Map of life expectancy at birth from Global Education Project.

Monday, November 03, 2008

The World's Still Turning

It's hard to get down to regular business today. The election tomorrow will be one of the most significant in our history, right up there with 1860 and 1932. That's not to say that Barack Obama will necessarily be remembered alongside Lincoln and Roosevelt. The challenges he faces are equal to theirs, but whether he can achieve greatness is up to all of us. Nevertheless, the coming moment may be the most important of my lifetime. Truly, I did not believe I would live to see this day.

In spite of all that weight of history upon us, we still have our own work to do. I'm happy to say that my colleague Kari White and I had our article Role Exchange in Medical Interpretation published on-line today in the Journal of Immigrant and Minority Health. Sadly, although the journal is on-line, it's not open access.

I will tell you, however, that when people who are not professional interpreters are called upon to interpret in health care settings -- as often happens -- disaster is likely to ensue. We observed nurses and social workers who were called upon to interpret substituting their own judgment for that of doctor and mother (these were pediatric visits) and making up false translations accordingly. We observed social services staff who were asked to interpret but who had limited training spending significant time socializing with mothers, giving their own medical advice, and editing mothers' and doctors' remarks for what they considered to be the medically relevant content.

So one important element of the universal, comprehensive, single payer national health care that President Obama is going to give us -- or even the more limited regulated insurance market we can actually expect -- is that it includes adequate reimbursement for high quality, professional interpretation when doctors and patients don't share fluency in a common language. That includes deaf people as well as immigrants, by the way.

Ultimately, as well, we need to promote bilingualism in this country instead of treating it as some sort of a threat. Learn another language -- you'll have access to twice as big a world.