Indigenous Interpreters Provide Missing Link for Natividad Medical Center Patients

by Kate Daniels Kurz, The WIP Director

Natividad Medical Center, located in Salinas, California – the heart of California’s “Salad Bowl” – is one of the state’s 19 public safety net hospitals. Providing healthcare services to patients regardless of their ability to pay, Natividad primarily serves Latinos in Monterey County, specifically farmworkers and their families who have migrated north in search of work from Central and South America.

Indigenous Oaxacan and Michoacan people may speak languages including Mixtec, Kanjobal, Acateco, Chuj, Nahuatl, Purepecha and Tlapanec. Photograph courtesy of Indigenous Interpreting+, a service of Natividad Medical Foundation.

Indigenous people from Oaxaca and Michoacan may speak languages including Mixtec, Kanjobal, Acateco, Chuj, Nahuatl, Purepecha and Tlapanec. Photograph courtesy of Indigenous Interpreting+, a service of Natividad Medical Foundation.

When I think of farmworkers and their families, I think of women wearing homemade face masks of various colored bandanas to shield their faces from the sun and the sometimes leering eyes of male coworkers. I think of white buses with port-a-potties trailing rear doors parked alongside highways that line lettuce fields. And I think about Spanish – the Spanish language, the songs playing from the radio and out car doors, or heard at local Mexican restaurants and spoken in line at the grocery store.

Yet one day, while shopping at the Super Max in Castroville, I was surprised to hear a couple in line speaking an indigenous language, not Spanish. This Super Max, a small town grocery store that offers many Mexican food items at a discount, is located in the artichoke capital of the world. Nearby artichokes grow alongside strawberries that fuel the economy with which this young woman and man were most likely connected.

It quickly became clear that the checker, alternating between Spanish and English, was unable to communicate with the couple. They were likely two of the over 685,000 Latinos of indigenous origin residing in the United States.

According to Indigenous Interpreting+, Natividad’s community and medical interpreting business that specializes in indigenous languages, the number of indigenous speakers in the United States is growing rapidly. Today there are 68 percent more Latinos of indigenous origin living in the United States than there were in 2000.

Triqui indigenous medical interpreting intern Felicitas Gonzalez with Linda Ford, President & CEO of Natividad Medical Foundation.

Triqui indigenous medical interpreting intern Felicitas Gonzalez with Linda Ford, President & CEO of Natividad Medical Foundation. Photograph courtesy of Indigenous Interpreting+, a service of Natividad Medical Foundation.

Five years ago, Natividad Medical Center had no data about the languages spoken by their patients. There were no interpreters on staff, and the hospital relied on families and Spanish-speaking staff to meet patient’s needs. They have since discovered that at least 60 languages are spoken by their patients. Among the top 10 are four indigenous languages for which no interpretation services were previously available.

According to Linda Ford, President & CEO of Natividad Medical Foundation, “We recognized the need to train qualified indigenous interpreters in order to provide quality care for everyone.”

Upon visiting Natividad, I met Angelica Isidro, Co-Founder of Indigenous Interpreting+. Before receiving training as a medical interpreter, Angelica worked as a farmworker for more than 20 years. When the need for indigenous interpreters was first identified, Isidro would take phone calls to interpret “literally from the field,” Victor Sosa, the hospital’s Medical Interpreter Coordinator tells me. Isidro “made personal sacrifices to get into this profession,” including losing farm labor jobs in order to be present at Natividad when she was needed.

When I asked Isidro to comment on what is now a career for her in medical interpreting, she is quick to point out, “It doesn't only benefit me, it benefits the community.” In fact, she tells me, “Everywhere would benefit from [indigenous interpreting] services.”

When Isidro moved to the Salinas Valley from Oaxaca, Mexico in 1991, she spoke both Mixteco and Spanish. Unlike many of her family, friends and neighbors, Isidro learned Spanish when she was eight years old and still living in Mexico.

Victor Sosa, who has been a professional interpreter since the early 1990s, has learned that medical professionals cannot assume that indigenous groups will automatically think like Westerners. “If in your culture nobody had a C-section you might wonder why the doctor is suggesting a C-section.” One of the biggest challenges for doctors at Natividad prior to indigenous interpreting was labor and delivery and the inability to communicate. “[Doctors] wanted to inform the patient that they wanted to do a C-section or the baby was under stress and the response they were getting seemed to suggest the patient did not understand the severity of it,” he tells me.

When faced with this challenge, Sosa began to investigate interpretation services for Natividad and quickly realized “if we wanted interpreters at a level where we could be confident that they were competent to communicate, we were going to have to train them ourselves.”

Of the 1 in 4 patients at Natividad that needs a medical interpreter, roughly 115 are patients who speak indigenous languages. “As word of the program spread, we began to receive calls from local and national organizations, and we realized this is an important service we can offer to communities around the country” says Linda Ford.

Today Natividad boasts more than 100 interpreters who are available to interpret roughly a dozen indigenous languages such as Triqui, Zapoteco, Náhuatl, Purépecha, Tlapanec, Amuzgo, Yucatec Maya, and Mam. To be sure, they have not received the education or the high-level training students of translation and interpretation programs receive. In fact, many of Natividad’s interpreters do not even have a high school diploma, but they have language skills most people looking for a career in interpreting do not have the opportunity to develop.

Indigenous community and health care interpreters Angelica Isidro and Brigida Gonzales with Victor Sosa and Dr. Peter Chandler.

Indigenous community and health care interpreters Angelica Isidro and Brigida Gonzalez with Victor Sosa and Dr. Peter Chandler. Photograph courtesy of Indigenous Interpreting+, a service of Natividad Medical Foundation.

In at least one case, becoming an interpreter is a dream come true. Brigida Gonzalez, 23, moved to the United States from a small mountain town in the state of Oaxaca. Before she began working as an indigenous interpreter she worked full-time picking strawberries and later peas. The work in the field was grueling. She worked 8 – 10 hours per day, often bent over for long periods of time and straining her back.

When describing her work as an interpreter, Gonzalez tells me, “It is something I love.” In fact, interpreting is something she dreamed of doing since she was a young girl. Gonzalez remembers the difficulty her family faced not understanding anything when they arrived – including not understanding what doctors would say to her or her family when they were ill. She knew one day she wanted to be an interpreter. She is currently taking Natividad’s interpreter training program and works three days per week interpreting Mixteco-English and Spanish-English and continues to work the other two days as a farmworker.

Currently, Natividad offers indigenous interpretation training to indigenous language speakers for free. The program is philanthropically funded in part by Driscoll’s, a distributor of fresh berries located in the Salinas Valley; The Agricultural Leadership Council (TALC); and the Community Foundation for Monterey County. Sosa finds the huge level of local buy-in within the hospital and in agribusiness unique. When compared to what he hears at conferences outside the area, where “generally farmers are seen as the bad guy ... it is very different here because many of the companies, the farmers, are the biggest funders of services to [farmworkers].”

“I am really excited to be here,” Brigida Gonzales tells me before I leave. “It is something that helps so many people.” Seeing the light in her face as she talks, I cannot help but believe this program has given her life new meaning too.

katharine danielsKate Daniels Kurz is the founder and Director of The WIP.

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