Infrastructure—lessons
from the field.
Recently I traveled to Central
America with the Honduras ENLACE Foundation whose mission is to support existing
health services through inter-professional and community collaboration to
improve the quality of life for underserved populations in Honduras, especially
those at risk, such as children under five and the elderly. Two medical teams
joined together, one from Indianapolis, Indiana (home of ENLACE), and one from
Kaiser Permanente-Vallejo, California.
As a charter ENLACE board
member, I knew the projects they have been involved in for years, and as a
Professor of Spanish, I have taught numerous medical interpreting classes and trained
healthcare personnel how to use medical interpreters. I was asked to accompany
these teams—which grew to be “the team”--to serve as an interpreter for the
doctors who set up mobile clinics in the mountainous villages around Taulabé,
Honduras, with our home base at the Clínica Las Lajas, one of the successes built
and run through the Honduras ENLACE Foundation. My second task was to teach a
foreign language methods class for teachers who would become the core educators
for Spanish as a Second Language for medical personnel who served the clinic
through the establishment of an on-site language school.
I knew my trip was going
to be logistically complex, but I looked forward to the experience. I could
never have imagined the robust and diverse scenarios that awaited me, as well
as the sense of accomplishment and friendship that resulted. I already had
extensive travel through Latin America and Spain, numerous trips as a study
abroad director and professor, and experience interpreting in hospitals and
clinics in Spain and Mexico. Honduras reinforced my fundamental belief that as
humans, we want to both give and receive.
On the giving end, I
witnessed a sense of dedication from doctors, dentists and nurses who worked
twelve-hour days to meet the medical needs of rural communities who had limited
access to basic health care. Beneath their observable passion to assure they
met the main clinical requests presented, I realized the solid infrastructure
healthcare providers work under proved by these particular individuals as
stellar providers. Many factors were unknown:
How many patients would there be, what medications would be the most
needed, what would be the main issues regarding communication and medical
attention, how accessible were the facilities, how would recommended follow up
visits to a clinic or a doctor take place? The list could go on, but there was
nothing stopping their goal of making an impact on the communities they were
there to help. Everybody on “the team” and everything that was planned through
daily briefings and debriefings highlighted the fact that everyone felt a sense
of accomplishment, a true bonding, and a heart.
The second component of
the giving were the teachers who learned methodology and spent hours preparing
for classes for dedicated doctors who not only spent an entire day seeing
patients, but then spent extra time learning Spanish to be able to communicate at
some level on a personal basis with their patients. It’s hard to brainstorm as
one individual preparing a methods class for teachers who are going to be
thrown into a class with students at different levels of language proficiency,
not to mention trying to prepare them in such a limited time frame. All rose to
the task, both teachers and students, and observing these classes was music to
this professor’s ears.
From the receiving side,
several items could be mentioned, but two stand out: the doctors and me. Did
the doctors feel they had received professional recompense and success for
their hard work? Unquestionably. Did the doctors learn what they could teach
others who went on similar medical brigades?
Undeniably. Would they do this again or recommend others to experience
practicing medicine in a cultural and linguistic environment they didn’t know?
Undoubtedly.
On my side, which may
sound bizarre to some, but maybe only healthcare interpreters could possibly
understand the angst I experienced as the code of ethics and standards of practice
were like computer chips I couldn’t shut down at night when I turn off my
laptop. These questions arose: How is the positioning going to work, will there
be terminology I don’t understand and a small medical dictionary won’t have the
word or a there will be no signal to access the dictionary app on my cell, will
I be able to interpret non-stop for an extended period of time without
suffering from interpreter fatigue? Again, the questions could be endless. The
bottom line, as a trained professional interpreter, we cannot have all the
resources we might need at our fingertips all the time, but we have an
infrastructure also, parallel to the infrastructure healthcare providers use to
move them forward and to practice medicine in the best way they know. My
infrastructure pulled me through, showing that interpreting is a profession,
and that “the team” not only got the job done, but the accomplishment felt
wonderful.
Muchas gracias a todos,
por el trabajo hecho, y por la oportunidad de haber tenido esta experiencia
inolvidable.
Enrica J. Ardemagni, Ph.D.
Professor Emerita, Indiana
University Purdue University Indianapolis
President, National
Council on Interpreting in Health Care
June 2016
