L.E.P and health

Health is more than just lack of disease and is more than what WHO defined as:

“a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.“¹
World Health Organization, 7 of April 1948

From what I learned discussing among healthcare professionals, anthropologists, psychologists, and many other public health-related professions a couple of years ago, is that health is also the capacity to overcome challenges and belonging… also, running on a definition of health established in 1948 is kinda old-fashioned, isn’t it?

This is where communication and language come into play. Language is a social construct (meaning that it is adapted socially and in constant evolution) that supports largely the message that we aim to convey to others. Language is a way to feel connected and own the social dynamics that we hold in our day to day.

What does L.E.P. stand for? You must be asking…

Limited

English

Proficiency²

Basically, it refers to every person that is not fluent in English language, which is often because it’s not their native language. But, how does this connect to health?

A while ago I worked as a Medical Specialist Interpreter, doing simultaneous interpretations from English to Spanish and vice versa over the phone. My work consisted of being on the phone, listening to a healthcare worker in English talk to me through a tablet or phone on speaker in their office, while giving instructions to a patient who could only speak Spanish and asking all sorts of questions that healthcare workers ask (most of them really are necessary), and transmitting accurately in Spanish the same information, on the same tone to the other person in the room… the L.E.P.

Now picture yourself:

…you’re in pain, you have no health insurance but you go to the doctor because you can’t tolerate it anymore, you speak a broken English from the words that you’ve caught from work. The person at the front-desk sends you immediately to the nurse’s office as they weren’t been able to fully understand you. As scary and overwhelming as it already is, someone in blue scrubs starts giving you instructions in English and starts putting on the cuff to measure your blood pressure, placing you on a scale and checking how tall you are. You are told to wait for the doctor in a light-green room. Suddenly, from the phone on speaker you hear words that sound familiar:

“Hola, buenas noches. Le saluda Juan, y voy a ser su intérprete por hoy. Voy a estar en la línea esperando que la persona que le va a atender venga a la habitación.”

At this moment, you start to feel connected. Not to the nurses, not to the doctor in front of you, but to the voice in the little black box on the desk.

That feeling of connectedness, of being able to express your aches in your language, with the words that have traveled with you from afar, and being heard and understood, are also part of your health.

Now, I’m leaving you with these questions:

What role do public health policies have in this matter?
What can healthcare facilities do to ensure their providers’ cultural competencies?
To growing waves of migration and increasing healthcare demands, are communication technologies the solution to this?

Disclaimer: This is based on my experience with English and Spanish languages, however this can be relatable to any other pair of languages. There is also a lot to learn on language colonialism, but that is a tea for another cup.