchester-based Catholic Medical Center. Both his hospital and Elliot Hospital on the other side of town struggle to track down interpreters. So the facilities depend on language lines. Elliot�s Joanne Fadale Wagner.
:46 so what we do now, across the board, is we use the language line which is able to offer 50 different languages. We use it via a speaker phone�we know it is competent, however, it sometimes is a barrier, it is hard to work with the provider, the patient, and the phone. It�s not as personal.
Personal contact, says the Community Center�s Chris McCracken, really improves the visit.
:43the things I think of are the 16-year old Mexican girls and never had a pap smear, is horribly nervous, may not have a lot of education about what the medical process is, and I find often, as the interpreter, I am holding their hand�if there is no other person in the room who would notice that, the provider is probably not going to say, �she looks very scared,� to the teleinterpreter.
Given the limits of language lines, the round the clock need for interpreters, and a lack of qualified people, non-profit organizations and health facilities have established their own training.
Track 19
1:54 sfx: room sound
1:50 this is new for NH, you are the pioneers, but hopefully, when you graduate from the class, people are going to look at you as professionals�you know you don�t take sides, be as transparent as possible. These are all things that interpreters up to now did not provide to the medical system. No you are providing something very different.
At the New Hampshire Community Technical College at Manchester, Zarita Rouge is instructing her students on the do�s and don�ts of interpreting. For example, speak in the first-person, not the third, don�t translate every word of an idiom. Don�t memorize medical terms, but be familiar with them.
The students work for health facilities and non-profits that organized the class. Together, they speak nine languages. Many of them already are working as interpreters. And students seemed to agree with classmate Ava Castillo that too often non-English speaking patients aren�t being treated right.
: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.
It�s something Instructor Rouge has heard before.
7:54 that patients are told they need to bring someone, bring a friend with them. That patients are sometimes sent back�but I also hear the stories that hospitals are very interested in trainings. So I think there is a movement in accepting it, and I think part of any changes, there is the minimization, oh, we don�t need it, they can bring someone, then there is the identification, yes we have some issues here, then there is the accepting stage, we need to do something about it, b/c we will all benefit.
The US Department of Health and Human Services Office of Civil Rights has caught wind of stories of people being turned away. The OCR has decided to review four New Hampshire health facilities. Federal law says that any federally funded health care facility must provide for all patient no matter what their national origin.
But while the federal government reviews larger facilities, it�s often the everyday visit to the doctor that can be the most daunting to someone who doesn�t speak the language. Sienna Larson works at the New Hampshire Minority Health Coalition.
:45 �The first is making the appointment. How will they speak to the secretary or nurse. The second is getting to the door. How do they know which office to get to? The third is intake and registration�The fourth is the appointment itself. And then also, is follow up. Which includes lab tests, does the patient need to go for blood tests, x-rays. Other doctor�s appointments, prescription drugs. Bill payment.
So a patient may need language assistance from the time they walk through the door until the day their pay their bill. And because the need extends beyond just the doctor�s visit, one suggestion is for health facilities to create an interpreter pool that could follow patients through the process.
9:48 It�s not simple to get this set up,
Manchester Community Health Center�s Chris McCracken.
�and we simply are too young in this state culturally dealing with a diverse population. We really need to do a quick speed up so we are able to meet the needs.
Delicious
Digg
Reddit
Facebook
Google
Yahoo