Use of an Interpreter and Translator for People with Refugee Experience

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Original Editor - Adiyta Vats and Jordan Awale as part of the PREP Content Development Project

Top Contributors - Naomi O'Reilly  

Introduction

Here we discuss the role and importance of a translator or interpreter where required when working with people with refugee experience, ensuring provision to necessary health-care services as well as introducing them to their new community. Everyone using the services of an interpreter or translator should be clear about the difference between the two, as well as the role each plays in aiding communication. Translators and interpreters, often referred to as community interpreters or social interpreters, since they do more than just translate. They build bridges between very different cultures and societies.

An Interpreter is a skilled and trained person that converts oral information into another language, while a translator is a skilled and trained person that converts written information into another language. [1] Their role is to make a clear communication between the service provider and the refugee who are both speaking different languages. Their goal is to convert oral or written information as “meaning for meaning” and not as “word for word”.[1] This implies that interpretation and translation must be done within some context of the message being conveyed, as well as the emotions and expressions it was delivered with. While the “delivery method” e.g. oral or written may differ between the two professions, both reflect the cultural terms, expressions, and idioms that provide meaning to the content. Both must capture any expression or nuance in the meaning of the original content. In certain instances, concepts will have no linguistic equivalent, but the interpreter and translator’s job is to find an equivalent way of conveying the message with accuracy and completeness. In addition, interpreters and translators can alert the creator of the original message to suggest a different approach. For example, if a provider is using complex medical terms that have no linguistic equivalent in the refugee’s language, the interpreter can ask the provider to repeat using less technical terms to express themselves.

Types of Interpretation

Consecutive Interpretation

This is by far the most common type of interpretation in a refugee context particularly in an interview for refugee status. As an interpreter, you listen to a segment of speech, then repeat what you have heard in the language of the listener(s). The speaker then resumes his/her statement, before pausing again to allow the interpreter to translate. In this way the interpreter alternates with the speaker (in contrast with simultaneous interpretation described later). The length of what you can retain before rendering your translation will depend upon the complexity of the statement being made, and upon your own experience. A new interpreter will need to keep the segments short (no more than a sentence or two). A more experienced interpreter will be able to take in longer segments. The chapters that follow will provide you with guidance on how to take notes, and other important tips on rhythm and delivery to help you perform as effectively as possible. 

Summary Interpretation

This is a condensed form of consecutive interpretation, and one that requires considerable experience and skill. The interpreter listens attentively to a lengthy statement, taking notes, and then provides a summary in the language of the audience. This implies using judgement as to what needs to be said, and reformulating in a more concise manner, perhaps even changing the order of the points made by the speaker. You may need to use this type of interpretation when there is a discussion between two or more people, which cannot be interrupted (examples: a meeting or conference). It is far less precise than the kind of consecutive interpretation we have just described. It is not appropriate for a refugee interview, or whenever detailed information is important. 

Verbatim Interpretation

This type of interpretation implies a word-for-word interpretation after each phrase or sentence. The interpreter thus gives an exact translation of the speaker's words, rather than interpreting the speaker's meaning. It is mainly used in court settings. In refugee interviews, verbatim interpretation is useful to convey precise procedures or a factual statement. Example: a word-for-word translation is useful to convey the definition of a refugee. F “Monitoring” is closely related to verbatim interpretation, but involves a written text. In this case, the interpreter simultaneously translates a statement that is being read aloud from a text. Example: the interviewer reads back the recording of the applicant's statement. At the same time, the interpreter translates word-for-word from the text, thus allowing the claimant to check on the accuracy of the written statement. This type of interpretation is chosen in order to exclude any possible misunderstanding on either side.

Simultaneous Interpretation

With this type of interpretation, the interpreter listens to the speaker and translates at the same time. It requires equipment such as soundproof booths, microphones and headsets, as well as technical support staff. It is the type of interpretation that is used in a multilingual conference setting, but is rarely applicable to interpretation in a field setting. F “Whispering” is another type of simultaneous interpretation, but one for which no technical equipment is required. The interpreter translates a statement while the speaker continues to speak. To do it, the interpreter must be close to the listener's ear, and use a low, regular tone (“sotto voce”). For obvious reasons, whispering is suitable for only one or two persons. Example: whispering can be used at a ceremony, public gathering or group meeting. Simultaneous interpretation is a difficult technique that requires a high degree of concentration, a good short-term memory and high level of language skills. Experience and intense practice is needed to master this technique. 

Typical Situations Where Each Apply

The type of interpretation or translation you choose will depend upon the circumstances e.g. translation of legal documents or interpretation for Interviews (Refugee Status), Ceremonies, Meetings, etc. It many situations a combination of types of interpretation may be required e.g. the Minister of Health has come from the capital to meet with a group of refugee leaders at a major camp. Concerns have been expressed by the refugee leaders. Upon arrival the Minister for Health makes a general statement on which you take notes and provide consecutive interpretation. The Minister then invites the leaders to voice their concerns. As interpreter you stand next to the Minister and whisper simultaneously your translation of the various statements and questions. Before leaving the meeting, the Minister makes a concluding statement. As interpreter, you revert to consecutive interpretation, speaking out loud once more.

Roles of the Interpreter

Community interpreters can facilitate clinician-patient interaction in a number of ways. In any visit between a healthcare provider and family members, a skilled interpreter can:

  • Help ensure that everyone understands both words and meaning ‘in the moment’, as they are being used.
  • Provide a clear and precise interpretation of the care provider’s questions and the individual’s answers, while being open to additional questions about what responses might mean.
  • Assist the communication process without leading it. An interpreter should not be ‘in charge’ of an interview, which may be likelier to happen if the interpreter was a health professional in their former country.
  • Understand the individual or family’s situation and specific issues, and be able to supply some cultural background for the healthcare provider (e.g., why a particular individual or family may be responding a certain way during an interaction).
  • Steer the healthcare provider away from actions or words that might be culturally inappropriate and help to prevent or clarify misunderstandings on either side.
  • Explain the role of the healthcare provider to the family and encourage them to ask questions.
  • Respect the confidentiality and integrity of everyone involved. An experienced interpreter will often start an interpretation session with introductions, explain their own role, and provide assurance that everything to be discussed will be kept private and confidential.
  • An interpreter can also help establish links within the individual or family’s local cultural community, if such a network is available and the family consents to this level of involvement.

Advantages of Using an Interpreter

For a refugee adjusting to a new country, developing a language skill set is just one of many major concerns. Displaced people must cope with the stress of building a life in their new country with potentially little to no support systems, and may also have to grapple with the traumas and hardships they have suffered in their country of origin and on the journey to reach their new home.

A Period of Adjustment

Many refugees may have trouble adjusting to the shift in perspective that is often required in order to live in a new culture. Customs, speech and behavior might be very different from those of the refugee’s home country. If there is no one to interpret what the refugee is seeing and hearing, it may become difficult for to meet even their most basic needs.

Refugees require access to education, healthcare, emergency and legal services, just like any other citizen. In relation to accessing healthcare services having certified medical interpreters at the hospital and telephonic interpreters at emergency dispatch centers or community based healthcare centres would go a long way toward providing refugees with timely and effective aid. By using interpreting services, healthcare providers would be able to better communicate, and administer the best course of treatment.

Help in Healing

There are many reasons why refugees might be forced to flee their home country. War, poverty, famine and political upheaval, among other catastrophes, often displace great masses of humanity and force them to seek safe haven in an adopted country. Events such as these can leave a person with serious psychological and emotional trauma, which they may not be able to deal with on their own. But in order for healthcare providers to provide help and support, they must first breach any existing language barrier.

Healthcare providers in particular mental health professionals need to gain as much information as possible in order to provide the best care. Engaging the services of a professional interpreter can help ensure that the lines of communication remain open during any treatment sessions, so that a the healthcare provider can best determine how to proceed in the healing process.

Community Integration

For a refugee, feeling that they are fully involved in the community in which they live can be a huge step in the process of adjusting to their adopted country. Becoming an active member of the community can allow a displaced individual to regain a sense of mutual trust and dignity.

Many refugees choose to live among people of their own ethnic group. Feelings of displacement can often be abated if a refugee is surrounded by people with whom they share a linguistic or cultural heritage. But some refugees either cannot or do not want to live among people of a similar background. Naturally, if this is the case, a refugee’s neighbors may end up speaking a different language from the refugee themselves.

Local governments or neighborhood organizations can help cross existing language barriers by hosting orientation or community-building events in support of a refugee or refugee population. But they will need to supply interpreters so that refugees can become familiar with their new neighbors without the pitfalls of having to communicate in an unfamiliar tongue.

The Need for Professionals

For many refugees, resources are in short supply and finding interpreters can be difficult. For this reason, friends or family members who speak the language of a refugee’s new country are often pressed into service for their interpreting and translating ability. But it is not sufficient to use interpreters, such as family or community members to facilitate a dialogue, particularly in relation to health. These individuals, while they might mean well, lack the expertise to provide thorough and precise interpreting services. Professional interpreters are trained to maintain their accuracy and neutrality, focusing only on getting the message exactly right and not letting emotion color the interpreting.

Of course, many refugees will not have the means to acquire an interpreter by themselves. Government and non-profit agencies may have to help displaced individuals by providing interpreting services. After all, until a refugee’s language skills improve, using an interpreter is one of the best ways to adjust to their new home.

Challenges to Interpreters and Translators working in the Refugee Context

Linguistic / Communication, Cultural, and Emotional issues have been considered three of the main challenges for the interpreters. Research demonstrates that many medical professionals feel that language barriers can have a negative effect and impact on the quality of care they provide and lead to a more stressful work environment. Stress-levels of medical professionals were significantly reduced when working alongside interpreters to address any issues relating to language barriers. This highlights just how important interpreters are for the work of healthcare providers, as it can mean the difference between low or high quality care to patients. Make sure to appreciate just how helpful your interpreters are, because they make your job easier, and are proven to reduce language barrier related stress.[2][3]

Research has shown that stress can impact the productivity and well-being of interpreters, and can eventually lead to burnout. An important factor that can cause stress relate to ethical values; translating questions, events or statements which could be considered morally wrong, offensive, controversial, traumatic, taboo and battling the thoughts of how or if they should translate such things can be mentally draining. So please remember that translating the experiences of your patients will also have a psychological impact on the interpreters too. Ensure that interpreters are well-supported and do not burnout! [4]

Many individuals providing interpretation services during asylum seeking procedures and for refugees in medical and psychosocial care settings are refugees themselves, with a substantial number of those shown to have previously experienced post traumatic stress disorder. Many have experienced primary trauma, first-hand experience, but also a small number may also experienced secondary traumatisation or exposure to the experiences of others that have themselves experienced trauma, during the provision of interpretation and translation services. Main factors for resilience in these refugee interpreters and translators were: male gender, a sense of coherence, and social support. Therefore, it is worth remembering that many interpreters you may work with may likely have already experienced trauma, and are at risk of further trauma when interpreting and translating the experiences of others. Females and those without much social support are those most at risk of resiliency issues relating to trauma, due to a number of reasons that need to be studied further. [5]

Key Points for Communicating with Interpreters

  • Shorten the sequence of your sentences. Do not give long sentences with many words
  • Adjust the kind of language that you normally use – e.g. less medical or formal words, instead use Lehman’s terms
  • Make sure that information is not lost in translation. It is easier if you stick to saying short, concise sentences
  • Interpreters should not have to feel the need to filter what they are translating. No matter how crude, harsh, or offensive, the interpreters should still translate exactly what was said from the patient – the purpose of this is to enable medical professionals to gain a full understanding of how the patient is feeling.
  • It is the medical professional’s job to work out what is going on if the conversation is going off topic, they should make sure they are in control. So following on from the point above, the professional should encourage the interpreter to translate EXACTLY what the patient has said at all times, but ensure only the important necessary details are told
  • As you try to be in control, it is CRUCIAL to make sure that the interpreters you work with have breaks and adequate rests. Breaks are VERY important for interpreters and mental fatigue can massively affect the quality of translation. Also please consider the potential psychological effects of either past experiences or interpreting the trauma of patients, it is so important to make sure that they do not burn out! [8]

Summary

Interpreters Translators and have a very significant role in shaping the integration of asylum seekers, displaced persons and refugees throughout each phase of the migratory process. They may provide support in several ways, teaching them to adapt and socialise within their new community. They bring a sense of social acceptance and provide an opportunity to talk about with their experiences. Thus, their role and importance should be prioritized for dealing with health-care services regarding refugees.

Resources

Interpreter Guidelines by Humanitarian Practice Network https://odihpn.org/resource/interpreter-guidelines/

References

  1. 1.0 1.1 https://refugeehealthta.org/access-to-care/language-access/interpreters-vs-translators/
  2. Bernard AC, Summers A, Thomas J, et al. Novel Spanish translators for acute care nurses and physicians: Usefulness and effect on Practitioners Stress. Am J Crit Care. 2005;14(6):545-550.
  3. Bernard A, Whitaker M, Ray M, et al. Impact of language barrier on acute care medical professionals is dependent upon role. J Prof Nurs. 2006;22(6):355-358.
  4. Hubscher-Davidson, Severine (2020). Ethical Stress in the Translation and Interpreting Professions. In: Koskinen,Kaisa and Pokorn, Nike eds. The Routledge Handbook of Translation and Ethics. Routledge Handbooks. Abingdon: Routledge.
  5. Kindermann D, Schmid C, Derreza-Greeven C, et al. Prevalence of and Risk Factors for Secondary Traumatization in Interpreters for Refugees: A Cross-Sectional Study. Psychopathology. 2017;50(4):262-272.
  6. VoicesAcademy. PREVIEW: "Interpreting for Refugees in Social Service Encounters" with Kathleen To. Available from: http://www.youtube.com/watch?v=SlDJMyC5iRY
  7. FIT Europe. Interpreting for refugees: Realities and challenges for a community interpreter. Available from: http://www.youtube.com/watch?v=alQzyWjHhd8[last accessed 30/08/20]
  8. Medical Volunteers International (2019) Inservice Training by German Sign Language interpreter, Lesvos Greece.
  9. Sarah Clarke. How to use interpreters effectively. Available from: http://www.youtube.com/watch?v=flB3DLEOsmg[last accessed 30/08/20]
  10. Arizona SLHS. Tips on Working with Interpreters in the Healthcare Setting. Available from: http://www.youtube.com/watch?v=Xo5McZ-kmfI[last accessed 30/08/20]
  11. Clarity Interpreting. Interpreter Training (Part 1). Available from: http://www.youtube.com/watch?v=3wg-qZjMhU4[last accessed 30/08/20]
  12. Clarity Interpreter. Interpreter Training (Part 2). Available from: http://www.youtube.com/watch?v=9e_nIDJV-Lk[last accessed 30/08/20]