By French-language Interpreter, Marie Dart

On April 28th, I received a call from my sister. There had been a terrible accident on Highway 101-a bus with 36 French tourists had overturned on the overpass in Soledad (Central California) and authorities were appealing to the public for interpreters. She knew that at least one of the victims had been transported to Fresno, where I live, a three-hour drive from the accident site.

I felt compelled to do something. Uncertain of which hospital any accident victims would be flown to, I proceeded to our largest facility, Fresno Regional Medical Center. After a phone call, the admitting clerk declared, "Yes, we do have a patient from that accident here." I felt relieved that I had found the right hospital. As my escort and I snaked our way through the corridors, my thoughts turned towards what might be awaiting me. My "relief" was replaced with apprehension.

So began one of the most rewarding and interesting experiences of my life. The accident victim was a 13-year-old girl, Emilie. In summary, it was Easter break in France when Emilie and her mother, Anais, departed for a two-week tour encompassing the Grand Canyon, San Francisco, Monterey, and Hollywood. Nearing the completion of the tour, the bus was in route from Monterey to Hollywood when the accident occurred. Unfortunately, mother and daughter were separated at the scene of the accident.

Anais had been ejected from the bus, rolled down a 60' embankment, and lay motionless in a ravine below the overpass. Restrained by officers at the scene, Emilie didn't know if her mother was alive or dead.

From the emergency room I broke the news to Emilie's father, Evan, in France. Reassuring him that his daughter's injuries appeared to be superficial, I promised to remain with her until he arrived.

Anais' condition and whereabouts remained a mystery for nearly 24 hours. Identified by photo, Anais was in an induced coma on a respirator at Stanford Medical Center. Her condition was very critical and would remain so for the next 72 hours.

Over the next two and a half days I spoke with, interpreted, and relayed messages to Evan, the French Embassy, Assistance Europe, social workers, CHP officers, and hospital staff.

I had the pleasure of meeting Anais before her return to France. She is an amazing woman, spiritually and physically. At the time of my visit, she had been off the respirator for about 10 days and was struggling with pneumonia and jaundice.

She had undergone surgery to pin her sacrum just days before. She sustained numerous injuries during the accident, not the least of which were twelve broken ribs and a fractured pelvis. A testament to her strength of character is her determination to one day return and complete the tour.

Since that time, I remain in contact via e-mail with my newfound friends from this experience.

I began working for Language Line in January of this year and had it not been for the pre-employment training I received, I would not have felt comfortable volunteering my services. I appreciate not only the training, but also the understanding and generosity which Language Line Services demonstrated during the time I helped the Boulanger family. It was an amazing experience.

Thank you, Marie, for a wonderful story. And for being an important member of our professional interpreter team.

If you would like to be an over the phone interpreter for Language Line Services, just visit our Career Center here and apply for one of our current openings.

Photo by physician/photographer Ed Uthman via Flickr

Readers will be interested to know that Texas is taking a leading role in what has become a national debate about the certification of interpreters and translators in the health care field.

(In last month's issue, Language Line Services' President, Louis Provenzano congratulated interpreter organizations in Texas who helped pass House Bill 233. This is an Open Letter to all who believe the delivery of health care services should know no language barriers.)

The House of Representatives and the State Senate passed House Bill 233, filed by State Representative Eddie Rodriguez, on May 27, 2009 and was signed by Governor Rick Perry on June 19, 2009.

The new law establishes a multidisciplinary advisory committee to recommend specific qualifications for medical interpreters, and its passage represents the hard work and vision of many elected officials and organizations, including the Texas Association of Healthcare Interpreters (TAHIT), the Texas Society of Interpreters for the Deaf, and the Texas Association for the Deaf.

Today, more than 6.8 million people in Texas are considered to have limited English proficiency (LEP), and this number is on the rise. According to U.S. Census data, on a national level over 47 million people speak a language other than English at home, and nearly 24 million are considered LEP. Overall, more than 145 different languages and dialects are spoken in Texas as well as American Sign Language.

Residents of Harris County speak over 97 languages which represents the 10th highest number recorded in any county in the United States. Given these numbers, many Texans would be surprised to find that currently there is no state or national standard for assessing the qualifications of medical interpreters.

In other words, when patients enter hospitals, clinics or physicians' offices, and cannot speak English, there are absolutely no guarantees that they will be able to communicate accurately with caregivers. The result can be incorrect diagnoses, mistakes in treatment, higher related costs, and delayed care. While medical errors in general represent a troubling issue, patients with limited English proficiency are almost twice as likely to suffer adverse events in U.S. hospitals.

Such events often have greater clinical consequences resulting in temporary harm or death according to a pilot study by The Joint Commission, an independent organization that evaluates and accredits more than 15,000 health care organizations and programs in the United States.

With the passage of House Bill 233, Texas becomes one of only a handful of states that are making significant progress toward the certification and better regulation of medical interpreters. Ultimately, with clear leadership like that shown in this bill, we can move toward implementing a truly national standard for training and testing the professionals who serve as the vital link between physicians and LEP patients.

The U.S. health care industry is one of the most highly regulated in the world. When a patient arrives at a hospital, he or she is assessed by a trained and licensed nurse or medical assistant, and ultimately sees a physician who is tested, licensed and subject to specific continuing education requirements. The technicians who run and service the medical equipment are certified. Even the individuals who sell health insurance to patients must abide by regulations and standards of certification.

It just makes sense that medical interpreters, who communicate information that could make the difference between life and death, be tested, proven and certified as well.

Texas has taken a vital step toward this goal.

Comments? Send them to healthletter@languageline.com. Thank you!

The Sioux Lookout Meno Ya Win Health Centre, situated in northwestern Ontario, Canada, is conducting a survey to investigate culture-related barriers to the safe delivery of healthcare to diverse populations.

The survey can be found at the following link: http://www.surveymonkey.com/s.aspx?sm=fpII6qixyF_2bXDESXsw4LMg_3d_3d .

The Health Centre has compiled a framework of 9 potential barriers. Through their survey they are seeking your help to validate these factors by confirming their presence in a variety of cross-cultural contexts.

As part of the survey, there are several questions which are optional, however, your input is extremely valuable to their effort.

The Health Centre would greatly appreciate any personal experience or ideas you may want to share with them. The survey should take about 15 to 20 minutes to complete. Responding to the optional questions may add more time.

Results of the survey will be published on the Health Centre's website when available.

If you have questions, please contact Roger Walker at rwalker@slmhc.on.ca or by calling him at 1-(807) 737-5130.

Minorities, Low Income Americans More Likely to Be Sick, Less Likely to Get Care

U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius on June 10th released a new report on health disparities in America and participated in a White House Health Care Stakeholder Discussion on the importance of reform that reduces disparities that exist in our current health care system. The new report "Health Disparities: A Case for Closing the Gap" is available at www.HealthReform.gov.

"Minorities and low income Americans are more likely to be sick and less likely to get the care they need," Secretary Sebelius said. "These disparities have plagued our health system and our country for too long. Now, it's time for Democrats and Republicans to come together to pass reforms this year that help reduce disparities and give all Americans the care they need and deserve."

A Case for Closing the Gap highlights some of the glaring disparities that exist in the current health system. Under the status quo:

• Forty-eight percent of all African Americans adults suffer from a chronic disease compared to 39 percent of the general population.


• Eight percent of white Americans develop diabetes while 15 percent of African Americans, 14 percent of Hispanics, and 18 percent of American Indians develop diabetes.


• Hispanics were one-third less likely to be counseled on obesity than were whites -- only 44 percent of Hispanics received counseling. African Americans are 15 percent more likely to be obese than whites.

The report also notes that 40 percent of low-income Americans do not have health insurance.

About one-third of the uninsured have a chronic disease, and they are six times less likely to receive care for a health problem than the insured. In contrast, only 6 percent of high-income Americans lack insurance.

Read the full HHS press release here >>

"The growing linguistic diversity of the United States is having a dramatic impact on the delivery of... health care services.

"Each day, thousands of patients arrive at hospitals, urgent care centers and primary care medical offices, and before their temperature is taken or their blood pressure is gauged, they face a potentially devastating barrier that could affect the quality of care they receive, the outcome of their visit, and their future health."

So begins a newly published white paper from Language Line Services based upon the latest data concerning the millions of American patients with limited English profiency (LEP).

Get your copy now! Share it with your colleagues.

Complete the brief form here and you can immediately download an Adobe Acrobat (PDF) version of "Breaking the Language Barrier - Health Care Quality, Efficiency and Savings through Professional Medical Interpretation".

By Laurie Larson, Trustee Magazine

Providing Linguistically Appropriate Care

A large part of a hospital's provision of culturally competent care means providing adequate language services for patients with limited English proficiency (LEP).

To be truly culturally competent, hospitals must face the fact that roughly 23 million people living in the United States have LEP-and a good share of them will be coming through their doors

Following are selected quotes from this article. Download your own copy here.

"Diversity is here to stay," says linguistic consultant and interpreter trainer Linda Joyce. "Our nation is becoming more diverse, more spread out over the whole country. If hospitals are interested in safety and quality, language and culture need to be addressed in every department; it has to be part of hospitals' goals and strategy. It can't be an ancillary service; it must be a funded core service."

"Language permeates all areas of the hospital," says International Medical Interpreter Association (IMIA) president Izabel Arocha. "It serves all departments in the hospital and is not a separate service. Everything is affected by language access."

"Hospitals don't have the knowledge they need for language services," Arocha says. "Language services need to be accurate for patient safety. There is liability for hospitals who do not have interpreters. Health outcomes are related to communication errors."

"I want to see interpreters accepted as equal members of the treatment team," Linda Joyce (former director of language interpretive services at Grady Health System in Atlanta) says. "Communication is 80 percent of treatment, and it must be accurate. We interpret meaning for meaning, taking in cultural considerations. The role of the interpreter is to be transparent so that the patient and provider talk to and look at each other, not at the interpreter."

Linda Joyce is involved with seeking national certification for medical interpreters through the National Council on Interpreting in Health Care. The council has already produced ethics and best practices that Joyce says professional medical interpreters strive to follow.

"A patient should be able to walk into any hospital in the U.S., and if he doesn't speak English, he must receive language assistance," says Marty Conroy, manager of Public Health Initiatives for Language Line Services.

You can find the entire article here >>

Selected News of the Month

• Language Line Services Provides Mid-Year Report on North American Emerging Languages. Leading Language Company Continues Recruitment Effort for Interpreters to Serve New Populations


• Surge in Foreign Language Interpreting Needs Expected Among Financial Institutions. Language Line Services Prepares for Spike in Demand for Assistance Opened up by Obama Plan


• Cross-Cultural Update for June 9 to June 22. Useful Cultural News, Tips and Timely Information

Read more Language Line Services news here >>

Communicate the Right Message, Regardless of Language

Given the changing demographics of today's consumer, many organizations translate or localize their written messages into other languages. Unfortunately, if you select an unproven vendor you may end up with mistranslated materials. There are ways to avoid that!

Sign up here for your FREE copy of "The Guide to Translation and Localization" now and we'll give you 10% off your next document translation project submitted by July 31, 2009.

PS: Remember to include your mailing address in the brief form on the Web page if you want a physical copy of the book. Otherwise, we'll send you a downloadable PDF version. Thanks!

Language Line Services, the leader in over-the-phone interpretation, is seeking to increase its interpreter team in many languages.

If you have excellent proficiency in English, with strong listening and comprehension skills as well as good customer service skills, you can become an interpreter for Language Line Services.

Visit www.languageline.com/careers.

View the "How to Become an Interpreter" Video.

Then, click on "Apply Today" under "interpreter Careers" OR "Corporate Careers" and follow the directions.

Here's what a valued client said just today (5/28/09) about one of Language Line Services' excellent interpreters:

"...interpreter #6100 for Farsi was awesome fantastic and amazing. I am speechless as to how good the interpreter was. We have a very difficult client that he made so easy for me. Thank you..."

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