The Linguist

The Linguist 58,4 - Aug/Sept 2019

The Linguist is a languages magazine for professional linguists, translators, interpreters, language professionals, language teachers, trainers, students and academics with articles on translation, interpreting, business, government, technology

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FEATURES A ccess to healthcare in one's native language is an important human rights and healthcare quality issue. In higher income countries and settings, healthcare institutions address the needs of clients by hiring professional interpreters for the languages that they commonly service. However, increasing international migration can strain these arrangements when patients speak less common or indigenous languages, and when contracted or in-house language services are unable to locate a qualified interpreter. As a Guatemalan language specialist, I am contacted almost weekly by hospitals all over the United States trying to locate speakers of Mayan languages. This reality also raises a larger question: if it is so difficult to provide linguistically appropriate care to speakers of less common languages in high-resource settings, what is the situation like in their countries of origin? Let's explore the case of Guatemala. One of the largest countries in Central America, Guatemala has a population of just under 17 million. There are 23 distinct indigenous languages in addition to Spanish, most of which are in the Mayan language family. Just under half of the population speaks a Mayan language, and several of these languages have communities of 500,000 or more speakers. 1 Since 2003, the government has officially recognised the right of speakers of indigenous languages to receive all public services, including education and healthcare, in their own language. 2 However, there is no funding and little political will to implement this law, so in practical terms, speakers of indigenous languages are unable to access any services (with the exception of basic primary school education) in their preferred language. A recent national healthcare survey illustrates this point well. Respondents were asked to report the language used at their last visit to a public hospital or health centre; more than 95% said Spanish was used. 3 In 2007, I helped to found Maya Health Alliance (also known as Wuqu' Kawoq), a unique primary healthcare organisation which is dedicated to providing services in Mayan languages and changing the national discourse around the use of these languages in service provision. 4 Although a small organisation, with around 50 healthcare providers, we are one of only a handful of bodies working to develop and disseminate best practices for work in Mayan languages and healthcare in Guatemala. We have learnt some important lessons along the way. An affirming institutional culture When Maya Health Alliance was founded, the main goal was to create a healthcare institution which prioritised service delivery in Mayan languages. To do this, it was critical to make deliberate personnel choices, taking the time to ensure that the people we recruited were able to speak Mayan languages. We are proud that more than 90% of our healthcare providers are themselves indigenous Maya and therefore able to provide linguistically appropriate care to their patients. Within the organisation, we prioritise the use of Mayan languages in other ways, such as encouraging their use in casual and office conversations, and by making excellence and innovation around language use one of the criteria for promotion and advancement. Given our connections to both Guatemalan and global academic health communities, many of our staff are able to attend regional and international professional meetings to share their work and receive recognition. The work of our nursing staff on using smartphones to provide care in Kaqchikel was recently featured on the front page of Guatemala's most important newspaper. 5 In this project, nurses work closely with lay midwives, who attend the majority of home births in rural parts of the country. Midwives can use their smartphone interface 18 The Linguist Vol/58 No/4 2019 A healthy approach to medical care in Guatemala means providing services in indigenous languages. Dr Peter Rohloff on the work of the Maya Health Alliance Mayan care

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