Pediatric interpreter Maria Elena Sacio interprets in Spanish as nurse Hanna Stelly explains Jose Miguel’s IVs to his parents.
Pediatric interpreter Maria Elena Sacio interprets in Spanish as nurse Hanna Stelly explains Jose Miguel’s IVs to his parents.
Houston Methodist Global Health Care Services liaison Ghada Darwich, center, and medical referral specialist Fady Ali, right, consult with a patient about her case.
Houston Methodist Global Health Care Services liaison Ghada Darwich, center, and medical referral specialist Fady Ali, right, consult with a patient about her case.
Medical referral specialist Mohammed Nassif, left, and liaison for the Arabic team Faten Ashrawi, right, discuss a patient’s case.
Medical referral specialist Mohammed Nassif, left, and liaison for the Arabic team Faten Ashrawi, right, discuss a patient’s case.
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Getting Un-Lost in Translation

Texas Medical Center institutions are overcoming language barriers to help international patients navigate health care in the United States

Getting Un-Lost in Translation

5 Minute Read

Houston is known for many things: barbecue, oil and gas, the Johnson Space Center, ZZ Top, Beyoncé—the list goes on. But another point of pride with many Houstonians is the city’s diversity. Houston has been ranked as one of the most ethnically diverse cities in the U.S. in numerous studies, with foreign-born residents making up 28 percent of the population and more than 90 languages spoken throughout the area. On top of that, the Houston Convention and Visitors Bureau estimated over 800,000 foreign travelers visited Houston in 2013 and the Texas Medical Center saw 14,622 international patient visits last year, according to the TMC

International Affairs Advisory Council. As a result of the rich cultural diversity in Houston, overcoming language barriers is a common challenge in the health care industry, and focusing on just the diagnostic and treatment process can easily eclipse the intimate human element of the medical experience. The stress of dealing with health issues, coupled with the anxiety of coming to a foreign country, can be an emotionally overwhelming experience for many, especially the patients and family members.

For Miguel Avila and wife Carina Coronel, bringing their nine-year-old son, Jose Miguel, from Venezuela to The University of Texas MD Anderson Children’s Cancer Hospital five months ago meant dealing with a foreign language on top of their child’s leukemia diagnosis.

“At first, there was that shock of a new language. In Venezuela, we don’t speak a lot of English,” Avila said, through Spanish pediatric interpreter Maria Elena Sacio. “Just getting onto the airplane, everything was in English. Right from the beginning, it’s very different. And when we got here, I can only say ‘hi,’ ‘bye,’ ‘up,’ ‘down.’ That’s it.

“One thing we’re very thankful for at MD Anderson is that there’s always either a physician available or someone to translate,” Avila said, adding that it’s important for them to have some sort of interpretation available.

Sacio, who is part of MD Anderson’s Language Assistance team, which works closely with the institution’s International Center, began working with Avila and Coronel upon arrival, helping them communicate more easily with the doctors and nurses who treat their son. The team employs 30 staff interpreters, who specialize in seven languages, and appoints them to assist non-English speaking patients—both international and domestic—with translating clinical documents and communicating with doctors on an as-needed basis.

“The language assistance department at MD Anderson has a highly qualified team of medical interpreters and translators who strive to provide caring and compassionate language services to our patients and providers,” said Cesar Palacio, director of language assistance at MD Anderson. “At the same time, we work hard on continuously improving the quality of our services and operational efficiencies.”

MD Anderson has long been committed to assisting patients from first contact through their treatment journey to returning home, and is equipped with technological solutions to minimize the difficulties of dealing with a language barrier. In the event an in-person interpreter is unavailable or if the hospital is unable to locate someone who is fluent in a particular language, there are various alternatives to assist with the communication between doctors and foreign patients. For instance, a dedicated phone
line is available 24/7 in 95 different languages, and the hospital recently added iPads that connect directly to an interpreter via Skype on every hospital floor.

In similar fashion, Houston Methodist Hospital manages the lan- guage barrier by bridging the cultural gap between international patients and health care providers.

“The needs of the global patients are very different in that our health care environment in the U.S. is very compli- cated and it’s very scary,” said Summer Dajani, vice president of global patient services and business development at Houston Methodist Hospital, which serves patients from over 95 countries, including the Latin American, Middle Eastern, and northern African regions.

International patients are assigned to a liaison who matches them up with physicians and maps out their medical itineraries, detailing their accommodations, scheduled appointments, treatment plans and expectations to help them navigate the U.S. health care system. But the liaisons don’t only help them plan; Dajani said they “become like family to the patients,” serving as trusted companions and interpreters to communicate in English and the patients’ native languages throughout the entire process—from doctor visits to lab work, imaging appointments to surgery preparation, pharmacy visits to prayer, and so on.

“We call them liaisons, but they truly are like case managers. They manage everything, not just the service only,” Dajani said. “They’re very knowledgeable in what they do and, by default, they create very special relationships with the hospital’s systems to be able to expedite their patients.”

Both MD Anderson’s International Center and Houston Methodist Hospital’s Global Health Care Services embody the “global” aspect of each organization. Liaisons and interpreters have extensive international training—whether that be in Morocco, Saudi Arabia or Mexico—and they apply their diverse backgrounds to understand cultural nuances that underlie commu- nication, lending itself well to better patient care.

However, hospitals are not the only places that deal with language barriers. In the same vein as MD Anderson’s dedicated phone line, Ronald McDonald House Houston uses CyraCom, a translating company that donates its service, to make 50 different languages available to house managers and families. RMH Houston provides a “home away from home” for families with sick children and regularly sees a diverse group of people with limited English-speaking skills.

Mariyah Pavlyukh, who has volunteered at RMH Houston for the past two years, said she understands the hardship and emotional stress of dealing with a communication disconnect in a new country.

“I remember when I first came to the United States [15 years ago], I wanted more than anything else just to hear my native language and be able to speak it,” said Pavlyukh, who also helps interpret and translate documents for families from Ukraine, Russia and Kazakhstan. “I can so much attest to that and empathize with them because I was in their shoes, except I did not have to battle these devastating illnesses. In addition, fighting these illnesses can add so much stress and burden, so I was very pleased to know that they found comfort in knowing there was someone in the house who speaks their language and can help translate.”

Pavlyukh said it’s “been a big blessing” to work with global patients and families. “To endure all that, you have to have such strength, so I ask myself, ‘Do I really help them, or do they help me?’” she said. “When I see them smiling and staying so positive, it really inspires me so much.”

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