The Work We Do: Medical Interpreters

There is growing recognition that providing quality healthcare depends on making sure providers can communicate effectively with the people who are seeking their care and treatment. The need for medical interpreters is growing rapidly as a result.

Translation used to be done on an ad hoc basis in many hospitals with bilingual healthcare workers being asked to step in whenever a clinician felt they needed help to communicate.

Since the introduction of the Affordable Care Act [ACA], however, healthcare providers who receive federal funds are required to provide qualified interpreters for patients with limited English proficiency.

Hundreds of bilingual 1199 members have answered the call and undertaken the training to become either Qualified or Certified Medical Interpreters (QMI and CMI).

Most patients who require interpretation at both Jamaica and Flushing Hospital Medical Centers in Queens are Spanish speakers. But a significant number also speak Bengali or Mandarin, too, so the pool of interpreters has grown to 135, mainly Union members. Interpreters also serve outpatient clinics attached to the hospitals in Queens and East New York, Brooklyn.

The 1199 Magazine caught up with a few of these interpreters at Jamaica Hospital Medical Center.

1.Shajneen Haque, is an 1199 Patient Navigator and Bengali speaker, who also elected to become a Qualified Medical Interpreter.

“I don’t just help people at the bedside, she explained. “Sometimes family members need help looking for parking or finding where their loved one is situated in the hospital. I also help people understand what sort of prescription refills the doctor has ordered over the phone.”

When the outpatient clinic where she works was giving out flyers containing information about everything from applying for Medicaid to food assistance and job opportunities, Haque helped Bengali speakers understand and benefit from the information.

“Sometimes people need help with navigating the healthcare system,” she said. “For instance, they may not realize that they can choose to see a doctor in the hospital or at an outpatient clinic. There are eight outpatient clinics that are part of the Jamaica Hospital system.”

Haque also helps patients navigate sticky cultural differences. “For instance, when a husband and wife come to the clinic together, the husband will often speak for his wife even if she is the patient,” she explained.

In one recent case, the husband was extremely concerned about his wife’s eyeglasses making an indentation on her nose. Haque helped him understand that this was not a significant concern to his wife. “By interpreting between patients, family members and medical practitioners, we are able to ensure that everyone can engage in open communication and receive a higher quality of care as a result,” she added.

2. “When I started working here in 2013, I was the unofficial interpreter,” 1199 Care Manager Ivonne Padilla, said. “The hospital was using staff on a case-by-case basis. But I wanted to put it on a more professional footing. It is a huge responsibility. It is so important that everything [I explain to the patients in Spanish] is accurate.”

Padilla was frequently being called to the Emergency Room where the situation could be life or death. “Sometimes, I had to use a dictionary because I was unfamiliar with the terminology,” she said.

Ten years ago, Padilla decided to take matters into her own hands and started taking courses at LaGuardia Community College in Queens to become a Certified Healthcare Interpreter.

She barely spoke any English when she gave birth to her son a year after arriving in the U.S. from Colombia 25 years ago.

“So, I can see it from both sides,” Padilla continued. “It feels like you are missing something big, like you don’t have the use of your hands. Now, it is required by the ACA that medical facilities provide interpreters. It is not just about words we use to interpret. It is also about providing a cultural bridge regarding dietary suggestions and religious traditions—language equals culture.”

3. 1199 Patient Navigator Alexander Tenf earned his Certified Medical Interpreter qualification five years ago.

“When I was little, my mother taught me Spanish and I acted as her interpreter when she went to her medical appointments,” Tenf said. “An interpreter gives patients the confidence to communicate their concerns and desires effectively.”

Tenf recently interpreted for a Guatemalan woman who was new to this country and did not understand how the health system here works. “She had not been able to afford to see a doctor where she lived before,” he said.

“She was diagnosed with diabetes, and I was able to facilitate her application for Medicaid insurance coverage so she could continue her treatment. I was also able to give her advice on lifestyle and dietary changes that would improve her health.

Certain foods like tortillas are staples in the Guatemalan culture, but they produce sugar in the body, so it was best for the patient to avoid them. “It is very important that our patients understand exactly what the provider is recommending,” Tenf explained. “But it is not just the medical encounter which requires interpretation. It is also about helping them to understand how lifestyle choices can put their health at risk.”

4. 1199 Patient Navigator Margarita Perla’s job is to provide advice to help people manage their health conditions after they return home from the hospital.

“I provide dietary advice for those with diabetes, smoking cessation to help family members with asthma and support for women who are breastfeeding for the first time,” she said.

Originally from Honduras, Perla understands how important it is for her patients to see a friendly face speaking to them in their own language. “Studies show that people are more likely to come to follow-up appointments if they know they will have an interpreter,” she said. When the chance came to train for the Qualified Medical Interpreter certification, Perla jumped at it. “There are many ways to improve public health outside of hospital. I can offer advice about housing, transportation options and food pantries—and that can make a big difference,” she added. Perla also helps people with chronic illnesses better understand the plan of care devised by their doctors, using both her language skills and cultural knowledge. “If a patient is overweight, I give simple suggestions like getting off two [subway] stops ahead of where they live and walking the rest of the way,” she explained. I tell them to eat grilled chicken instead of fried. If they say they can’t afford to go to the gym, I advise getting a small stationary bike and storing it under their sofa.”

5. As an 1199 Dental Assistant at Jamaica Hospital Medical Center, Alicia Feliz is frequently asked to interpret. She was offered the chance to study and become a Qualified Medical Interpreter in 2007—and was “thrilled” to have the opportunity.

“Here in the Dental Department, we see 150-200 people per day, and around 80 percent of them do not speak English,” she said. “Just this morning, I interpreted for four different patients in the pediatric section. “It is important to start getting dental checkups from the age of two. Even though children lose their baby teeth, they must be healthy to keep space for the permanent teeth. If baby teeth come out prematurely, the permanent teeth can grow in crooked, and the child may need braces later on.

“I love doing interpretation. Ninety-nine percent of the patients really appreciate it when we take the time to explain things to them in their own language,” she added. “We have a mission in this community to treat all our patients fairly— and that includes communicating with them in a way that is relatable.”