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Patients Lose Voice To State Cuts

Ruby de Luna

Imagine living overseas where you don't speak the language. One day you're sick. You go to a clinic. But your limited vocabulary makes it difficult to tell the doctor what's ailing you. In the US, Medicaid patients who don't speak English get help through an interpreter. But in Washington state that service will end in March. KUOW's Ruby de Luna spoke to a local patient who relies on the service and has this story.


Hyung–Ja Kang was born in Pusan, Korea. She came to the US in 1992. Two years later she became pregnant. She went to International Community Health Services (ICHS). ICHS is the community health clinic in Seattle's Chinatown–International District. Kang's English is so limited that she needs an interpreter when she sees the doctor. Kang also spoke with me through an interpreter.

Kang (Interpreter): "I don't understand what doctor said to me so interpreter helps a lot."

Kang is 46 years old, a petite woman with a shy smile. Her round face is framed by a brown and orange hat. Kang was recently diagnosed with breast cancer. She had surgery to remove the lump and is now undergoing chemotherapy. Kang goes to Swedish Hospital for her chemo. Every week Kang and her husband drive from Bellingham, where they live, to Seattle for her treatment and medical appointments. She says it's worth the long drive to get care where she knows someone speaks her language.

Kang (Interpreter): "They have community health center in Bellingham area, but they don't provide Korean interpreters there. My husband went to dental clinic over there. It's very uncomfortable. No interpreter service."

I ask Kang if there's anyone else in her family who could translate for her. She says her 16– year–old son speaks English. But it's a lot to ask a teenager to speak on her behalf about her breast cancer, not to mention a delicate subject.

Kang (Interpreter): "I don't want to say what part of the body is the cancer. It's not easy for a boy."

Kang says it comforts her to know that someone at ICHS speaks her language; it allows her to tell the doctor her symptoms, which helps the doctor recommend the right treatment.

Kang is one of thousands of immigrants and refugees who rely on interpreter services at ICHS. About 70 percent of the community clinic's patients need interpretation. The most commonly spoken languages are Cantonese, Mandarin, Vietnamese and Korean. At its Holly Park clinic patients predominantly speak Spanish and East African languages.

Funding for interpreter services come from federal and state sources. If Governor Gregoire's proposed budget goes through, it will cut off funds for interpreter services for the next two years.

Batayola: "It would be unconscionable for us to speak only in English to them and know that they don't understand what we're saying, and know that we don't understand what they're saying."

Teresita Batayola is the clinic's executive director. She says they can't go back to the days when patients relied on friends or family for interpretation.

Batayola: "There's the risk that the family member who's interpreting might also be softening or translating differently than we would consider optimal communication so that we truly understand what's going on."

In addition, Batayola says providing interpreter services is a civil rights issue. Washington's interpreter program was created in 1991 following a class action lawsuit. Under a negotiated settlement, DSHS agreed to provide appropriate bilingual services to recipients who don't speak English. Batayola says dropping interpreter services could potentially violate federal guidelines. It also raises other legal concerns.

Batayola: "There are privacy and confidentiality laws regarding health care that really tells us that the use of friends and families is not the best way to go; that potentially you could end up violating the confidentiality and privacy rights of the patient."

Turning to friends and family to help bridge the language gap may be fine in social situations. But in a clinical setting, there are medical terms that can't be simply translated.

Batayola: "Health care is one area that you don't want to make a mistake in. You do not want to have a provider not be able to give the right diagnosis because there are far worse consequences."

Batayola says the clinic is fortunate that most of the clinical staff is bilingual. But their capabilities don't cover all 50 languages that they encounter.

Hyung–Ja Kang has four more months of chemotherapy. She's thankful the cancer was diagnosed at an early stage and she has experienced few side effects from the treatment.

Kang (Interpreter): "I didn't lose weight that much, so hopefully is okay."

And given how her treatment is coming along, Kang says she feels hopeful.

I'm Ruby de Luna, KUOW News.

© Copyright 2011, KUOW