Interpreting in Sexual and Reproductive Health Consults With Burma Born Refugees Post Settlement: Insights From an Australian Qualitative Study

Abstract

Interpreters work with health care professionals to overcome language challenges during sexual and reproductive (SRH) health discussions with people from refugee backgrounds. Disclosures of traumatic refugee journeys and sexual assault combined with refugees’ unfamiliarity with Western health concepts and service provision can increase the interpreting challenges. Published literature provides general guidance on working with interpreters in primary care but few studies focus on interpretation in refugee SRH consults. To address this, we explored the challenges faced by providers of refugee services (PRS) during interpreter mediated SRH consultations with Burma born refugees post settlement in Australia. We used qualitative methodology and interviewed 29 PRS involved with migrants from Burma including general practitioners, nurses, interpreters, bilingual social workers, and administrative staff. The interviews were audio-recorded, transcribed, and subjected to thematic analysis following independent coding by the members of the research team. Key themes were formulated after a consensus discussion. The theme of “interpretation related issues” was identified with six sub-themes including 1) privacy and confidentiality 2) influence of interpreter’s identity 3) gender matching of the interpreter 4) family member vs. professional interpreters 5) telephone vs. face-to-face interpreting 6) setting up the consultation room. When faced with these interpretation related challenges in providing SRH services to people from refugee backgrounds, health care providers combine best practice advice, experience-based knowledge and “mundane creativity” to adapt to the needs of the specific patients. The complexity of interpreted SRH consultations in refugee settings needs to be appreciated in making good judgments when choosing the best way to optimize communication. This paper identifies the critical elements which could be incorporated when making such a judgement. Future research should include the experiences of refugee patients to provide a more comprehensive perspective.

Cultural brokering in pregnancy care: A critical review

“…Two articles describe a cultural brokering program in Minnesota, USA that required community‐based doulas serving as cultural brokers to “have at least minimum English language skills” 60,61 . Little discussion of language was included in articles about interpreters 20,47–51,58,62–64 …”

“…Reviewed articles mentioned the lack of availability of the cultural broker at all times as a barrier to effective cultural brokering; 20,58 specifically, clinicians stated that in‐person interpreters, serving as cultural brokers, provided higher quality interpretation than phone interpreters, but in‐person interpreters were less available, especially during evening and overnight hours 20,58 . Finally, two articles describing interpreters serving as cultural brokers acknowledged that clinicians sometimes felt that male interpreters could hinder dialogue in pregnancy care 58,63 …”

“…20,58 Finally, two articles describing interpreters serving as cultural brokers acknowledged that clinicians sometimes felt that male interpreters could hinder dialogue in pregnancy care. 58,63 Two different articles described concerns of pregnant patients with distrust of cultural brokers stemming from both belonging to a small community. 58,62 An article about dual-role interpreters serving as cultural brokers in a Chuukese community included perspectives from Chuukese patients who did not trust Chuukese interpreters with their private health information.…”