Non-English speakers struggle in encounters with health care system

By DEBORAH KONG, The Associated Press
Monday June 24, 2002

OAKLAND – In his halting English, Elvia Marin’s husband struggled to tell the nurses and doctor that the pain in his wife’s stomach and back was so intense, it was worse for her than giving birth. 

But the words that would have helped pinpoint her ailment — urinary tract stones — eluded him and doctors in the Oakland, emergency room couldn’t identify the problem by her discomfort alone. A few hours later, the pain subsided and she left without treatment. 

Others who don’t speak English relate similarly disheartening tales of failing to receive medical help. It’s a tough problem hospitals and doctors are trying to solve as immigrants with limited English increasingly flow into their hospitals and offices. 

“I felt really desperate and also frustrated at my inability to communicate in English and explain my own problem,” said Marin, a Mexican immigrant. “I feel like we’re not being listened to, not being paid attention to. We’re not considered important.” 

Doctors say they want to help patients, but object to interpreter costs that can range from $30 to $400, according to the American Medical Association. 

Others, like the Arlington, Va.-based advocacy group ProEnglish, say requiring doctors to provide interpreters is “a good example of multicultural ideology gone berserk.” Newcomers should assimilate by learning English, the group says. 

About 21.3 million speak English “less than very well,” according to 2000 census data, compared with 13.9 million people in 1990. 

Without adequate translation, health care for patients who speak limited English is at best inconvenient, and at worst life-threatening, advocates say. 

According to The Access Project, a community resource center at Brandeis University, a survey of more than 4,000 uninsured patients found 8 percent needed an interpreter but did not get one. Of that group, more than a quarter said they did not understand instructions for taking prescribed medications, the survey found. 

“The health care delivery system has been a little slow to appreciate the growing diversity of our nation,” said Mark Rukavina, the project’s executive director. “Over and over again, community systems are being strained by the changing demographics.” 

Without an interpreter to tell her what was going on, one Hmong woman thought she was being kidnapped when she was driven 100 miles from a clinic in Fresno, Calif., to one in Modesto. 

Xe Chue told her sister Pang Thao, “they kept driving, driving away. As they went further away, she got more afraid,” Thao said. “She thought they were going to take her to some bad places and just do whatever they wanted to her.” 

When she arrived, Chue motioned to two security guards she wanted to phone her family, but they ignored her, Thao said. 

“You’re supposed to trust doctors and nurses with your life,” Thao said. 

Federal civil rights law requires hospitals and doctors receiving federal funds to provide services that can be understood by non-English speakers. In general, doctors cannot turn away patients simply because they don’t speak English. 

An executive order signed by President Clinton emphasized that programs provided in English that are not accessible to those who speak limited English are discriminatory.