Effective Patient-Provider Communication Across Language Barriers: Focus on Translation

1. Effective Patient-Provider Communication Across Language Barriers:Focus on Translation Bruce T. Downing, Ph.D. Laurence H. Bogoslaw, Ph.D.

2. Patient < > Provider Communication • Spoken language: interactive discourse • immediate, contextualized, non-durable • Written language: usually unidirectional • carefully composed, self-contained, durable • Other media: • physical demonstration • drawings, photos, films • video dramatization

3. Interlingual Communication Aides: • For spoken language: INTERPRETERS • making a speaker’s words understandable by recreating a spoken message in a different language. • For written language: TRANSLATORS • creating a target-language text on the basis of an existing source-language text

4. Interpreting “the process of understanding and analyzing a spoken or signed message and re-expressing that message faithfully, accurately and objectively in another language, taking the cultural and social context into account” (ASTM 2000)

5. Translation “the conversion of a written text into a written text in a second language corresponding to and equivalent in meaning to the text in the first language” -- California Standards for Healthcare Interpreters, 2002.

6. . • Translating written texts differs from interpreting oral discourse in all the ways that writing differs from speech. • Writing ability is not natural but results from schooling, feedback, reading and practice. • Writing uses forms of language (words and syntax) rather different from speech. • Writing must be self-contained and relatively independent of contextual cues.

7. The text is static, produced sometime in the past. The text can be studied and analyzed. The author and intended readers are typically unknown. The text can be edited and revised by others. The utterance is dynamic, in process here and now. The utterance “lasts” only in memory. Interpreters interact directly with speakers and listeners. The rendition must be right the first time. Translation Interpreting

8. Essential translator qualities • Thorough and broad knowledge of two languages, especially the target language • A comfortable familiarity with both cultures • A commitment to keeping up with language varieties and new terms, slang and usages • Exceptional reading and writing skills • Flexibility with respect to genres and styles • Research and reference skills • Facility with computer hardware and software

9. Theories of Translation --a quick overview

10. Literal “word for word” Translation • Languages are not isomorphic. • Words and idioms in one language do not necessarily correspond to words or idioms in another. • Similar meanings are expressed by different arrangements of words in different languages. • Simply replacing words in one language by words in another cannot in general result in a meaningful or grammatical translation.

11. Literal Translation • A Finnish example: • Uutinen puhu-tt-i nais -i -a pitkään. • news-item talk-CAUS-PST woman-PL-PART long-ILL • “The news made the women talk for a long time.” • (Davis & Koenig, March 2000, in Language 76(1):75.)

12. A Creole Text with Literal Translation(The Lord’s Prayer in the Tok Pisin language of New Guinea) • Papa bilong mipela, yu i stap long heven. • Father of us, you PRT be/stay/live in heaven • Nem bilong yu i mas i stap holi. • Name belong you PRT must PRT be/stay/live holy • Kingdom belong yu i kam. • Kingdom belong you PRT come • Laik bilong yu ol i mas behainim long heven … • Will of you they PRT must behind-it in heaven ...

13. Translation as Substitution • A translation might be produced by a process of substituting equivalent elements: • Equivalency may sometimes be at the level of individual words, but more often involves whole idioms, “collocations,” or phrases-- or even whole sentences. • In translating between unrelated languages, the only real equivalent in a successful translation may be the whole of the two texts.

14. Meaning-based Translation • Don’t try to match up words or phrases between languages. Instead: • First analyze the source text and extract the meaning. Hold the meaning in memory. • Then, write a new text, using natural target-language forms, to express the meaning. • “Repackage” the meaning in ways that are relevant and comprehensible to the reader.

15. Dynamic Translation (Eugene Nida) • Not constrained by the linguistic properties of the source text. • Instead, the new text attempts to convey the intent and spirit of the original using idioms and expressions meaningful to the reader. • References and implications implicit in the source text may be made explicit in the target language text.

16. Source orientation Emphasis on semantics (of the source text) Retrospective attitude (procedures for “processing” the source text) Target orientation Emphasis on culture (of the target readership) Prospective attitude (goal-oriented: achieving the purpose of the target language text) Theoretical Orientations

17. Functionalist Theories • The translation must respond to the intent (purpose) of the translation initiator. • The purpose of the translation must take into account the cultural characteristics of the intended readers (receptors). • To fulfill its intended function, the translation product may differ significantly from the source text.

18. Clarifying/specifying the function • According to skopos theory (functionalism): • the translation initiator must determine and express a purpose or function for each translation project; • the translation team works from the source text AND the specifications for the task; • the specifications guide the nature and degree of cultural adaptation of the product.

19. Application forms Health history check lists Survey instruments or questionnaires Legal documents, including consents Preventive health materials Other educational materials Explanations of coverage or illnesses Instructions for care and follow-up Relatively literal  Culturally adapted 

20. To make sure this is clear:What are some possible functions of a translation?

21. So--which translation theory is correct? • In practice, skilled translators make use of all these views of the translation process. • The more recent functionalist theories are best-suited to modern, nonliterary translation tasks. • Why? Because of their practical emphasis on achieving a communicative purpose--connecting with the readers.

22. Conclusion • We have reviewed: • the difference between speech and writing, interpreting discourse and translating texts; • the essential qualities of a good translator; • Source-oriented and target- (recipient) oriented approaches to translation; • the need for being clear about the purpose and target readership of a translation.