Fourth National Conference on
Quality Health Care for Culturally Diverse Populations:
Integrating Community Needs into the National Health Agenda

September 28-October 1, 2004, Washington, DC
Hilton Washington, Washington DC

Workshop A-3: Cultural competence in the context of addressing language barriers: issues for interpreters and managers

Beneath the Tip of the Interpreting Iceberg: Cultural Competence

All too often, the qualifications considered to be of utmost importance for a successful interpreter are the linguistic skills of the individual. These, of course, are the basic tools that are the most obviously required capabilities needed to facilitate communication between two parties who speak different languages. Nevertheless, simple linguistic ability is not enough to ensure competent or culturally sensitive communication between two such parties. Beyond basic bilingual proficiency, an interpreter must also acquire the specific skill-set involved in providing accurate and complete renditions of the words uttered by the two parties. In other words, knowledge of interpreting protocols and how to use them, skill in efficient and effective note-taking, and good short term memory skills, among other elements, are equally as important as language proficiency. However, even these two elements, which represent the "tip of the interpreting iceberg" are not enough to ensure culturally sensitive and relevant communication.

This presentation will examine in detail the underlying "bulk" of the interpreter's task, which is to have the ability to relate to at least two cultures, to recognize when a cultural issue is causing a breakdown in communication, and to find a way to bridge that communication gap when two cultures are in conflict. This is not, however, an equally important role for all types of interpreters, since some settings preclude the possibility of the interpreter doing any culture brokering. Therefore, this discussion will focus on Medical Interpreters, whose role must include that of a Culture Broker for situations when the gap between the Biomedical Culture and the culture of the Limited English Proficient (LEP) patient can potentially mean the difference between life and death.

As the presentation progresses, specific practical suggestions and steps will be offered to help interpreters develop this crucially important skill. In addition, real-life examples of how interpreters have or have not been able to bridge the cultural gap because of their possession or lack of cultural competence will be provided. Audience members will be encouraged to provide their own examples of situations in which culture was either overcome as an obstacle, or presented an obstacle to the provision of quality healthcare to LEP patients.

Amy Wade has been an interpreter for 7 years and has performed interpretations for healthcare organizations across the country. She studied at the Monterey Institute of International Studies in the Master of Arts program for Translation and Interpretation. As a Recruiter and Interpreter Evaluator for Language Line Services, she has been a part of the Assessment Development and Administration team for 5 years. During the search for qualified interpreters in languages spoken by relatively small, immigrant populations in the US, she has had to conduct extensive research into the culture and health practices of people who speak these “rarer” languages.

Amy Wade
Recruiter and Interpreter Evaluator
Language Line Services
2593 Glenfield Drive, Green Cove Springs, FL 32043
Phone: (904) 406-2893
Fax” (800) 496-5330
awade@languageline.com
www.LanguageLine.com

Forming a Bond Between Language Access and Cultural Competence Programming

Health care organizations in the United States often approach linguistic and cross-cultural aspects of care as two separate entities. On one side, a hospital may have a department of interpreter services; on the other, a diversity council or a department of cross-cultural health care.

The goal in building cultural competence is to have all aspects of operation, from clinical to organizational, demonstrate active and constructive attention to matters of culture and language.
This presentation will argue that because the two areas are integrally connected, they may function best when they are unified. Both of them address barriers to health care and health disparities; both exist to serve populations that have been underserved and disenfranchised; both serve to redefine the meaning of patient-centered care; and both are relatively new arrivals into the health care systems. Combined, they can benefit from each other's scope and sphere of influence. Consequently, this union between the domains of language and culture, as applied in the practice of health care, has numerous implications on the professional role of staff interpreters in health care organizations, which will be discussed in this presentation.

The presentation will draw upon the experience at Children's Hospitals and Clinics in Minnesota, the largest pediatric health care system in the Upper Midwest of the USA, where such a combined model is being implemented. The audience will receive concrete ideas of potential problems and possible solutions in developing language access and cultural competence as a shared model of practice and discussion aimed at sharing audience's experiences, problem-solving or strategy devising.

Boris Kalanj, MSW, LISW
Boris is director of Cross Cultural Care and Interpreter Services department at Children’s Hospitals and Clinics in Minneapolis and St. Paul, Minnesota. He is charged with leading organizational development toward such systems of care that can successfully meet the special needs and overcome the special barriers experienced by linguistic and other cultural minority patients. This includes provision of language access services, workforce education, and building better data collection, evaluation and research capacities related to access and quality of health care for limited-English speaking patients and families.
As a licensed social worker grounded in the commitment to social justice and human rights, throughout his career Boris has thrived on seeking ways to give voice to the voiceless. Prior to his appointment at Children’s, he was a staff social worker at the Center for Victims of Torture in Minneapolis. Boris has experience working both as an interpreter for Bosnian refugees in Minnesota and as a provider using interpreters in his communication with clients. He has given numerous workshops for providers in health, human services, and education fields on communication skills, working with interpreters and other areas of cultural and linguistic competence. Boris has a Master’s degree from the University of Minnesota, and a B.A. degree from the University of Zagreb, Croatia.

Elsa Batica, M.A.
Elsa is manager of Cross Cultural Health Development & Training for Children’s Hospitals and Clinics. In her role at Children’s, Elsa develops and delivers cultural competence training to health care providers and other staff; coordinates activities of the organization's Diversity Action Council; works with leadership, directors and managers on activities to enhance Children’s health care services to linguistic and cultural minority populations; helps Children’s develop collaborative relationships with multi-cultural community organizations; and coordinates implementation of select community-based projects. She has extensive experience in participatory action research, instructional design, group facilitation and one-on-one counseling on workplace diversity and management issues. Throughout her career, she has developed and delivered hundreds of workshops, consultations and facilitated sessions to a diverse client list of government, corporate, education, health, non-profit and community settings. She is currently an adjunct professor teaching Human Resources: Effective Employee Selection, Leadership and Management course for Law Enforcement and Strategic Management of Diverse staff. She is a trained and experienced civil rights mediator.

Boris Kalanj, MSW, LISW
Cross Cultural Care and Interpreter Services Director
Children's Hospital and Clinics
2525 Chicago Ave So
Minneapolis, MN 55404
Tel: 612-813-7989
Fax: 612-813-7633
boris.kalanj@childrenshc.org
www.childrenshc.org

Elsa Batica, M.A.
Cross Cultural Health Development and Training Manager
Children’s Hospitals and Clinics
2525 Chicago Ave So
Minneapolis, MN 55404
Tel: 612-813-7724
Fax: 612-813-7633
elsa.batica@childrenshc.org
www.childrenshc.org

essentials | models and practices | policy | legal issues | networking | table of contents | contact us | who we are

Copyright © 2004, DiversityRx; www.diversityRx.org, Last update:June 11, 2005

 Diversity Rx is sponsored by: