The language of health

Izabel Arocha is president of the International Medical Interpreters Association. (Jonathan Wiggs/Globe Staff)

When a non-English speaker goes to an emergency room or clinic, accurate translation can be as important as quick medical attention. That's where Izabel Arocha comes in. She trains and supervises more than 80 interpreters for Cambridge Health Alliance, and is president of the International Medical Interpreters Association. The association is based in Boston, where medical interpretation was born in the 1970s, says Arocha. Here is an edited version of our recent conversation.

BINA VENKATARAMAN

Q. What languages are in most demand in the Boston area?

A. It really varies by hospital. At Tufts Medical Center, for example, Asian languages are the primary languages. Here in Cambridge, we have Portuguese as our top language, followed by Spanish and Haitian Creole. If you go to Beth Israel [Deaconess Medical Center], Russian is one of their top languages. Patients will actually travel long distances if they have to because they want to have care in their language.

Q. Are there enough interpreters for the growing demand?

A. We've seen, especially in the last 10 years, a growth in training programs. I think that has really enabled there to be a pool of interpreters. But the one thing that's missing is certification. What we have is a huge diversity of levels of medical interpreters - some much more qualified than others - and there's no standard qualifier in the state or the country.

Q. You've done a lot of interpreting in other settings. How does medical interpretation differ?

A. There's a huge responsibility, knowing that a mistake or a misjudgment in communication can have an adverse effect on the person's health. The variety of different specialties is also quite immense. One minute you are interpreting in maternity, the next minute you're in palliative care or in the emergency room with a child that had an accident. There's a huge variation, just in a day.

Q. What is an example of a cultural issue that comes up?

A. Often, the provider will explain a treatment plan and put some choices before the patient. A lot of times, the patient is completely confused because perhaps in the patient's culture, the provider is the one that makes the decisions and not the patient. And so the patient will keep saying, "You make the decision." And the provider will keep saying, "No, you need to make the decision."

Q. Why did you go into this field?

A. My mother was a translator and my father was a diplomat. I was raised in many different countries - Belgium, Spain, Japan, Mexico, Serbia, and Brazil - and saw cross-cultural issues all the time. I was always a newcomer in a new country trying to communicate with people I couldn't understand. I fell into interpreting, almost accidentally, interpreting at church for individuals who couldn't understand the sermon.