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Language Barriers in Health Care: Meeting Spanish-Speakers Half Way (I)

Posted by on January 13, 2015 at 4:45 PM


Health education is becoming increasingly important. As hospitals and insurers like to tell their clients, it is the tool through which they become active players in their own healing. In LanguageCare, we invest a great deal of thinking on how to address the issue of health education for Hispanics. And this thinking comes from a reflection on what we do best: translating health care information for Spanish-speaking communities.

The question for us is how to approach health education for those whose primary, and sometimes only, language is Spanish. The answer seems obvious —through a simple and honest translation, right? It may not be that simple. Traditional translations do not to take into account the national context of the target audience. In other words, they allow a client to understand the information being presented, but do not empower him or her to take that information into the real world and use it.

Ideally, the materials translated into Spanish should also allow the reader to utilize that information in an English-speaking environment. Let me illustrate this point with the following hypothetical situations:

Doña Victoria Pérez, a senior from the Dominican Republic, was provided with a perfectly translated description of a rehabilitation exercise following hip replacement surgery. However, she could not understand her therapist's English directions to perform such exercise. Would it have been so difficult to include the English term in parenthesis, or a brief English-Spanish glossary at the end of the Surgery Booklet?

Another example: Mr. Carlos Sandoval, was able to read in the Guía del Paciente he received in the mail, that right after surgery he would be taken to a post-anesthetic care unit, or /pi/ /ə/ /si/ /ju/. However, he could not understand the acronym when it was presented to him verbally at the hospital.

This problem can be avoided by simply inserting a phonetic transcription (see highlighted below).

Lastly, our fictional Margarita Garza was very happy to read in a Spanish brochure that her local family practice was expanding with a new set of specialists, including an otorrino infantil for her hearing-impaired daughter. Unfortunately, the translation omitted the English term for the specialty: “ear and nose doctor”. As a result Ms. Garza was faced with an unnecessary difficulty when trying to request a referral.

There are other reasons to support a bilingual approach in Spanish translations. Hispanics in the United States are the most heterogeneous users of Spanish in the entire world. This diversity comes from regional variations, of course. There is, however a more poignant singularity that our translators need to take into account: variations in linguistic competence.

Hispanics cover a wide spectrum that range from English monolingual to Spanish monolingual, and all the bilingual hues in between. But even those who are considered Spanish-only speakers will inevitably be familiar with English words that are absent in their Spanish lexicon.

Our translators must be sensitive to this linguistic coexistence, full of mutual interferences and invasions, and apply their instincts to have all the bases covered without hindering the natural flow and structure of the target language (see the example below).

A pedagogical translation is an adaptation specifically devised for Spanish-speakers in the US that includes an array of aids, such as reverse translations, phonetic transcriptions, and bilingual glossaries.

I firmly believe that these translations empower Spanish-speaking clients in their inexorable journey towards integration by providing limited but key vocabulary in the language in which health-care primarily unfolds: English.

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