'I have trouble understanding,' says newcomer of health care language barriers

Dr. Beth Mitchell, former psychologist at the London Health Sciences Centre, is calling on all forms of government and health care providers to increase access to professional interpretation services.

Wasan Al Rubaee fled a civil war in Iraq and arrived in London a year ago, where she faces a different kind of uncertainty. Language barriers have left the Arabic-speaker at times confused when it comes to her daughter's medical treatment.

Her six-year-old daughter is living with epilepsy and is required to see a doctor every month for a check-up.

"There are a lot of unfamiliar terms [health care professionals] use or they speak really fast so I have trouble understanding," said Al Rubaee, through a translator, of her frequent visits to a London hospital.

"It's hard to go to the hospital and not understand anything," she said. "An interpreter is important."

Al Rubaee is accompanied by a community interpreter every other visit.  However, one isn't always available to the mother of four. 

Call to action

Beth Mitchell, a retired psychologist who worked at the London Health Sciences Centre, is calling on all forms of government and health care providers to increase access to professional interpretation services.

She's lobbying for health interpretation to be recognized as a necessity, part of a standard protocol in London and Middlesex, as outlined in a report commissioned by a working group at the London Middlesex Local Immigration Partnership.

"Right now, access is very limited," she said, as translators are often costly for health care providers. "The service exists but people don't use it as often as they need to."

Mitchell said language interpretation services are often provided in large-scale hospitals, however, many people who need translations aren't made aware the service exists. Small-scale family physicians also struggle with accessibility to community translators, she said.

The report looks into the financial and emotional cost of language barriers within the health care sector.

Several solutions are outlined through health care provider sensitivity training when offering for interpretation services to patients. It also outlines an educational program to raise awareness to community services offering interpretation services to immigrants or new comers who need it. 

Local interpretation services

There are external agencies in London such as Across Languages and the Cross Cultural Learner Centre that offer medical interpreters to health care providers.

The CCLC currently has 30 medically-trained interpreters ready to accompany people who have limited English language proficiency. 

Valerian Marochko, director of the CCLC, said most of interpreters are swamped with requests. 

"Interpretation is a very big barrier for newcomers," he said, with many families often relying on younger children who are more English proficient to translate at medical appointments. However he says this could often cause problems at home.

"You may have some issues you don't want your child to know about, especially when talking about mental health," he said.

Do you need an interpreter?

"I think it's good to have that question built in every access point ," said Mitchell, who's rolling out a medical questionnaire as a pilot project to help health care providers offer adequate interpretation services without the stigma attached.

"Sometimes a patient won't ask for interpretation because they embarrassed," she said. "How would you be comfortable telling me about your medical issue and in what language?"

Mitchell is going to meet with people who require interpreters and health care providers to test out the questionnaire.

She hopes the questionnaire becomes standardized for London and Middlesex County.