BEATRICE HALE and LINDA ROBERTSON discuss the need for skilled and well-trained interpreters in New Zealand’s health services.
From recent research carried out with a group of senior Mandarin-speaking Chinese in Dunedin, we have been made more aware of the need for skilled and well-trained interpreters in the health services.
According to Statistics New Zealand there is an increasing number of older people living here, many of whom followed to support their younger family members who migrated for educational and work opportunities. Often these younger family members move on in search of further employment, while their older family members remain in the original city, and with their isolation and lack of opportunity, might require considerable assistance in their later years. Such assistance could require the use of skilled interpreters. Learning a language is easier for younger people but older people might experience issues of social isolation and have fewer opportunities to build their English language skills. This observation is supported by research from the Dunedin Settling Report, published in March 2012.
Our small research group of Chinese seniors supported these comments; the older women had a poorer command of English than the men or than younger women in the group. Obviously we needed an interpreter in our research.
Process of working with an interpreter
Working with our skilled interpreter, and, through him, with the group, helped us understand some of the subtleties of interpreting and we realised how skilful were the interpreters we used. Not only did they have to understand and convey our meanings, but also to create from the group responses, the answers to our questions.
Some questions from the group necessitated invitations to specific health professionals to come and talk to us. From these, and from the group’s own discussions, we discovered that there was a dearth of trained interpreters. And comments from group members showed just how important it was to them and to the health services professionals, to have good available interpreters.
What we needed to do with our interpreter, was: a) to ensure that we as researchers were very clear about our questions; b) these questions needed to be broken up into small component phrases, so that the interpreter is comfortable about remembering them and repeating them in the appropriate dialect; c) be aware of time! Interpreting is time-consuming, so that the research will take longer than anticipated. Not only does the two way process of communicating from researcher to interpreter to group take more time than we anticipated, but also the responses from the group have to be managed by the interpreter, and replayed to the researchers and noted.
Interpreting and communicating through an interpreter can be difficult. Though we had every faith in each of our interpreters, it was good to see that the transcripts agreed with the direct interpretations during the meetings.
Skills of interpreting
Our experiences in the research resulted in further investigations on interpreting in New Zealand. Robyn Pask from Interpreting New Zealand said that while there are quite a few trained interpreters in New Zealand, there are also many volunteers, some of whom are untrained freelancers, particularly those outside Auckland, Wellington and Christchurch. Interpreting New Zealand was set up in 1993, in response to the needs of various agencies, in particular health and legal agencies for a consistent standard of interpreting. Interpreting New Zealand has been in Wellington since 1993 and in Christchurch since 2008, and has recently started training and providing interpreters in Dunedin. Interpreting, says Robyn, means conveying a message exactly as it was intended, not something that is either summarised or has the interpreter’s spin on it. Interpreting is a demanding task, and even though there can be some confusion in the speakers’ messages (for example in health settings, particularly mental health), they must be conveyed as far as possible as spoken, Robyn insists, because it gives the doctor useful information. Interpreting is to ensure that the patient’s messages are exact, not to check for understanding.
Training includes a discussion of the ethics of interpreting. Confidentiality is very important, as are role boundaries to ensure the interpreter remains completely impartial. There should be no intervention from the interpreter as in giving advice or opinion, for example, or advocating on behalf of either party. Robyn described a situation where a doctor wanted to tell a patient she had terminal cancer. The family member interpreting was upset and said “you can’t tell her that!’. But in fact, the interpreter’s job is to pass on the message, with empathy, not to re-state the message, or avoid giving it.
To be an interpreter requires the trust of both groups. In our research situation trust in the interpreter came from ourselves and from the participants. We were certain that our questions received careful consideration from the interpreter, who did not hesitate to check the information he was hearing to ensure its accuracy. Likewise, the group of participants trusted him to relay their answers to us.
Trust includes building rapport which is part of a good interpreter’s role: sensitivity to the local conditions and perceptions, and also, where an interpreter belongs to the group being studied and is acceptable to that group as an interpreter, he or she can become a key informant; avoiding the ‘interpreter effect’ where information can be blocked by interpreters not acceptable to the group, or improved by acceptable interpreters.
Robyn is insistent on the value of trained interpreters, especially in the sensitive situations of health care. These trained interpreters are culturally aware and sensitive, and bound to an interpreter ethic. As well as the strict training from Interpreting New Zealand, training is available from a number of other places, for example Unitec in Auckland which offers a Certificate in Liaison Interpreting, Auckland University with a certificate, in translation and interpreting, Decypher, which is a non-profit interpreting agency I Hamilton, who provides assessment as well as training. Interpreting NZ, the non-profit interpreting agency ensures that successful candidates are eligible to apply for the New Zealand Society of Translators & Interpreters membership and AUT which encourages graduates to become freelance.
Interpreting New Zealand has interpreters available on the phone or via video link to any agency around the country, as well as face-to-face in Auckland, Wellington, Palmerston North, Christchurch and Dunedin.
When there is no interpreter available for face-to-face work, as well as the phone/video service from Interpreting New Zealand, we also have Language Line, a telephone service which will provide skilled and trained interpreters for use in surgeries and in hospitals. There are 44 languages available, and requests can either be booked or be provided on demand. This is a government-subsidised service, and operates between the hours of 9 and 6 pm during the week and 9-2 on Saturdays. Prior to using Language Line, agencies must make arrangements with them to be signed up.
Judi from MBIE said that there is in place a major three-year project to ensure training and registration of interpreters. However, that is another story. Details can be found on the Immigration website.
By Dr Beatrice Hale, independent researcher, Associate Professor Linda Robertson, Dept of Occupational Therapy, Otago Polytechnic. With thanks to Robyn Pask, CEO, Interpreting New Zealand, for willingly sharing her knowledge and expertise.