Immigrants who don’t speak a national language have particular problems when it comes to seeking medical help.
From April 1, help will be on hand in the form of a telephone interpreting service for medical emergencies or for brief clarifications. Interpreters will be available to translate from 12 languages into the three Swiss official languages German, French or Italian.
Community interpreters are already available to sit in and translate in consultations, and as of April 1 doctors will also be able to contact them by phone to interpret in emergencies.
The Federal Health Office has selected Medios, part of Zurich’s AOZ specialist organisation to promote social and professional integration, to run the pilot project. Medios is providing interpreters to translate from 12 languages into the three Swiss official languages German, French or Italian.
Studies have shown (see links in right hand column) that for a number of reasons migrant communities have a generally poorer level of health than the native population.
The Swiss constitution says that “everyone has access to the health care that they require”, but this provision can be undermined when there are communication problems between doctor and patient.
Inadequate medical care can in the long term have “a negative effect on the course of diseases, which, in turn, generates higher costs”, as the Federal Health Office says on its website.
Community interpreting, where the translator can, if necessary, give input about the customs and culture in the patient’s country of origin, has been a recognised profession since 2009, which means that there are training courses leading to a qualification valid throughout Switzerland.
Hospitals wanting to make use of the new telephone service will register with Medios and be given a security code. They can then phone in at any time of day or night and, it is hoped, be put in touch with an interpreter within about five minutes.
“We have calculated that we need ten to12 interpreters per language combination, and then we can be 99 per cent certain that one of them will be at home,” AOZ director Thomas Kunz told swissinfo.ch.
There will be some important differences with on-site work, not least that the interpreter will have no time to prepare.
“If you get a call at half past one in the morning, and suddenly have to translate, going from zero to 100 per cent – that’s quite a challenge. And you can’t see the people either,” said Kunz.
But Necdet Civkin, already an experienced community interpreter between Turkish and German, is not daunted.
“I’m prepared to step in at any time day or night. Telephone interpreting will only be for ten or 20 minutes. You don’t have a chance to prepare, but it won’t be for anything complicated, so it’s doable,” he assured swissinfo.ch.
Sanja Lukic, who heads the Medios service, admits that it’s not for everyone.
“It’s clear that some people don’t like being permanently on call, and others say, ‘That really suits me’. In the end it’s very much an individual thing.”
This is a pilot project, and Medios is well aware that some things may change as they gain experience. For example, other languages may be offered if there is a demand. And it is working on plans to create a telephone interpreting module as part of the professional community interpreter’s certificate.
Community interpreting of any kind requires skills that go beyond language knowledge.
“A person may be able to speak and write two languages fluently, but that doesn’t mean that they are able to interpret well. It’s a special job,” said Civkin. “You really have to be able to listen, and process what is said and convey it to all sides. You need a kind of intuition.”
A delicate balance
The interpreter’s situation is somewhat paradoxical, Lukic explained from her experience as a face to face interpreter.
“The person doing the translating on the one hand has absolute power, because they understand everything. But on the other hand, you have to try to be as invisible and unobtrusive as possible. The rule is that the well qualified therapist is the person who guides the conversation.”
“There’s a balance to be found between empathy and dissociation. It would not be good to have too much empathy, but if I function like a machine that would show a lack of respect towards the patient.”
Civkin stressed that interpreters translate as closely as possible to the original: it is up to the therapist to ask follow-up questions if the answer is not clear.
“Turks often say ‘huh, huh’ or nod, and the doctor asks me what that means. I tell him it could be either ‘yes’ or ‘no’, then it’s for the doctor to ask the person directly: ‘What do you mean?’”
“Of course, these aren’t normal conversations,” Kunz pointed out. “There’s a specific reason for them. There’s a problem to be solved.”
It is not only patients and therapists who have an interest in mutual understanding, which is why hospitals and other users are willing to pay for the interpreting service, he explained.
“In the last few years institutions have started to realise that they can work much better and more efficiently if they start off by ensuring they can communicate.”
An urgent need
There are currently about 200,000 people living in Switzerland who do not speak one of the country’s four national languages or English.
Others who can communicate on a daily basis have difficulties in talking about complicated health matters.
This can make treatment difficult, or even impossible.
There may also be cultural problems hindering understanding between patient and doctor.
The telephone interpreting service will be offered round the clock.
Interpreters will be available from the following languages: Albanian, Arabic, Italian, Kurdish, Portuguese, Russian, Serbian-Croatian-Bosnian, Somali, Spanish, Tamil, Tigrinya (spoken in Eritrea and Northern Ethiopia), Turkish.
They will interpret into the three official languages: German, French and Italian.
The service will cost user institutions four francs a minute once the connection has been made to an interpreter.
The Federal Health Office will support the service financially until the end of 2013 while it is being set up; after that it must be self-supporting.
User institutions will register and be given a password to avoid abuse of the system.
The phone number is 0842 442 442.end of infobox
The aim of the AOZ is to support people with a migration background to integrate socially and professionally in Switzerland.
It is used by the city and canton of Zurich and by communes and other parties mainly in the Greater Zurich area.
It provides advice to state authorities on the conception and implementation of measures to aid integration.
It also acts as a consultant to interested third parties.
Its linguistic activities include teaching German, often to people with a limited educational background.
Through Medios it provides interpretation services in about 70 languages, using some 250 professionally qualified community interpreters.
The service is available to institutions, not to private individuals.
It is funded by the users; although it is hard to calculate, the economic benefits from efficient communication are presumed to greatly outweigh the costs of the service.end of infobox