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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20 The Linguist Vol/58 No/4 2019 ciol.org.uk/tl FEATURES neologisms. If a Spanish loan word is well understood and commonly used in everyday speech, then we encourage our providers to use it. Pulmón, for example, is the most commonly used word in Kaqchikel for 'lung', whereas almost no speakers recognise the native word pospo'y. However, there are other Spanish loan words which few people understand, and we target these words for replacement with native neologisms. Although many patients use the Spanish word diabetes to describe their illness, some do not understand what diabetes is. In contrast, our new word rukab'il ri kik' ('sweet blood') is readily intelligible to most speakers and conveys important information about the disease. Innovation and consistency of care Another area of language-based innovation involves the development of a 'care navigator' role. Although patients may receive linguistically appropriate care within our organisation, when they are referred to a different institution they likely will not. We collaborate with several large hospitals to provide cancer and cardiovascular care, and none of these facilities has interpreters on staff or access to contracted interpreter services. This means that there is no access to interpreters for indigenous patients in any of Guatemala's major medical facilities. To address this, we train care navigators, who are native Mayan language speakers and professionals, typically with a social work background. Training begins with formal didactic sessions reviewing the social and cultural barriers to healthcare access in Guatemala, assessing dialogic strategies taken from motivational interviewing and shared decision-making theory, and discussing conflict resolution. Subsequently, new navigators 'learn by doing', working in tandem with an experienced navigator who models behaviours. They then gradually assume responsibilities, with direct observation and feedback. When patients require referral, care navigators accompany them to the hospital, providing logistical and emotional support and, most importantly, acting as interpreters so that patients can understand what is going on. Unfortunately, formal training programmes for interpretation are a long way off in Guatemala, and we recognise that our navigation staff still have much to learn. In fact, a long-term goal is to develop more formal standards and a training programme for Mayan language interpretation. Nevertheless, at this time, the arrangement works well, since patients express a high degree of satisfaction with – and confidence in – their navigators. In particular, overcoming the language barrier means that they are more likely to complete their treatment. For example, in our experience of providing navigation services for indigenous women with cervical cancer, more than 80% successfully complete their entire treatment course compared to less than 50% previously. More than 10 years after starting this work, we continue to advocate for the use of Mayan languages in healthcare and to show that it is possible to provide high-quality care in these languages. By raising the visibility of Mayan languages in healthcare – by providing accompaniment and interpreting services in public referral hospitals and training other institutions in our approach to language use – we are also contributing to a national discussion about language rights and healthcare inequality. Notes 1 Richards, M (2003) Atlas Lingüístico de Guatemala. Guatemala City, Guatemala: Editorial Serviprensa 2 Government of Guatemala (2003) 'Decreto Numero 19-2003'. Guatemala City, Guatemala: Government of Guatemala 3 Ministerio de Salud Pública y Asistencia Social (MSPAS) (2015) 'VI Encuesta Nacional de Salud Materno Infantil'. Guatemala City, Guatemala: MSPAS 4 Maya Health Alliance; www.wuqukawoq.org 5 Ola, AL (26/8/18) 'App Salva Vidas'. In Prensa Libre CARING PROFESSION A patient and doctor of the Maya Health Alliance (Wuqu' Kawoq). Mayan speakers are more likely to complete treatment when it is administered in their native language