Infrastructure - lessons from the field

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