Translation is a key process in any medical student’s life. As a third year medico I have faced a lot of situations where I thought that maybe we need a better solution for the translation issues. In this essay, I have dealt with the translation problems faced during my MBBS course and newer ideas as a solution.
My first research and Google translate:
During my 2nd year, me and 5 of my friends did a cross-sectional study on,” diarrheal diseases in relation to possible risk factors in Thanjavur. First, we created the protocol and we started framing research questions. Framing the research questions was absolutely easy as we got a nice internet source. But translating the questionnaire to Tamil was really tough. For that 6 of us divided the 6-page questionnaire (each 1 page) and started translating. 2 of us, including me, used Google translate and the others just translated themselves with few references from the internet. In the end, when we compiled we found that lots of sentences seemed senseless in the pages translated by Google. Google translate is an effective model for translation, but it has its limitations. Afterward, we finished those 2 pages by ourselves and compiled the questionnaire. Machine translation cannot know which definition the source material pertains to as a single word may contain more than one meaning.
Other ways for translating questionnaires:
- Google translate made a recent update to increase the precision of translation. Also, we can download any language and use it offline. We could translate either way when we have 2 languages.
- Microsoft translator allows a faster way of translation. We can just type in our regional language words in English letters (as we do during whats app chats) and the translator automatically converts it to English or the regional language letters as we wish. This was popularly being used in whats app chat where we could use the G symbol to access this option.
- Photo translation is also provided in the recent version of Google translate and this makes translation even easier. We simply need to scan the page we need to translate and instantly the page will be translated to the language we want.
- SmartMATE machine translation provides a secure translation platform. This service is provided by CAPITA. This service could be used when we have a really large questionnaire or if there is the need for translation into multiple languages.
Dengue outbreak in our area and the stumbled survey due to translation issues:
In the winter of 2016, we had a dengue outbreak in Tanjore. At that time our students along with our PSM department started doing surveys regarding the risk factors of dengue house by house. We had a very good questionnaire in Tamil and the survey was going well without any interviewer bias. At that time a super specialty block was under construction on our campus. Most of the workers in that work were from North India and Andra Pradesh. They couldn’t understand our questions and we couldn’t understand them too. Luckily we got some batch mates from North India and also some knowing Telugu. Thus we have managed to tackle the issue and conducted our survey without any difficulty. This event insists on the need for a real-time translation which would prevent such language barriers.
Real-time translation devices:
- WT2 real-time translator device by Timekettle is a real-time translation device which brings translation to the next level. It is basically 2 wireless earphones and one phone with an application (hence called 1+2 translation system). We need to charge and plug one on the examiner’s ear and other on public’s ear. It translates face to face. The translation application is meant for use only in i.o.s, as on now. They need just Bluetooth pairing headphones. There are different modes like ask mode, speak mode, chat mode(master) and chat mode(slave)
- Handheld mobile applications and devices are also available where interviewers like to pass and talk. But all of these are error prone and difficult to use. Yet these are cheap and could be considered in unavoidable situations and there of a lot of such devices and applications available in the market.
- Google pixel buds are more convenient as the examiner alone needs earphones and the other person hears translated version played through the phone. This cost similar to the WT2.
- BPC 2+2 type of translation devices are available but not suitable for real-world scenario as it requires both the examiner and the other person to have mobile with the application and also earphones.
- The pilot system by Waverly labs is an application that allows translation between languages in two ways: speaking or texting. The source language and the target language must be selected and if both are available then real-time translation. This now needs data but future versions could be offline.
University examination in Madhya Pradesh Medical University- a novel approach to language hurdles.
On May 30 this year, Madhya Pradesh University has decided to allow medical students to write their exams in English or Hindi or HINGLISH (both languages mixed). This is a very novel approach to allow students to exhibit their full potential without any language hurdles. I am from English medium, but I got friends from Tamil medium too. During 1st year exams, they found it very difficult to exhibit what they know in their papers. Most of them adapted but still, some find it difficult to express their knowledge. Allowing them to write in their comfortable language would provide everyone a fairground in the exams. In the medical profession, we get to interact with our patients only in regional languages. So English is actually a tool for learning (as many medical books are available in English) and also for academic purposes. Other than that having a great English knowledge is not an important thing for a good medical practitioner.
Other language patients entering in our outpatient department:
Effective doctor-patient communication is essential for a good health care system. One day in our ENT OPD we got a north Indian patient who does not speak Tamil or English. We were unable to elicit a history from him. For example, if I need to ask the type of pain from a patient in his own words I should put forth the leading question about how the pain is. I finished my B.A. equivalent degree in Hindi (Praveen Uttarardh) from Dakshin Bharath Hindi Prachar Sabha on 2015. When my professor asked, “Anyone knows Hindi?” I raised my hand and went to take history. But I could only elicit his personal details and his chief complaint as difficulty in breathing. Other than that I was not able to elicit any. Luckily we got an ENT postgraduate from LakshwadeepDr.Shahira who knows Hindi well. She elicited the history and the patient was diagnosed to have an allergic Rhinitis. Such language barriers seem to hinder even when practitioners know the language to some extent. This event proves that we need an effective referral system for such patients.
Health Information in Other Languages
The National Library of Medicine provides access to health information in other languages on general health and special topics. These resources include:
HealthReach — Health Information in Many Languages
MedlinePlus en español — Información de salud para usted
MedlinePlus — Health Information in Multiple Languages (45 languages)
infoSIDA — Información sobre el tratamiento y los ensayos clínicos del VIH/SIDA
ToxMystery (en español) — Una actividad ToxMystery.
ToxTown (en español) — Inquietudes de salud ambiental y sustancias químicas tóxicas en su lugar de residencia, trabajo y diversión.
Across the word technologies now used to overcome language barriers:
There’s an app for relaying basic medical instructions in Fukienese, a group of dialects spoken in southeastern China. Need a way to help bedridden non-English-speaking patients instantly alert a nurse for assistance? Touch-screen software exists that allows patients to click a pained face — perhaps marked “pain” in Russian — to instantly alert a nurse. Both were created by New York City-based Transcendent Endeavors to improve communication between patients and healthcare professionals who speak different languages.
For now, phone-based interpretation services are the best technological substitute for having a trained interpreter in the room. Some hospitals have made it their policy to use phone-based services in emergency rooms because it’s faster to call than to wait for an interpreter to arrive, says Catherine West, the senior research scientist at the George Washington University School of Public Health and Health Services
Federal law regarding language services:
Federal law requires all health care facilities that receive federal funding offer language services to patients who need them. Most hospitals accomplish this by relying on a mix on staff interpreters, bilingual staff, outside interpretation agencies, and phone-based services. Yet many facilities don’t do a good job connecting patients with language services. Less than half of patients who need an interpreter say they usually get such assistance, according to a 2001 survey from the Commonwealth Fund.
Language barriers are everywhere in the medical field. Starting from a 1st-year student trying to learn concepts of physiology to a senior medical practitioner getting stumbled by other language patient coming to his OP. in this essay I have dealt with the possible solution for language barriers in medicine.
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