Friday, November 30, 2007

Ethnicity and Inequality in the NHS II

The basic premise of the Cancer Research UK paper is that even though healthcare professionals may have gone through cultural sensitivity training, they feel inadequate and unconfident in their capability to deal with cultural differences. The fact that cultural sensitivity training discusses “cultures”, not individuals, may lead to stereotyping by practitioners – the woman behind the burqa is not an individual.

Training in the differences between cultures, the paper admits, remains essential but you cannot teach every healthcare professional about every culture they may come across. There is a need for healthcare professionals to be encouraged to view each patient or carer as an individual with their own experiences and value systems regardless of culture.

The paper also recommends, almost as a final aside, “Any steps must be integrated with other efforts to support intercultural communication and reduce misunderstandings caused by language and communication style”. I would thus extend such training to Language Line, the private sector interpreting service used by the NHS with hourly-paid interpreters.

Our first interpreter was a disgrace. From our ex-colonial power and because Nanda is black African we received every bit of second-hand tot clothing she could lay her hands on, every second-hand tot toy she could lay her hands on. Sorry luv (you patronized us so I will patronize you) – we can clothe our daughter, we can entertain her. Nanda might be black, she is not poor or ignorant. Nor is our daughter.

Our second interpreter, same language, white but not from the ex-colonial power was far more sympathetic.

Language Line (LL) interpreters also need a minimal knowledge of medical terminology and procedures. This lack will certainly inhibit the healthcare professional’s ability to interact with and respond to the patient/carer’s personal needs. Language Line needs to evaluate its interpreters, whether they are full-time (do they have any?) or freelance. Patient and practitioner response also need to be evaluated by both LL and the NHS … even though I think as a whole our response would be “we’re grateful for anything from the NHS …”.

LL, although an international company, works like an amateur private English-as–a-Foreign-Language School in a foreign country. The interpreters they call upon for the NHS do not have professional interpreting qualifications.

I would love to see the NHS-LL contract …

For Nanda, although her English is still poor (she is not a language learner in which she has a common trait with the UK white population), she learned the hospital and medical procedures relatively quickly, how to read the lab report, how to ensure hospital transport was booked etc. She soon dismissed interpreting services. Much of that, of course, has to with the amazing sensitivity of RMCH staff and in our case John, our consultant, and Teresa, our social-worker.


Lea White said...

Hi there,

It seems as if you guys have a bit of a difficult time with your interpreters. It is frustrating when people make assumptions without thinking the effects it may have on somebody, such as assuming that second-hand clothing and toys would be what you need.

Just wanted to drop by to say hi and that I'm thinking of you guys.

Has Kezia managed to get back to school?

Just out of curiosity, what language does your wife speak as a first language? I remember from 3 years ago when we left South Africa, it had something like 11 official languages. I can speak two (English and Afrikaans) and am able to say hello and a few other bits and pieces in Sesotho. I've always been quite interested in different languages and wish I learned a few more when I was younger, but at this age it has become difficult to grasp the "soul" of a new language.

Do keep strong and count to 10 and breath deeply when you find people who are ignorant and perhaps quite insensitive.

Angus said...

Hi Lea

Kezia's back at school. Tomorrow is the school Xmas party and she gets to meet Santa - hopefully it will go well.

Nanda's (and the kids, of course) first language is Portuguese. She doesn't have a need for an interpreter any more - it got to the stage where she understood what was going on better than they did.

Happy to hear Bianca is off the Dex - so hopefully this week will be less stressful! But inevitably you'll go therough it all over again and again and ...

Yeah - we could do with help paying the bills rather than 2nd hand clothes!

Look forward to seeing the photos of your nude head!

2 1/2 weeks until I see them all!