Language can be barrier at some hospitals

Sunday, April 20, 2008

NEW YORK -- Two years ago, Aida Torres rushed her feverish daughter to the emergency room.

Doctors at the Brooklyn hospital tried telling Torres that her mentally retarded daughter, Madayeli, needed surgery for an ovarian cyst, but the scared mother didn't understand them because she doesn't speak English.

Frustrated and desperate, the native of the Dominican Republic sought help from a Spanish-speaking hospital maintenance worker. He wasn't able to help either; Torres eventually asked a friend to leave work to interpret.

The New York Immigration Coalition and other groups released a report this week on the availability of language assistance at city hospitals for non-English-speaking patients -- a vexing problem in a city where roughly 2 million people speak little or no English.

The report says that such help at hospitals seems to have improved since 2006, when state health officials began regulating communication between hospitals and their non-English-speaking patients, but more still needs to be done, particularly regarding languages such as Korean, Haitian Creole, Russian, Arabic and Bengali.

For people who don't speak English, the language barrier makes it difficult for them to explain symptoms, understand doctors' diagnoses and navigate the insurance system, advocates said. The barrier can lead to misdiagnoses and even death, they said. Mistaken amputations, sterilizations and abortions have resulted from such barriers, they said.

Forcing patients to rely on hand gestures or relatives, friends or other patients to translate medical information can lead to miscommunication, violates privacy laws and can traumatize, say, a child relaying to a parent that the parent has cancer.

"It is simply impossible to provide quality health care unless patients can communicate their symptoms clearly, understand their diagnosis and knowingly consent to medical procedures," said Andrew Friedman, co-executive director of Make the Road New York, a civil rights organization that participated in the report.

The report, "Now We're Talking," was based on surveys conducted between October 2007 and February of this year of 617 patients who speak Spanish or Korean but not English. Officials stressed that the study wasn't scientific and provided only a snapshot.

It showed that 79 percent of patients said they received help in their native language compared to the 29 percent who said during a survey before the 2006 regulations that they communicated with hospital staff in their native language.

Before the regulations, which require private and public hospitals in the state to provide skilled interpreters, translate important hospital forms into common languages and ensure patient care isn't delayed because of language issues, it wasn't uncommon for hospitals to tell non-English-speaking patients to bring their own interpreters.

According to the new report, only 5 percent of patients reported being told to bring their own interpreters.

"Hospitals have made real strides and have figured out how to communicate with Spanish speakers," said Adam Gurvitch, the coalition's director of health advocacy.

But there's "a real disparity" when it comes to hospitals serving speakers of other foreign languages, he said.

"There's some progress there, but not nearly enough," he said.

Nisha Agarwal, a staff attorney with New York Lawyers for the Public Interest, which advocates for such patients, said language assistance in hospitals appears to have improved since 2006 and she doesn't get as many calls from patients.

Claire Pospisil, a spokeswoman for the state Health Department, said the agency is constantly working to ensure that language assistance is provided to New Yorkers at hospitals.

She said the agency's hospital complaint line receives more than 10,000 calls each year; of those calls, there were only 20 complaints about language translation in 2006 and 10 last year.

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