Public healthcare systems around the world tend to suffer from a lack of funding and staff. This means that, unfortunately, language training for doctors and nurses, along with the hiring of professional translators and interpreters, are often among the first aspects affected during budget cuts.
DW News reports that Germany has yet to fully implement translation services in its public healthcare system. Despite being a world-leading economy and having a population where 15 percent (approximately 13 million people) do not speak German as a first language, the country lacks a centralized public system for booking medical interpreters. This gap has unfortunately led to discriminatory practices in some private healthcare settings, where patients with limited German skills are turned away unless they bring their own interpreter. Doctors who defend this practice argue that treating patients without clear communication involves risks, such as giving incorrect advice or misunderstandings, and they do not want to take legal responsibility for such risks.
In other countries, there are centralized systems for managing medical interpreters. In the United Kingdom, for example, the National Health Service (NHS) is responsible for providing interpreters to patients who need them. Patients can request this service through their local doctor’s office, which will schedule the nearest appointment with an interpreter. To reduce costs, interpreting is often done remotely, through phone calls or video calls, rather than having the interpreter physically present at the hospital. Most interpreters used by the NHS have a degree or certification in interpreting or equivalent relevant experience, as medical interpreting requires specialized skills that untrained bilingual people generally do not possess.
Funding and staffing challenges
Despite the system in place, funding and staffing challenges within the NHS have occasionally hampered the provision of adequate language services, particularly for uncommon languages, in remote areas and within emergency services. Slator, a source of market intelligence on translation and interpreting, found that a third of frontline workers in the UK, including in the NHS, rely on Google Translate and ChatGPT to communicate with people whose native language is not English. This can be dangerous, and research has warned medical professionals about this risk.
A shocking case of how dangerous this can be is that of a Syrian expatriate in the UK who, in 2018, ended up undergoing a hysterectomy (removal of the uterus) without her consent after hospital staff used only Google Translate to explain the procedure to her. In Arabic, she had explicitly refused the procedure, but staff did not understand her due to the limitations of the app’s translation. While translation apps can be useful for tasks like asking for street directions or food, they are not suitable for conveying highly sensitive information, such as obtaining patient consent or providing discharge instructions. Even when medical documents are automatically translated, they are always reviewed by a human post-editor.
As an expat, you probably have private health insurance, as you are unlikely to qualify for free public healthcare as a non-citizen. Make sure that any bilingual doctors with private practice are included in your insurance network. You may even be able to find expat doctors from your home country who can communicate fluently in both your native language and the local language. You can look for recommendations for expat doctors on forums like Expat.com or other support groups. This will save you the trouble of requiring interpretation services if you visit a public hospital.
A few months before your departure or as soon as you arrive at your new destination as an expat, gather all your medical records and have them translated into the country’s official language. This will simplify things when you need medical assistance. You don’t want to be looking for a last-minute, more expensive translation only when you have an asthma attack or need to have a painful tooth pulled!
Relying on professional translation services
Similar to interpretation, it is important to rely on professional translation services. Avoid asking an unqualified family member or friend to translate specialized documents. In some countries, medical translators are legally required to be sworn or certified by a regulatory authority. For example, in Australia, translators of official legal and medical documents must be certified by NAATI (National Accreditation Authority for Translators and Interpreters).
You can explore the “find a professional” directories of translator and interpreter associations. These directories allow you to filter your search by location, language pair, and specialization (in this case, medical translation). While these associations are often based in one country, they also include international members who practice in other regions.
As mentioned above, while translation apps, including the newer AI-powered ones, are incredibly useful, relying on them for medical interpretation without human verification is still risky. Whenever possible, seek the assistance of a professional interpreter who can help clarify doubts on both your part and the doctor’s part and also act as a cultural intermediary. An app may have difficulty recognizing cultural nuances, such as the use of euphemisms when discussing sexual health, or finer technical details, such as variations in drug names in different countries.
It’s natural to bring a family member or friend to the hospital for emotional support, but having them act as untrained interpreters can be dangerous, especially for more serious health issues (for example, a cardiology appointment versus a routine doctor’s visit for a common cold). EthnoMed, a network of healthcare providers in Seattle that serves immigrant patients, gives two reasons why this isn’t recommended: one, a relative or friend may not understand specialized medical terms and communicate misinformation, and two, they might omit or modify information depending on their emotional ties to you. It’s much safer to request an interpreter through the hospital, find one at a professional interpreting organization or NGO that supports expats and immigrants, or consult a doctor who speaks your native language.
Learn the basics of medical communication in the local language
Before or during your preparation to move to your new destination as an expat, you’ve likely started learning the local language. Make sure you learn key health-related phrases, such as “My stomach hurts,” “I have a fever,” or “I took painkillers.” Remember that medications with the same chemical composition may have different brand names in different countries, so research the local names of common medications like cough syrups and painkillers.
If you have pre-existing conditions and are already taking medications when you move to a new country, it’s crucial to learn their names in the local language. For example, if you’re a diabetic expat living in China, even if your Chinese level is limited, knowing the term “táng niào bìng” for “diabetes” could save your life in an emergency, as a single word could convey critical information to a doctor.
If you have a language tutor, ask them to help you practice doctor-patient role-play scenarios. Additionally, platforms such as Coursera and EdX offer online courses focused on medical communication in foreign languages, such as “Spanish for Successful Communication in Healthcare Settings” from Rice University and “Clinical Terminology for International and U.S. Students” from the University of Pittsburgh.
