HY*, a 45-year-old woman, was scheduled for a visit to establish care at one of our health centers. HY arrived as a refugee from China, and in her chart, we listed her preferred language as Mandarin. Upon review of her previous notes in the chart, we learned that HY was uncomfortable with the Mandarin interpreters, stating that she "didn't trust them." HY preferred that her adult son translate for her, even though he was not a registered interpreter with us. Upon further investigation, HY's caseworker shared that this patient was from the Uyghur community in China.
Uyghurs are a cultural group in Asia of about 12 million people. They speak their own language, similar to Turkish, and are traditionally Muslim. In China, many Uyghurs have been victims of genocide, forced labor, torture, and forced sterilization. This has occurred under the supervision of Chinese government officials who speak Mandarin.
Hearing a particular language can sometimes trigger memories and past trauma that individual patients have suffered. We should remember that if a patient can speak a particular language, that doesn't always mean they want to. In HY's case, it was the language that made her uncomfortable, and she found it to be re-traumatizing. While our interpreters are excellent and go beyond their responsibilities in assuring that patients feel comfortable, even their well-intentioned efforts can remind patients of their past trauma. Knowing this can help providers become more trauma-informed and ask how the patient prefers to communicate.
Asking a patient's preferred language shows that we care about the patient's past experiences, cultural background, and their individuality. If a patient declines a specific interpreter or language, trauma informed care teaches us to respect their decision. At times this may mean that we must find an interpreter for a less common language. Many of our patients have endured long, difficult journeys to get to where they are now, and we want to help them heal. By recognizing this we can build lasting rapport and trust with our patients.
*In order to protect the identities of individuals involved, false initials were used in this piece.
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Marissa Higbee; New American Services Coordinator, Redwood Health Center