Canku Ota

(Many Paths)

An Online Newsletter Celebrating Native America

November 1, 2003 - Issue 99

Navajo Interpreters Foster Communication

TUBA CITY – Many elderly Navajo patients have long withstood pain or hesitated to see a doctor because they feared that what they said wouldn't be understood. Compounding the language barrier problem is that these same patients couldn't understand what the doctor was telling them.

Last month, the Tuba City Regional Health Care Corporation took a huge step in remedying this problem when 23 employees in 10 departments, all women, received training as Navajo medical interpreters.

"This is a phenomenal class, just phenomenal," said Karen Muich, a registered nurse and TCRHCC's nurse educator and facilitator of the course. "It's a Joint Commission on Accreditation of Healthcare Organizations requirement to have interpreters that are educated to correctly interpret for non-English-speaking patients. But we brought this on even before we knew about that because it's the right thing to do."

The course was taught here by Ida Bradley, RN, patient advocate, and Margaret Whalawhitsa, health promotion coordinator, both whom work at the Northern Navajo Medical Center in Shiprock. Additional instructors participating were Joann King, RN, public health nurse; Hazel Sherman, dental assistant supervisor and Maeuneka Wero, health technician with the Navajo Division of Health.

The 40-hour program requires more than just being fluent in the Navajo language, Muich said. It means fully understanding the most important aspect of medical care—the relationship between the doctor and patient.

"The interpreter serves as a bridge for communication," Muich said. "This is achieved by first person interpretation rather than the former third person interpreting."

What that means, she explained, is that instead of saying "Mrs. Begay says she has a stomach ache," a certified medical interpreter would say more precisely in her own words, "The patient says, ‘I have a stomach ache.'"

In addition to learning many Navajo words for many parts of human anatomy, course participants gained insight into a patient's feelings and psychology.

"Patient fears and misconceptions regarding Western medicinal practices were also discussed," Muich said. "A great deal of cultural information about why there could be conflicts between Navajo culture and Western medicine, fear of the unknown, was covered in depth."

Jennifer June, a TCRHCC operating room medical support assistant, said she worked at the hospital 20 years ago and has just recently returned.

"In that time, medical interpreting has really come about," she said. "It should have been happening way back." She said the course also dealt with issues of ethics, litigation and specifics terms in the language of medicine.

"The ladies that did the training are very knowledgeable and knew what they were doing," June said. "I got to learn a lot more about the anatomy and say those terms in Navajo."

Pauline Cornfield, a surgical orthopedics certified nurse assistant, said there are different ways to interpret many things. "The Navajo language is different in different areas, from the eastern side of the reservation to the western side," she said.

She said her aunt taught her the Navajo words for many body parts while butchering sheep growing up. Pauline, who has been at the hospital for 39 years, says she needs to speak to patient in Navajo frequently in her job. Bradley said the interpreter's curriculum comes from the Cross Cultural Health Care Program in Seattle, Wash., and was originally for formulated by Dr. Robert Putsch, a physician who worked in Shiprock in the 1960s.

"He realized at that time there were some gaps in the interpreting," Bradley said. She said he noticed interpreters were adding, omitting and changing what they were trying to get across. She said the Northern Navajo Medical Center began to look for an interpreter's program in 1998 and attended a presentation in Albuquerque called "Overcoming Language Barriers to Health Care."

That led to her becoming one of the first 10 trained Navajo medical interpreter instructors in 2000. Now, there are 200 trained Navajo interpreters throughout the Navajo Nation, Gallup and Flagstaff, she said. "This course motivates people," Bradley said. "They realize they have a lot of potential and want to go back to school. It's a real positive curriculum."

The courses earned the participants 40 hours of education. The nurse education department will sponsor another course Nov. 17-21.

Those trained include: emergency room—Arlene Nez, Joann Howard and Leta Begay; operating room—Jennifer June; pediatrics—Marian Brown and Theresa Mexican; obstetrics—Linda Begay, Alberta Nez; clinics—Pauline Cornfield, Mabel Dawson, Sally Tahy and Alvina Rosales; adult Care Unit—Sallie Begody, Verna Chee, Lillie Bilagody and Alice Klain; post anesthesia care unit/short stay surgery—Geneva Colorado; public health—Geraldine Tohannie and Lillie Wilson; intensive care unit—Diane Johnson, Madelene Hudson and Leona John; medical records—Rose Coolie.

(George Hardeen is editor of "In Focus," the Tuba City Regional Health Care Corporation's newsletter.)

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