Hospital translators filling void; Need for interpreters is rising

Yvonne Wingett
The Arizona Republic
Jun. 3, 2007 12:00 AM

Martha Martinez was halfway through her shift at the hospital one recent afternoon when her pager beeped - again.

A social worker in pediatrics needed help communicating with the family of a sick boy. Martinez made her way through Maricopa Medical Center in central Phoenix, to the child's room. For the next five minutes, she interpreted in English and Spanish a series of questions about the child's medical history, his symptoms and prescriptions.

Every day, Martinez is on the front lines of caring for patients at the state's only public hospital. She does it through language, not medicine.

AOT 2007

As metro Phoenix continues to swell in population and diversity, so does the demand for bilingual interpreters and translators trained in medical terminology. More and more, the patients seeking care at the county hospital don't speak English, officials said, and interpreters are the go-betweens, helping them understand treatments and diagnoses.

Medical interpreters and translators trained in medical terminology are in high demand nationally, and at other hospitals throughout the Valley, including Phoenix Children's Hospital, John C. Lincoln's North Mountain Hospital and Banner Good Samaritan Medical Center in Phoenix.

Part comforter, part interpreter, Martinez often holds the hands of families and patients as she delivers bad news and as nurses poke and prod. Many families have used her shoulders to cry on, when family members die or when children are born.

"It's important because you're the bridge between the patient and the doctor," said Martinez, 39, of central Phoenix. "You help the family understand the doctor and help the doctor and the family."

Growing demand
Spanish is the most requested language for interpretation and translation, Valley health care officials said, because of recent immigration trends from Latin America.

There is also a growing demand for interpreters who speak Vietnamese, Somali, Russian and the dozens of indigenous dialects within the Spanish language. The number of Maricopa County residents who speak a language other than English rose 29 percent between 2000 and 2005, according to the U.S. Census. About 26 percent, or 883,752 people, living in Maricopa County in 2005 spoke a language other than English at home. That's up from the 683,998 people who spoke another language in 2000.

It's difficult to find interpreters and translators who are fluent in medicine, anatomy, physiology, diseases and medical procedures. Several Valley hospitals train doctors, nurses, technicians and other clinicians through a Spanish Bilingual Assistance program. They use telephone interpretation services for about 200 other foreign languages.

Last year, Maricopa Medical Center's interpreters and translators handled about 70,000 cases, said Luis Gendreau, who manages the department. The staff meets the need but is stretched thin. He said that ideally, four more interpreters are needed to handle the load, now ranging from 20 to 35 cases per interpreter, per day.

"The need for Spanish interpreters has increased tremendously," said Gendreau, since he started working at the hospital in the mid-1990s. "In some shifts, I only have one person."

County officials could not provide numbers of patients who speak foreign languages. But Gendreau estimated that 60 percent of all county hospital patients are Hispanic; the percentage is higher in some units, such as pediatrics, obstetrics and gynecology, and the emergency room. Many of those patients speak limited English or none at all.

When it comes to medicine, communication can mean the difference between life and death, national health experts said. Poor communication can discourage some patients from returning for treatment and can lead to incorrect prescriptions, treatments and tests, said Wilma Alvarado-Little, director of the outreach committee for the Center for the Elimination of Minority Health Disparities in New York.

"When they can't communicate with their patients, how can you ethically diagnose the problem?" she asked.

Cross-cultural divide
Martinez supervises a staff of 14 interpreters and translators who zip from the trauma unit to the emergency room, closing communication gaps for doctors, nurses, technicians, social workers and others.

More than learning how to translate terms like tracheotomy and urinary infection, interpreters must be culturally aware.

"Sometimes doctors don't understand why a mom believes in the evil eye, malo ojo," she said. "You have to be able to explain that to doctors. You have to be a person with compassion. A person with a heart. A person with sensitivity."

Later that day, Martinez helped a nurse explain a diagnosis to a young Hispanic mother whose child was sick. In spitfire Spanish, Martinez ran through the toddler's symptoms, then a medical questionnaire.

"Has she ever been hospitalized," Martinez asked the mom. "Do you have a history of diabetes? Is there a history of diabetes in your family?"

She started working at the county hospital in 1991 as a housekeeper.

"I saw a lot of need (for interpreters)," she recalled. "I was having people pull me aside and saying, 'Can you help me talk to them?' "

Martinez took English as a Second Language classes, and then signed up in classes to get certified in medical terminology. She worked her way up, and today she supervises the hospital's interpreters and translators team. She also coordinates and teaches the hospital's Spanish Bilingual Assistance program.

"Sometimes it's hard to do this, like when you have to deliver bad news," Martinez said. "Sometimes, it's good, like when a baby is born, and it's beautiful to be in that room and help that mom understand what is happening."

Last updated on October 7, 2008