Wakati napitapita nimeona habari hii nikahisi tunaweza kunufaika nao kwa kujua maendeleo ya lugha yetu ughaibuni.Fatilia hapa chini Doctors lost in translation use assistance. By Mary Pickels TRIBUNE-REVIEW Sunday, October 21, 2007 Social worker Sue Mull still remembers the Mexican student who was a patient at West Penn Hospital. His parents didn't speak English, Mull recalls. "They were at his bedside most of the time," she said. But the student was often too tired or ill to translate for them, so when doctors and nurses wanted to talk to his family, they turned to a handy interpreter: a telephone for medical translation. Such translation systems offer 100 or more language options -- from Spanish to Swahili -- and connect patients and caregivers with translators by a dual handset or speaker phone. An interpreter speaks with the caregiver in English, then translates in the patient's preferred language. "Some days there's a demand for it several times," Mull said. "It works beautifully in situations where I've used it." According to the American Hospital Association, up to 23 million U.S. residents have limited English proficiency, and a recent survey found 48 percent of hospitals encounter patients with limited English skills on a daily basis. Federal law requires hospitals to provide interpretation services. The Hospital and Healthsystem Association of Pennsylvania is working to address an increasing number of patients who are not proficient in English or are hearing-impaired, spokesman Roger Baumgarten said. A 2006 Health Research and Educational Trust report found that telephonic services were the most used resource, followed by staff interpreters. Most hospitals in the region use both. Some have interpreters on staff; others contract with interpreters who are called in when needed. UPMC's Center for International Patient Relations receives more than 4,000 requests a year for translation services, said Miriam Erukhimov, department manager. Full-time staff interpreters are the first called. For patients from outside the United States, translator services are set up before check-in. The hospital system also uses bilingual staff members and contracts translators. "Face-to-face interpretation is truly the best way," Erukhimov said. The most requested languages are Spanish, Turkish, Italian, Arabic, Mandarin Chinese and Vietnamese. Swahili is one of the more recent. "It's a fluid thing," Erukhimov said of languages that change along with the city's culture. Marie Legowik has worked for UPMC Health Plan and volunteered as a translator for two years. The native of Poland, who also speaks Russian and German, helps patients over the phone and in person. "I understand if you cannot truly communicate comfortably, especially in a stressful situation," Legowik said. "You feel helpless and paralyzed. I offer this help as sort of giving back something." One of her most rewarding experiences involved a Polish citizen who came for a kidney transplant. The patient spoke some English, but his donor, a friend, did not. Legowik spent several days with the two before and after the surgery. "I truly recognize this as a very good example of personal sacrifice and friendship," she said. Legowik does not accept payment, Erukhimov said. Her compensation is more personal. "When the interpreter shows up, the patient smiles, the doctor smiles, the nurse smiles," Erukhimov said. West Penn, Allegheny General and Excela Health hospitals all subscribe to telephone translation services. For years, Latrobe Area Hospital had a bank of staff members and volunteers proficient in languages including Dutch, Italian, Spanish, German, Farsi, Japanese, Ukrainian, Vietnamese and Portuguese. They were called in to help explain treatment to a patient, to translate thank-you letters written to hospital physicians, or to decipher a hospital bill. The hospital is now part of the Excela Health System, including Westmoreland and Frick hospitals. The system recently began a transition to telephone translation, primarily because it's available around-the-clock, officials said. Holly D'Amico, Excela's director of clinical resources, said volunteer translators were not always immediately available. Irene Mankovich of Latrobe, a native of Austria-Hungary who was a volunteer hospital translator for many years, said she was called only a few times. Her last time was for a patient whose mother had a heart attack while visiting him. "No one was able to explain what happened," Mankovich said. "They called me. I told him she was going to be all right. "In that case I was really needed," she said. "It makes you feel good when you help somebody." Spanish is the most requested language at Excela hospitals, which treat few non-English-speaking patients, D'Amico said. Easing communication West Penn's speech therapy department uses the software program Boardmaker to produce picture boards for patients. Senior speech therapist Beckie Lemley said the graphics database includes 4,500 communication symbols in 44 languages. The program produces a single-use form that's inexpensive and disposable. The boards show icons and dual language phrases such as: "I'm hot," "I'm cold," "Turn the light off," "I need my medication." "It gets the point across quickly," Lemley said. She estimated patients use the picture boards a few times a week. "Given our location, Bloomfield," Lemley said, "Italian is probably the most common language request." Allegheny General Hospital posts language charts throughout the facility to alert patients that they can request an interpreter, said Kimberly Hopey, director of case management. "For the vast majority of patients, the phone works very well," Hopey said. Dru Ann Delgado, manager of Allegheny International, said resident physicians who speak multiple languages help with translation. But because they rotate out of the hospital, she also subcontracts interpretation services. Her sources include Catholic Charities, churches, universities and social organizations. She tries to assign one translator to accompany patients through registration and appointments. "I've had translators go into the operating room," she said. Mary Pickels can be reached at firstname.lastname@example.org or 724-836-5401.