1. Make sure the interpreter has sufficient information about the proposed conversation prior to the appointment so that they can research terminology. It is best that this is done when booking an interpreter. Remember, medical professionals had to learn medical specific terminology to do their jobs; an interpreter will also need learn medical jargon to be able to do their job efficiently. Furthermore, they have to know the terminology in two languages!

2. Allow enough time for the session for all involved (medical professional, patient and interpreter). Working with an interpreter will most likely double the amount of time you’ll spend with a patient. Allow time for a brief discussion with the interpreter before and after the office visit.

3. If you aren’t ready for your patient to hear it, don’t say it in front of him/her. An interpreter must not add, omit or change anything being said by anyone who is present.

4. Allow for interpreter to clarify linguistic or cultural issues. Due to linguistic variations from region to region, no interpreter will know every word in the patient’s target language. They may also need to clarify a procedure or medical term with the medical professional. If an interpreter is aware of cultural practices that may impact the medical interaction, he/she will transparently share those with the medical professional.

5. If possible it is advisable to hold a short conversation with the interpreter before you meet the patient to make certain they understand you. There are many different accents and speech styles, and everybody thinks that they speak clearly, but unfortunately this is not the case.

6. In addition, a preconference could also help bridge cultural gaps. For example, a doctor was using a Hindi medical interpreter who was on duty for a basic physical exam of a 70-year-old Indian woman. The doctor was taking the woman’s history, asking her questions about the number of sexual partners she’d had. If the doctor would have had a minute to discuss it with the interpreter before walking into the room, the interpreter could have told the doctor that females of this culture in this age group will be very hesitant to answer such questions. If the doctor were receptive to the interpreter’s insights, the interpreter could have suggested ways in which to obtain the information in a culturally sensitive manner.

7. Make sure you look at and address your patient directly (use “I” and “you”). Your interpreter will maintain these forms of address and will only use the third person to clarify any potential issues.

8. Try to avoid jargon and technical terms where possible. Instead of telling a patient you will order an MRI to identify probable causes of TBI, tell the patient you will order a special imaging test that will help you identify the possible causes of his or her brain problem.

9. If you speak to the patient using a high register (high level of literacy/textbook medical terminology) the interpreter will use the equivalent words in the target language in that same high register. He/she will not automatically lower the register for the patient, as he/she is not a medical professional and will not change the message you give. When you lower the register so will the interpreter.

10. Make sure the interpreter can see everyone’s face (where practicable) and that he or she can hear properly. Excessive background noises or distractions can make interpreting especially difficult.

Check out our blog about why using a professional interpreter saves money and lives! Or for professionals in other fields, have a look at our general tips for working with interpreters.

Watch this space for Top Tips for Healthcare Professionals and Interpreters Working Together Part 2. If you have any tips you’d like to be included, please let us know!

There have been many high profile law suits in recent years that could have been avoided if a professional interpreter had been used. The following are examples of when spending a bit of money on an interpreter could have saved millions in settling a lawsuit:
1. The lack of an interpreter for a 3-year-old girl presenting to the emergency department with abdominal pain resulted in several hours’ delay in diagnosing appendicitis, which later perforated, resulting in peritonitis, a 30-day hospitalization, and two wound site infections;
2. A resident’s misinterpretation of two Spanish words (se pegó misinterpreted as “a girl was hit by someone else” instead of “the girl hit herself” when she fell off her tricycle) resulted in a 2-year-old girl with a clavicular fracture and her sibling mistakenly being placed in child protective custody for suspected abuse for 48 hours;
3. Misinterpretation of a single Spanish word (intoxicado misinterpreted in this case to mean “intoxicated” instead of its intended meaning of “feeling sick to the stomach”) led to a $71 million dollar malpractice settlement associated with a potentially preventable case of quadriplegia;
4. In the United States where Pharmaceutical Companies are required by law to translate prescription instructions, a recent study tested the translation programs (yes…programs) used by pharmacies and found that over half of the prescriptions produced contained serious errors. These errors pop up on real prescriptions all the time: “By mouth” is changed to “by little,” “two times” is changed to “two kiss,” and in one spectacularly disquieting case, the instructions for blood pressure medicine caused a man to take it 11 times a day instead of once because “once” in Spanish is “11.”

Another recent study, conducted at two American pediatric Emergency Rooms and published in the Annals of Emergency Medicine, found that potentially dangerous mistakes, like giving the wrong medication dose, were about twice as likely if there were no interpreters or if the translator was an amateur. Studies have found that patients prefer to have an interpreter available, and that it improves care and cuts costs by avoiding unnecessary tests and other mistakes. When an individual such as a family member or a bilingual member of the hospital staff was used (not a professional interpreter), 20 to 22 percent of their translation errors were potentially risky. Errors are least common when professional interpreters with 100 hours of training or more are used. In these cases, only two percent of their translation slips had the potential for doing the child harm.

The most common interpreter errors that were listed in the study were as follows:
1) Omission: (52%), in which the interpreter left out an important piece of information;
2) False fluency: (16%), in which the interpreter used words or phrases that didn’t exist in a specific language;
3) Substitution: (13%), in which a word or phrase is replaced with another word or phrase of a different meaning;
4) Editorialization: (10%), in which the interpreter’s opinion is added to the interpretation;
Addition: (8%), in which a word or phrase is added by the interpreter.

Omissions are almost always caused by the cognitive pressures and stress in interpreting. According to interpreting studies theorists, in virtually no other profession does one undertake a similar cognitive load as in interpreting. “Interpreters are under a considerable amount of pressure in their job and there are a number of areas of concern [...] work could be organized to take many of them into account, although some are less amenable to change (Cooper et al. 1982: 104)”. When an interpreter is working simultaneously, it is possible to fall behind when trying to reformulate the message into the target language. Different languages have different structures, and interpreters working simultaneously often have to wait until the speaker has finished their sentence before they can start speaking. When an interpreter is working consecutively, they have to take notes and rely on their memory to remember everything that was said while they are interpreting the message into another language. In both modes of interpreting, this means that occasionally a part of the message is omitted. Professional interpreters are trained to deal with all of these issues. They have skills that allow them to anticipate what is going to be said in simultaneous interpreting and also have worked on their cognitive skills to be able to divide their attention between listening, translating and speaking. In consecutive interpreting, professional interpreters are equipped with note-taking skills as well as memory training.

In addition, vicarious trauma can affect interpreters as well. The part of the brain that controls emotions, the limbic system, temporarily overrides all other brain systems when an emotional event is taking place. The left side of the brain, which controls language, shuts down and the right side of the brain takes over. Therefore the interpreter may struggle with finding the appropriate words to interpret the client’s experience.

Therefore, to provide the best and safest services possible for patients, the following is recommended: always use a professional interpreter, preferably one that has been trained specifically for interpreting in a medical setting. This normally means that they will possess a DPSI (Diploma in Public Service Interpreting) in Health. Other DPSI certified interpreters or interpreters with a postgraduate degree are also well trained and professional.

We have some basic tips on how to get the best out of your interpreter. For a more in-depth look at how interpreters and medical professionals can work together more efficiently to provide excellent health care service for all, please wait for our next blog! If you have any tips or suggestions, we’d love to hear from you!

There are some issues that certain bilinguals may have trouble with, such as code switching, or the process of ‘swapping’ between languages, often when proficiency in certain lexical domains is lacking, and calquing, knowingly or unknowingly converting elements of one language into elements of the other language, i.e. using words like courrier noir (literally mail that is black) in French, instead of the proper word for blackmail, chantage. However, the idea that speaking several languages confuses the brain and might even hinder cognitive development has recently been widely disputed. Many experts held the belief that people who could speak two or more languages had difficulty using either. When speaking to each other, bilingual people can quickly switch between two languages, usually choosing the word or phrase from the language that best expresses their thoughts. However, bilinguals rarely slip into a second language when speaking to people who only speak one language.

It is well known that language processing is one of the most complex activities carried out by the brain. According to the American linguist Noam Chomsky, the “language acquisition device”, or the mechanism which enables an individual to correctly recreate the rules (grammar) and certain other characteristics of language, wears out over time, which explains why many adults and adolescents have trouble learning a second language. However, for those polyglots who were not raised in a bilingual or even trilingual environment, one theory suggests that a spike in testosterone levels in the womb can increase a brain’s asymmetry, creating a greater incidence of left-handedness, autoimmune disorders, learning difficulties, homosexuality and talents in art, music and languages. By any means, both those who have acquired second languages or those who brought up speaking two or more languages are now thought to benefit from an array or cognitive advantages.

The variety of advantages stemming from multilingualism is just starting to become apparent. Newspapers from around the world have published articles describing the positive effects of bilingualism. These range from being able to communicate with individuals from around the world, to improving executive functioning in the brain (the ability to pay attention, plan, organize, and strategize). Multilingualism has also shown to enhance mental processes such as memory, inhibition (the ability to refrain from carrying out one rule), shifting (the ability to make the change and act on another rule) and the ability to multitask and to prioritize. Further studies have shown that speaking a second language fine tunes the nervous system that governs hearing as well as other mental processes.

A study of bilingual people carried out by Judith Kroll, a psychologist at Penn State University, supported the idea that the mental workout needed to constantly manage multiple linguistic systems increases cognitive flexibility and makes learning easier. She found that bilingual speakers could outperform monolinguals in mental tasks such as editing out irrelevant information and focusing on important details. Bilinguals were also better at prioritizing and multi-tasking, she said.

In another study that compared bilingual English and Spanish speaking teenagers with English-only speaking teens, bilingual teens were significantly better at encoding speech sounds, meaning that their nervous system, which governs hearing and enhances attention and working memory, was better tuned. Researchers maintain that this is a result of advantages in auditory attention.

Learning a second language and speaking it regularly doesn’t only improve your cognitive skills, it can also delay the onset of dementia, according to researchers who compared bilingual individuals with people who spoke only one language. In research published recently in the journal of Neurology, scientist Ellen Bialystok looked at 211 people with probable Alzheimer’s disease, 102 of whom were bilingual and 109 monolingual, and noted the age at which the patients’ cognitive impairment had started. Her results showed that bilingual patients had been diagnosed 4.3 years later, on average, and had reported onset of symptoms 5.1 years later than monolingual patients. She said switching between different languages seems to stimulate the brain so that it builds up a cognitive reserve. “It is rather like a reserve tank in a car. When you run out of fuel, you can keep going for longer because there is a bit more in the safety tank.”

According to Dr. Teresa Parodi, lecturer at the University of Cambridge, some children are at risk of losing their second language because the language is not deemed to be “useful”. However, she stated that it is important to increase awareness regarding the usefulness of bilingualism so that this does not occur. We here at Express Language Solutions believe that although bilingualism is very beneficial in terms of its cognitive effects and would be interested in seeing more studies carried out. Please give us your opinion!

Resources

• http://www.highlighthealth.com/nih-research-news/bilinguals-switch-tasks-faster-than-monolinguals/
• http://news.bbc.co.uk/1/hi/wales/north_west/8452843.stm
• http://www.guardian.co.uk/science/2011/feb/18/bilingual-alzheimers-brain-power-multitasking
• http://www.cam.ac.uk/research/news/bilingualism-is-good-for-learning/
• http://www.9wsyr.com/content/family_healthcast/story/Study-Speaking-a-second-language-strengthens/x2rGuoAleE2-_lmsY83XQw.cspx
• http://health.usnews.com/health-news/news/articles/2012/04/30/more-evidence-bilingualism-aids-thinking-skills
• http://www.nytimes.com/2012/03/11/nyregion/a-teenage-master-of-languages-finds-online-fellowship.html?pagewanted=2&_r=2
• A Global Perspective on Bilingualism and Bilingual Education (1999), G. Richard Tucker, Carnegie Mellon University

It is common knowledge among linguists that of the nearly 7,000 languages spoken on Earth, many are in danger of disappearing within the next century. The Foundation for Endangered Languages estimates that between 500 and 1,000 of threatened languages are spoken by only a handful of people. Alarmingly, each year the world loses around 25 mother tongues. That equates to losing 250 languages over a decade. On the contrary, 10 major languages, each spoken by over 109 million people, are the mother tongues of almost half of the world’s population.

The BBC published an article in September 2010 entitled “Are dying languages worth saving?” The article revealed the debate regarding whether or not endangered languages should be saved. Writer and broadcaster Kenan Malik argued that it was “irrational” to try to preserve all the world’s languages. He maintained that trying to save languages was not just a waste of resources but a misunderstanding of how language works, given that languages naturally die out over time. Thankfully, many do not share his opinion. According to Nicholas Ostler, chairman of the Foundation for Endangered Languages, “Different languages will have their quirks which tell us something about being human”. Indeed, many linguists believe that apart from giving us stories, myths and rituals, small, unwritten languages could offer key insights into biology, pharmacology, genetics, and navigation.

In Europe, many seem to agree with Mr. Ostler. There is a European Charter for Regional Languages, which every European Union member has signed, and the EU has a European Language Diversity For All programme, which was designed to protect the most endangered languages. In addition, a unique partnership between Discovery Communications Inc., the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the UN Works Programme celebrates languages and cultural diversity. Their work includes television programming and website features, where it is possible to learn about endangered languages from the few people who still speak them.

Some have other ideas on how to save languages. Although many think that globalisation could be the cause of many languages disappearing, perhaps it could also be its saviour. “Small languages are using social media, YouTube, text messaging and various technologies to expand their voice and expand their presence,” said K David Harrison, an associate professor of linguistics at Swarthmore College and a National Geographic Fellow. Dr Harrison stated that not all languages can survive, and many inevitably will be lost as remaining speakers die off. Nevertheless, he is of the opinion that the new digital tools do offer a way back from the brink for a lot of languages that seemed doomed just a few years ago.

The idea that digital tools could save languages is shared by the Living Tongues Institute for Endangered Language, who scientifically document threatened languages and help communities preserve and revive their native tongues through the use of technology. The institute is currently working on a project called “Endangered Language Technology Kits”, with the aim of providing recording equipment and computers for 8 indigenous language activists in India, Papua New Guinea, Chile and Peru. The Language Technology Kit will allow the activists to record their languages as well as receive training and mentoring from media specialists.

We here at Express Language Solutions concur with Dr. Harrison and the Living Tongues Institute. However, we must be careful, because although social media can save languages, it can also corrupt them, as was the case with Kinyarwanda. For the full story on how mobile communication affected the Rwandan language, see our LinkedIn page or our Twitter account. Please share your opinions with us!

In Haiti, Holy Week is marked by colorful parades and traditional “rara” music played on bamboo trumpets, maracas, drums, even coffee cans. The holiday is a mixture of Catholic and Voodoo traditions. Voodoo believers make an annual pilgrimage to the village of Souvenance. In the photo below devout voodoo believers hold a goat head and other parts, as offerings to the spirits, during a ceremony in Souvenance village, Haiti. Showing devotion to the spirits, the celebration is marked by drumming, chanting and animal sacrifices.

In France, church bells ring every day of the year except for the three days of Easter. Legend has it that the reason the bells stop ringing is because they’ve made a trip to Rome in order to be blessed. On Easter Sunday, the bells make their return and tour the entire country sprinkling chocolate eggs, chickens and rabbits as they go in each and every garden. After midday, children head to the gardens to find their hidden treasures left by the blessed bells. The day of events also includes a hearty meal, normally consisting of lamb, which is the Easter dish of choice in France.

Lebanon’s Christians not only make up almost half of the country’s population, but are also very fervent in their beliefs. As such, Easter is a big deal here. Visitors will notice the ornately decorated streets, shops and restaurants filled with all things Easter from bunnies to chocolate, painted eggs and even live baby chicks in some places. Good Friday is marked by a mass that symbolizes the crucifixion and, depending on one’s Christian denomination, can last up to three hours. Easter Sunday is a huge celebration where absolutely everyone goes to church. After taking communion, the 40-day fast comprising a strictly vegan diet, is broken with an absolute feast featuring lamb and lots of egg breaking. A custom that is particularly unique to Lebanon is Shanineh, which is held at church where candles decorated with ribbons and flowers are handed to children who form a procession and carry them around the church. Also unique to Easter in the region is the consumption of sweets called Maamoul, these are little cookies made with a mixture of semolina and butter then stuffed with either dates or ground sugared nuts and dusted with icing sugar. They melt in your mouth.

Painting Easter eggs and … whipping girls? Czech Republic has what can certainly be counted among the most unusual Easter traditions in the world. Czechs refer to Easter Monday as “Whipping Monday” because, on that day, it is customary for boys to slightly tap girls using willow twigs braided to form a whip known as “pomlázka.” No harm is intended though. The practice is purely symbolic for it is believed that the twigs would bestow on those whipped lasting youth and wellbeing. To show their appreciation, the girls present the boys responsible for hitting them with Easter eggs.

Kite flying is a popular Easter custom in Guyana and is believed to symbolize Christ’s resurrection and ascension to heaven. The Guyanese start flying kites in the weeks leading to Easter, with the grand finish occurring on Easter Monday. On that day, people wielding kites of various shapes and colors can be seen along the coastland, which is also the favorite spot of many spectators and picnickers.

Happy Easter from Express Language Solutions!

Dina will present alongside experts from the UKTI, Enterprise Europe Network, Natwest and Barclays. The event will focus on helping British entrepreneurs to expand into overseas European markets.

It is a free event with networking opportunities and lunch, and takes place at 9.45am on Monday 6^th February 2012 at Liverpool Chamber of Commerce. Click here to register (limited places available). We look forward to seeing you there!

An article on the 25^th year of the Salford Hundred Venture project was recently featured in our local newspaper The Salford Advertiser. The non-profit organisation, which works exclusively with Salford businesses, aims to help local people turn their ideas into business ventures, and supports existing small enterprises to grow and develop.

Express Language Solutions’ CEO Dina Railean, pictured in the centre of the top right-hand corner image of the article, received support from the organisation when setting up her company.  See her comments below:

“There is a lot of excellent free advice and support if you are thinking of starting a business in Salford. I would urge anyone who is considering this to take advantage of the services provided by Salford Hundred Venture.

They are friendly and approachable and have some great ideas on how to get your business up and running, securing appropriate funding and gaining that most important commodity – customers. I know have a pool of 3500+ linguists providing interpreting and translation services for in excess of 120 languages, and in 2010 my success was recognized in the Business Awards where I reached the final stage of the competition”.

If you are considering setting up a business in Salford and feel that you would benefit from  free advice and training from local entrepreneurs, why not get in touch with Salford Hundred Venture Ltd on 0161 742 4424  or visit www.shv-training.co.uk

Express Language Solutions, along with other Business Language Champions across England, participated in activities which engaged over 22,000 students between June 2009 and March 2011. Figures have shown that teachers feel participation in the Business Language Champions project had a direct impact on raising uptake and student interest in languages.

Express Language Solutions continues to offer advice on cultural awareness and languages to local participants of the Business Language Champions project. We hope that they found the project both useful and enjoyable, and we wish them the very best of luck for the future.

Australia – with temperatures of around 30°C, the Christmas day celebrations are the polar opposite to how we celebrate in the UK. Australian’s might wander over to the beach or at least spend the day outdoors after opening their presents. As for the Christmas menu, forget turkey dinners, it’s more likely to be a BBQ.

Australians celebrating Christmas on the beach

Japan – Like in the UK, children in Japan have to make sure they behave themselves all year round, or they might not receive their ‘O-toshidama’. This is an envelope containing money that is given to them by their families on New Year’s Day, or ‘O-shogatsu’. On the eve of O-shogatsu, temple ceremonies are televised and a gong is struck 108 times to wipe away the 108 sins of the past year. The next day, Japanese families dress in their Kimonos and visit the temple. They might then visit the temple market, go home to eat, play traditional games, the children often fly kites and the adults practice calligraphy.

Japanese child wearing a festive Kimono receiving her O-toshidama

Mexico – In Mexico, ‘Las Posadas’ are celebrated, a festival which takes place between 16-24 December. Each night, members of the neighborhood form a procession carrying statues of Joseph, Mary and an Angel, and visit a different house each night. They carry candles, sing prayers and ask for ‘lodging’ in the different homes. Food and drink is shared and at the end children take it in turn to try and break the piñata with a stick. They are blindfolded and the other children tell them where the piñata is. When it is broken, sweets fall out for them to share.

Mexicans singing during the Posadas festivities.

Spain – In Spain, the gift-giving festivities actually take place on ‘El día de los Reyes’ (Kings day) which celebrates the day of the three Kings, Caspar, Balthasar and Melchior. On the 25 December, Christmas day is more and more celebrated due to commercial influence, but the tradition is to celebrate Reyes on 6 January. Legend has it that if children leave their shoes outside on the eve of Reyes, then the Kings will fill them with gifts.

The Three Kings travelling through Spain to deliver gifts

Sweden – In Sweden, it is the Christmas gnome Tomte who emerges from his home under the floor and leaves gifts for everyone. One significant celebration during the holiday season is the Queen of the Light festival on 13 December when processions take place, carols are sung and everyone thanks the Queen of Light (St Lucia) for bringing hope during the darkest time of the year.  The eldest daughter of each family dresses in white with a red sash and wears an evergreen wreath on her head with several lit candles. This is to mark the day of St. Lucia, a Christian saint who carried food to Christians in hiding, lighting her way by placing candles on her head.

Swedish child celebrating the Queen of the Light festival.

So, in the run-up to the big day, I hope that you are all feeling very festive and I wish you a very merry Christmas! Please comment with more interesting facts about how the festive season is celebrated in your country.

Without a doubt, GoogleTranslate is one of the technological marvels of our times.  I myself, a professional translator, have used it to translate pages from Eastern languages where I’m interested in the content, if not necessarily the way it’s said.  I’m not about to get on my high horse and say that it’s an absolute abomination of the modern era and is destroying the translation industry, because it most certainly is not.

That said, I think a demonstration is in order to show GoogleTranslate’s shortcomings.  There’s no doubt about Translate’s ability to interpret individual words and it’s even useful for advanced high-tech or sci-tech terminology that you can’t find in your bog-standard dual language dictionary.  But Translate’s real shortcoming is not a shortcoming in code:  its shortcoming is the fact that it is not human, and like humans languages change and evolve and sometimes say one thing to mean the exact opposite (cue Michael Jackson’s ‘Bad’).

So let’s have a little play around with GoogleTranslate and see what comes up.

Ehrm... Not quite.

The above is an expression you’d most likely hear on the streets of Madrid—two businessmen discussing how much something has cost: Doscientos pavos por la cara, m’a dicho, logo trescientos más.  The first problem with this expression is that it’s vaguely slangy—pavo literally means ‘turkey’.  Although I was anticipating this to catch Translate out, the machine gets at least a half-point for the American ‘bucks’.  However, as I accessed the site from google.co.uk would ‘quid’ have been too much to ask?

Secondly, Translate doesn’t take into account regional dialects.  The m’a dicho and logo above are both Madrilene dialect corruptions of me ha dicho (he/she/it [has] told me) and luego (lit. ‘later’, in this case ‘and then’).  This catches the machine out as it’s not ‘proper’ Spanish.  Mind, if we do use proper Spanish (see below), it’s not much better, and the translation of luego as ‘after’ is actually the opposite of what is meant in Spanish!

Ehrm... Still don't get it.

Lastly, Translate can’t manage colloquial expressions.  Por la cara (lit. ‘by the face’, ie ‘up front’) is almost as common as pavo and yet, because GoogleTranslate works primarily on a one-word basis, ‘up front’ becomes ‘for the face’.

I’m not trying to denigrate Translate and I think it does a great job for what it is.  But I wouldn’t want it translating my website, or the Articles of Association for my new start-up or even an e-mail from a friend.  Language is a particularly human trait.  And although computers superficially use a language that looks and reads like our own, would you ever want to replace our spoken English with programmer’s code English?  No, me neither!

So what would the above example look like translated by a human? I personally would say: He told me 200 quid up front and then 300 more at a later date. And that’s the difference between GoogleTranslate and the human mind.

So if you ever consider having a translation done and are weighing up the options, take the human translator every time.  Because you can communicate with another human much more easily than you can with a computer, and the whole purpose of a translation is effective communication.