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Healing words

Health-care interpreters an essential lifeline for indigenous patients receiving care in a language they don't understand

Hey there, time traveller!
This article was published 14/11/2016 (194 days ago), so information in it may no longer be current.

Geri Pascal and George Boulanger share a special relationship.

In part it’s a reflection of the fact they come from the same part of Manitoba, around the Berens River/Bloodvein region on the northeast side of Lake Winnipeg.

JOE BRYKSA / WINNIPEG FREE PRESS</p><p>George Boulanger, a indigenous-language interpreter (left), talks to dialysis patient Geri Pascal at the Health Sciences Centre.</p></p>

JOE BRYKSA / WINNIPEG FREE PRESS

George Boulanger, a indigenous-language interpreter (left), talks to dialysis patient Geri Pascal at the Health Sciences Centre.

They also share the same first language: Ojibwe.

In fact, it’s their mutual mother tongue that has forged their tight relationship — one built on trust that has developed since they met about five years ago.

Yet the two men aren’t friends in the normal sense of the word — though a deep relationship has indeed evolved between them.

Instead, Boulanger is Pascal’s guide through the health-care system since Pascal speaks very little English and Boulanger is an interpreter resource worker with Winnipeg Regional Health Authority (WHRA).

It’s his job to assist patients like Pascal, translating English to Ojibwe and vice versa during encounters with physicians and other health-care providers.

"He (Geri) was very quiet when I first met him, so we really had to work to build the relationship we have now," Boulanger says about Pascal, who has kidney failure and undergoes dialysis three times a week at Health Sciences Centre.

"He wouldn’t open up to me at the beginning and maybe tried to hide his medical condition sometimes. He didn’t want to say anything."

His assistance is essential to Pascal’s care, and more broadly, language-interpreting services form a vital part of the WHRA’s initiative to address the growing need for culturally sensitive health care for Manitoba’s First Nation and Inuit peoples.

Called Indigenous Health, it also offers cultural and spiritual care as well as cultural sensitivity training for staff while also focusing on hiring more indigenous workers so the system better reflects their representation in society.

"But all of this really began with interpreting," says Kandice Leonard, regional director for WHRA’s Indigenous Health, adding the first interpreters were hired in the 1980s.

"And through those interactions there was a realization other services were needed to support indigenous patients."

While services have evolved over several years, Indigenous Health — which until last month was called Aboriginal Health Programs — officially started in 2002. Its importance to the health-care system is growing by the day, not just because indigenous people are among the fastest growing segments of the province’s population, but because of the recognition of the need for better care for indigenous Manitobans, Leonard says.

Language services remain central to the overall program’s mission. Today, about a dozen interpreter resource workers are spread across the region at HSC, Grace, Seven Oaks and St. Boniface hospitals, providing services in Cree, Oji-Cree and Ojibwe.

And their presence is expanding, largely because interpreters are in high demand. The program receives about 1,000 referrals annually for interpreter resource workers.

But that doesn’t include followup help they provide to patients on an ongoing basis, Leonard says.

"It’s an opportunity to play a critical role in the patient’s health care to provide the best possible outcomes," she says.

"We have trained professionals that are able to interpret medical information and they do that accurately to ensure that not only the patient understands, but that their privacy is respected."

Interpreters are the linchpin of a patient’s care as much as any other provider. That’s often because patients come from indigenous communities in the province’s north. They are far from friends and family and often speak no English (or French). Consequently, they often are lonely and can experience significant anxiety.

"If you’re a patient and you can’t understand what people around you are saying about your health, your body and your wellness, that is a very scary situation, which can have negative outcomes if there’s misunderstanding," Leonard says.

In Pascal’s case, he has been separated from his family since he had to come to Winnipeg for dialysis in 2011.

"He is mostly by himself, and he says it was very difficult at first," Boulanger says, translating for Pascal.

While Pascal’s situation is rare — many families do move to Winnipeg — Pascal’s shy, quiet demeanour isn’t, Boulanger says.

Speaking little English, Pascal, 51, is cautious around strangers, and that’s common among the older generations of indigenous people.

"They generally are not very open about their medical condition," Belanger says.

The language barrier certainly factors in their reticence, but it’s also a symptom of the legacy of the treatment of indigenous Canadians by government agencies in the past, Leonard says.

"The health-care system can be a scary experience for anyone; it’s large and complex, but then you layer on top of that the generational trauma of the residential school experience and a general mistrust of government agencies is understandable."

The Indigenous Health program aims to overcome these challenges.

"Just the very fact our resource workers speak their language creates a connection," she says.

"It maybe doesn’t lead to immediate trust, but it certainly goes a long way to building it quickly, which is what’s needed when a patient needs his or her health care needs met."

But an interpreter’s job is more than translating English into the patient’s mother tongue. They also must be well versed in medical knowledge to explain in a patient’s language technical terms that cannot be translated directly into indigenous languages.

"Generally there aren’t words like hemoglobin or white blood cell in Ojibwe so you have to describe them and their function," says Boulanger, who specializes in Ojibwe translation. "You really have to know what you’re talking about."

While often challenging, he adds it’s often a gratifying experience.

"I get a lot of satisfaction knowing that I help people on a daily basis."

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History

Updated on Monday, November 14, 2016 at 8:10 AM CST: Adds photo

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