By Cara Anna

Associated Press


UTICA, N.Y. - With nearly one in four American births now to a foreign-born mother, pressure is growing on health-care centers to not only deliver babies but to deliver in more languages than one.

A report issued this month by the Center for Immigration Studies says that as of 2002, 23 percent of all births in the United States were to immigrant mothers. Births to Hispanic mothers accounted for 59 percent of those.

The Civil Rights Act of 1964 says hospitals that get federal money must provide interpreter services. It does not say how. Most hospitals reach out with phone-based interpretation services. But critics say the phone has limitations, especially during childbirth.

"What, are they going to pass the receiver back and forth while the doctor is catching the baby?" asked Francesca Gany, director of the Center for Immigrant Health at New York University School of Medicine. "Health-care facilities are definitely feeling the heat."

The Joint Commission on Accreditation of Healthcare Organizations is studying the link between medical error and interpretation issues, Gany said. And the National Health Law Program is looking at how small health-care providers can offer language services. A report by the Washington-based Institute of Medicine said 56 percent of such providers surveyed had received no language training.

Although studies are under way, there are no national numbers for access to, or use of, interpreter services in health care. But there are telling samples.

One hospital in Madison, Wis., said requests for interpreters more than doubled, to more than 4,000 requests a year, from 2000 to 2003.

A survey of New Jersey's hospitals shows that in a largely urban state, where 11 percent of residents have limited English, just 3 percent of hospitals have a full-time interpreter. Eighty percent of hospitals offer no staff training on working with interpreters, and 31 percent have no multilingual signs.

Cost is a barrier and most hospitals told the New Jersey survey that reimbursement for translation services was needed. A 2002 study by the National Association of Children's Hospitals found interpreting costs at 22 hospitals ranged from $1,800 to $847,000 per year.

The alternatives to a trained translator can be, and have been, a Spanish-speaking janitor pulled into the delivery room, said Portia Jones, an assistant professor at Albany Medical Center in Albany, N.Y.

Jones oversees a pilot interpreting program for the center's medical students. In a city of just under 100,000, the program includes about 30 volunteers who speak Russian, Spanish, Arabic, Farsi, Japanese, Polish and other languages.

Utica's number of refugees per capita, 10,000 in a city of 60,000, is one of the highest in the country. The Multicultural Association of Medical Interpreters in Utica contracts with about 40 interpreters in 14 languages and arranges about 600 interpreting sessions a month, triple the number in 2002.

Even with such numbers, the lack of interpreters at Utica-area hospitals brought complaints less than two years ago. A woman, writing in Russian, thanked hospital employees for their care but urged more interpreters. She had consented to an operation on her fetus without quite understanding why.
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God forbid we should expect foreigners to learn English!

If you're going to come to this country, legally or illegally, acclimate yourself to our culture. Do not expect the United States to make you feel totally at home.

Part of the requirements of becomeing a citizen should be the enrollment in and completion of a course in basic English.

As I've actually interpreted in hospitals a few times in the States and in France, (I was listed as a Red Cross volunteer in Tennessee when I lived there) though not in emergency situations, I tend to agree that we shouldn't have to provide translation services to each hospital, yet, childbirth and other operations make you lose your faculties to reason well, and if it were possible to have a volunteer interpretor as they do here on call for many places in several languages, some major decisions could be covered. If the family needed help making a health care decision, a translator might help enormously.

Though I was a translator in France, I have to say that when my back was in extreme pain, I happened to get a provider who was from England and it was a relief to be able to speak my own language. I had to help a big bunch of foreign students with French doctors in France, and their French was so basic that it would have been ridiculous to expect them to know how to speak that well after a few months of lessons. The doctors sometimes had enough English to get it across but the legal matters and paperwork are terribly hard to figure out. I had to translate a few minor emergencies and help with paperwork there.

Here in California with our multicultural society, most hospitals try to accomodate with volunteer translators and often are looking for Hmong, Vietnamese, Chinese, Spanish and Russian in my town.

The Hmong people for example, may never have been able to attend school in refugee camps etc in their own language much less English though they catch up amazingly well when they have the right kinds of classes.
So, if there are volunteers amongst each community, I'd think that would be the best way to go.


I am thinking that we are not speaking about simple things in English but complicated life and death matters. This is why I was listed as a translator for the Red Cross.
So though I agree that living in this country, speaking English should be a must, there's no telling if a person will have been able to reach a level of English necessary to tackle paperwork or life and death medical issues.
It may depend on the circumstances which brought them here.

And also how long they've been in the country needs to be taken into consideration. English is a very difficult language to learn for foreigners, so it'd be pretty ridiculous to expect them to be able to communicate effecitvely after only having been in the country for a few months. I can speak 4 languages fluently, and wouldn't mind helping out if someone couldn't quite grasp the level of English used, but yeah, it does bother me when people have been in an English speaking country for 20 or 25 years and still can't put together a simple sentence. Like my aunts and uncles who use a satellite dish to catch 24 hours a day of Spanish programming. How are they going to learn the language if they refuse to watch English programming. I guess it comes down to people not really wanting to assimilate since there are tons of free English classes for those who want to learn and they are tailored to the best suitable times for the learner. I once had a service call from Bell Canada, which is the biggest phone service provider in Canada, and the man on the other end had the worst broken English I'd ever heard, I had to say "what?" every other word and he had the gall to get mad at me when I couldn't understand 9 words out of 10 that he would say. If you're going to work at a job that requires communicating with other people ALL DAY, then yeah, I say they definitely need mandatory English courses if English is not your first language.

Good points, gemini.

It reminds me of my ex-wife's grandparents. When I first met them, I thought that they were 'right off the boat' from Italy. They could barely speak English. Spending an evening with them was like being in Naples for three hours. Their furniture was Italian; Italian music played in the background; pasta was served (all food was Italian and home-made.) The only thing missing was Ezio Pinza singing "O Sole Mio". One of the few utterances I understood was when Tony (the grandfather) said to my fiancee, "Ee's a nice-a boy, but ee's a no Italiano".

On the ride home, after my third chorus of "O Sole Mio", my fiancee embarrassingly told me that both of her grandparents were BORN IN PHILADELPHIA. They were in their late sixties and existed in some sort of environmental warp. I was incredulous at our wedding when I met the grandparent's friends and other relatives who were carbon copies of Tony and Gunzie. America didn't exist for them. Italy was their only reality.

I find it hard to believe that this could exist. If it does, I think only the very old could get away with it in today's world. Tony and Gunzie could have spoken better English; they chose not to and, as a result, deprived themselves of so much.