In healthcare settings and medical facilities - Swift assistance phone number for overcoming linguistic challenges
It's a distressing situation for parents: Their child is severely ill, they need to rush to the emergency room of a hospital or consult with a doctor – and they can't comprehend the language. Such scenarios are not uncommon in pediatric wards and clinics, and by sheer luck, someone might be around to act as a translator.
Research conducted by the German Medical Association indicates that communication barriers exist in 10 to 30% of interactions between doctors and patients or parents with a migrant background.
Communicating through gestures isn't ideal
Fabian Bärtling has firsthand experience with scenarios where doctors, nurses, and non-German-speaking families must communicate. The 40-year-old has been the head physician at the Christian Children's Hospital in Osnabrück, the second-largest children's clinic in Lower Saxony, since the previous summer.
"You either have to communicate through gestures, or you're lucky enough to have staff in the clinic who speak a second foreign language," he says. Neither solution is ideal – even relying on translation apps does not promote effective communication.
Simplified interaction with the interpreter
Since the spring, his clinic has been utilizing a medical interpreter hotline supplied by the non-profit organization Triaphon. A single number and a button press for the required language instantly connects to an interpreter – at any time of the day or night. "Someone who can translate responses instantly, without the need for complicated mediation," explains Triaphon CEO Marthe Hammer.
A total of 130 interpreters are available across the country to interpret conversations. Around ten languages are now offered. The interpreting service is anonymous – the interpreters cannot see which clinic is calling.
Common "escape languages"
The languages provided cater to the needs of clinics nationwide, says Hammer. They are referred to as "common escape languages": Arabic, Persian, Bosnian, Croatian, and Serbian; Polish, Romanian, Russian, Turkish, Ukrainian, and Vietnamese.
For a patient's treatment, it's crucial to obtain accurate information from the parents, says Bärtling. He vividly recalls the year 2015, when numerous individuals came to Germany from Syria. "At that time, as a resident doctor in the emergency room, I was regularly left feeling helpless," the pediatrician recalls.
Frequently, he could only understand that the child had a fever. However, for treatment, it's essential to know how long the fever has been present, whether the child has had a fever prior to this, how long ago their stay abroad was, or if the child has a cough. "All these are details that are requested – and it's impossible if there's a language barrier," the doctor explains.
He also recalls a challenging situation. A six-month-old child had been in the intensive care unit following a serious operation. Eventually, the doctors realized that they were only prolonging the dying process with intensive medical care, but could not save the child.
Conversing with the parents was necessary to make it clear that we believe it's appropriate to stop ventilation and discontinue circulation-supporting medication, thus avoiding prolonging the child's suffering. Even a translation app is not an adequate solution in such situations, according to Hammer.
Especially in such scenarios, it's important to communicate effectively with the parents, says Bärtling. They must comprehend what the doctors and nurses are thinking. It should not appear as if we are merely walking into the room and turning off the machines. "That would be disruptive – it wouldn't work," says the pediatrician.
Societal Potential
Currently, around 170 facilities utilize the Triaphon service, says Hammer. Among them are numerous doctor's practices. The company was established in 2017 in Berlin by a doctor and a pediatrician. There are also commercial providers who sometimes offer translation services via video calls.
The original concept of Triaphon was to leverage the existing cultural potential of bilingual individuals. "There are so many bilingual individuals in Germany, and at the same time, there's such a high demand for interpreters in many facilities," explains the managing director.
Problem: Lack of Funding
Language mediation plays a critical role in the daily lives of patients, parents, and doctors. However, the issue of funding remains. Practices and hospitals must fund the service from their own budgets; it is not a service covered by health insurance. Many clinics are currently facing financial difficulties, even the threat of insolvency.
The coalition government agreed in their 2021 contract to integrate language mediation – also with the aid of digital applications – into the Social Code Book V, which governs services provided by statutory health insurance.
Insurance benefit – or societal responsibility?
The German Medical Association urged the legislature to implement this change promptly in 2022, says Mark Berger, deputy press spokesperson for the German Medical Association.
However, health insurance companies reject the notion of covering interpreter services entirely through insurers. It's a societal obligation that should also be linked to integration policy, claims Claudia Widmaier from the press office of the GKV association.
Despite the German Medical Association identifying communication barriers in 10 to 30% of interactions with patients or parents from a migrant background, many clinics struggle to fund medical interpreter services. Fabian Bärtling, head physician at the Christian Children's Hospital in Osnabrück, expresses the importance of overcoming language barriers, especially in critical situations, stating, "Conversing with the parents is necessary to make it clear what we think is appropriate – it should not appear as if we are merely walking into the room and turning off the machines."
