Release date: June 2, 2009

Moses Rain is a busy man. In the mornings he works for the Immigrant and Refugee Community Organization (IRCO) as a assistant employment specialist in the New Arrivals Employment Services and in the afternoons as a parent educator in the early childhood development services. In addition he works for Portland Public Schools as an on-call interpreter outside of regular work hours. The rest of the time, as a leader in the Burmese community he is available around the clock to help when and where needed, especially in medical emergencies.

In February, Rain devoted 16 hours of his precious weekend time to attend IRCO's free Health Care Interpreter trainings class. The class is often considered a first step in the process of becoming a certified health care interpreter, although he has no plans to take that trainings.

So why would a job coach, parent educator, and competent interpreter sacrifice so much personal time to take a health care interpreter class that does not provide him with professional certification?

The parenting educator's services support medical issues like making appointments, transporting clients for medical services, helping with registration at the hospital, taking clients to doctor and dental appointments. "Often the medical provider can't find interpreters for the dialects from our country. Or the provider uses tele-interpreters but they don't understand the dialects our clients speak, so the provider asks me to do it," Rain said. "In those instances, I am forced to act in the role of a health care interpreter. This training is essential for folks not certified as health care interpreters but whose job as a case manager, or even whose position of leadership in their community frequently forces them to act in that role."

Rain has been in the U.S. for only 11 month. Prior to that he lived in a refugee camp on the Thai-Burma border for 8 years, where he worked unofficially with the United National High Commission on Refugees, especially as an interpreter. Not in America, but many times in the camp he saw situations where insufficient medical knowledge on the part of interpreters put life at risk or forced patients to sign consent forms with insufficient understanding to know what they were consenting to be done to them.

The most important thing about the training, he stresses, is learning the ethics of health care interpretation. "Case managers and community helpers or leaders act in dual roles," Rain said, "not only medical interpreting but also family and community care. Before taking this training, I mixed up the situations. Sometimes I act for the entire group. In health care interpretation, from the start to the end, I have to focus solely on the client/patient."

In this country Rain has found himself in many situations where serious medical situations could arise as a direct result of insufficient English. For instance, many pharmacies do not use interpreters. Without an unofficial interpreter, a person receiving two or more bottles of medication may mix them up and take them at the wrong times, in the wrong doses, or without knowing that they should be taken only with food, or be aware of the risk of drowsiness. Also, frequently the patient unused to health care will assume that if one pill is good, two must be better and double the doses.

"Before the training," Rain stated, "I interpreted like normal conversation and used the third person: she said, or he said. The training taught me to use the first person only. It's more effective and causes no confusion for the provider. The first person makes it clear it is the patient speaking. When not interpreting but explaining cultural issues to the provider, I have to make the distinction that it is me speaking, not the patient."

Small clinics may not have interpreter services available, and those that do offer interpretation during the week frequently do not have it available on weekends. That means that often English-speaking community members find themselves in a position of high levels of responsibility.

"It not just the transliteration of the words," Rain said. "You also must put the concept into terms the client can understand. It may even require calling the client the night before the surgery to remind him that he can't eat anything after dinner, etc."

Health care interpreter trainings are held frequently at IRCO's Asian Family Center. There is no charge for the classes, which usually run for 2 full days. A typical class will have approximately ten people. A recent class composition ranged from an Iraqi who had been in the county only one month to several people who had been here for 30 years.

The classes are particularly advantageous to English speakers from small, new communities with languages of lesser diffusion that re less likely to have any certified health care interpreters, even if they do not work as interpreters. "Learning the glossary of medical terms and the health care interpretation were the most important things," said Rain.

Upcoming classes will be held on June 12th and June 19th and again on July 25th and August 1st. All days are from 9 AM to 5 PM. To register or get more information, call the Asian Family Center at 503 235-9396.