Interpreter service aids non-English speakers

By Aubrey Gibavic - June 8, 2006

After an intensive study examining the low utilization of Island medical services by non-English speaking residents, mainly Brazilians, the Island Medical Interpreter Service has started to offer interpreting services. Spearheaded by Cynthia Mitchell of Island Health Inc. and run by Miryam Gerson, the program has been in place for eight weeks, and the directors have plans for expansion.

"We're very excited about how well it's going and how well it seems to be accepted at the hospital," Ms. Gerson said. The program is available at Martha's Vineyard Hospital and Community Services.

The hospital contracts directly with the program, and contacts an on-call interpreter when requested. The hospital pays for the service, and patients are not charged extra.

The program has 15 active translators with someone on call 24-hours a day. Translators work 12-hour on-call shifts, from 7 am until 7 pm, and vice versa. Ms. Gerson said they are all Portuguese and English speaking, except for one Spanish interpreter who has not yet been used.

The interpreters must go through a 48-hour training program and be fluent in both languages in order to be eligible for the program. Lisa Morris from UMass Medical School in Worcester trains the interpreters, after which they must pass a test to receive certification.

The most recent training program was run this spring, and Ms. Gerson said she plans to hold more sessions in the future, as people have started seeking out interpreter positions on their own. "This was all word of mouth," she said. "They called us and said, 'We hear there's a program; can we get involved?'"

The Martha's Vineyard Brazilian Health Study, released in May of last year, interviewed 168 year-round Island residents, 56 percent of which were non-English speakers. "Overall, the Brazilian sample is young, has low educational and income levels, but has good social support related to relationships," the study states.

Only 28 percent of interviewees visited a physician for a regular check-up in the past year, and the majority of those were in Brazil, according to the study. "One of the conclusions was that the Brazilian population's access to care would improve if there were a medical interpreter service," Ms. Mitchell said.

The study concludes that a combination of financial and language barriers deter non-English speakers from utilizing health care on the Island more fully. "Although Brazilians seek health care available to them, such as through free screenings and free health clinics, utilization rates are still significantly lower than the national recommended standards of care," the study states.

"One of the problems of having a language barrier is you can't talk to people," Ms. Gerson said. "And a cultural barrier grows when you don't know where to go or how to ask for what it is that you need."

Six years ago, the Health Council initiated a program called the Vineyard Health Care Access Program, where director Sarah Kuh explored issues surrounding health care on the Island. "Based on their clientele's needs and demographics, it was becoming obvious that this was an issue," Ms. Mitchell said of the language barrier in health care.

In Sept. 2002, the Council received a $462,000 grant from the Federal Department of Health and Human Services Office of Rural Health Policy, to establish a rural health clinic, now Island Health Inc. Roughly $75,000 of that grant was designated to assist in the development of a formal medical interpreter program. The grant ran from July 2003 until April of 2006.

"We put that as one of our goals because if you can manage to do that, then you're going to be addressing a major access barrier for a certain population," Ms. Mitchell said.

An additional planning grant of $15,000 and an implementation grant of $50,000 were given by the Blue Cross Blue Shield of Massachusetts Foundation.

"The goal is to be self-sustaining from revenues from the program," Ms. Gerson said of the program's future financial goals.

Ms. Gerson said they sought grants after finding that non-English speakers were both having trouble seeking medical care or not going through the process at all, and foregoing needed medical care.

While Ms. Gerson and Ms. Mitchell said the actual population of non-English speaking Islanders is unknown, 95 percent of them speak Portuguese.

"There is a very strong year-round Brazilian community," Ms. Mitchell said. "And by the year 2000 these needs were beginning to make themselves known."

Ms. Gerson said they are looking to expand the program into private doctors' offices and the Martha's Vineyard Regional High School for help in parent-teacher meetings. "I'm hoping that we'll start that in the early summer with any doctors who want to get involved with us," Ms. Gerson said. "We're actively looking for funds from local philanthropic organizations or granting organizations. The doctors as well, we hope, will make a contribution to it."

This process is more complicated, because doctors would pay almost as much for the interpreter as they would receive in reimbursements, Ms. Gerson said. Patients would also be asked for a donation.

"The hospital's been very pleased with the service, and the interpreters have been very happy to be doing what they're doing," said Ms. Gerson.