Titles, community interpreting and health care settings

Ann Corsellis pithily states in her 2005 “Training Interpreters to Work in Public Services,”  that “clarification of title is a useful beginning.” In community interpreting, also known as public service interpreting, there are currently two primary approaches to title designation: the first addresses community interpreting as comprehensive of all interpreting that occurs at a community level, regardless of sector (health, legal and public services) and the second is title segmentation, whereby community and, largely, medical interpreting are recognized as distinct designations. Both approaches have been applied in different regions.

As the profile of community interpreting comes to higher prominence, and as stakeholders advance the dialogue on standards, certification and training for community interpreting, the distinctions become more significant. It is important that all key players, and principally the practitioners, understand how the divergent approaches can support or hinder future efforts at professionalization.

Community interpreters provide a valuable service in the provision of health and public services. Community interpreters are language professionals who adhere to a strict code of conduct, professional standards and ethics, and are trained in the core competencies of interpreting. Without the inclusion of community interpreters, non-English-speaking clients and English-speaking service providers are left to rely on family members, friends or organizational volunteers — all of whom cannot and should not provide language services. Community interpreters who are screened and properly trained ensure not only access, but also quality access, demonstrated by confidential, impartial and accurate services.

In addition to facilitating access to services for vulnerable populations, community interpreters themselves are primarily immigrants and refugees who have utilized their language skills and professional training to build and contribute to one of the largest growing global industries. This is an important point to note. We often exclude those very necessary and central voices from the discussion, and instead create definitions without truly appreciating the realities of interpreting at the community level. Community interpreting has its own unique characteristics.

In the late 1980s to early 1990s I was fortunate to have been the manager of a community interpreting service based in one of the largest immigrant services in British Columbia, Canada, and to have experienced the evolution of the industry at ground level. At the time, community interpreting was still very much in an evolutionary state in British Columbia. The crossover from bilingual volunteer to trained language interpreter was in full process, and for the most part, service providers, health practitioners and the like were beginning to feel the language and cultural barriers created by clients from multilingual, multicultural populations. The fact that service providers tended to attribute this pain to a client’s inability to speak the official language and not to the fact that poor planning and insufficient resources to welcome a diverse client base might actually be the reason was why the onus was placed on the client to bring his or her own “interpreter” along.

We had been advocating for the use of properly trained and screened interpreters across public services for some years, but the critical mass did not happen in British Columbia until the late 1980s and even then the challenges were uniquely felt in the health care system. At the time, health care administrators, executives, practitioners, policy makers and educators departed from the position that it was necessary that they define the role of the interpreter in a health care setting, rather than acknowledging that a professional definition existed, and it was a matter of building a place for the interpreter within the health care team. It was a position that led us to explore the specific role of the interpreter in health care. But the initial provocation for this investigation could be attributed to the fact that health care systems and practitioners alike were at the time unfamiliar with how to work across languages and cultures. And to help them navigate the cultural divide, they imbued interpreters with all types of roles and responsibilities that were simply outside the core role and core competencies of interpreters. What was needed were interculturally competent systems, not protocols that relied on the interpreter to assist them in overcoming the nonlinguistic barriers that arise when working across cultures. 

In Canada we have now embarked on the road to certification and I find myself coming back to this issue: how distinct is interpreting in the health care field from other community-based settings? Is it fair to community interpreters that we create more silos, thereby creating more costs and complicated procedures for a segment of the language industry where practitioners move fluidly between health, education, corrections and social work settings all in one day? Are the current efforts at establishing titles for community interpreters reflective of the industry reality?

We fought and won the larger battle for the preservation of the role of the community interpreter as a language conduit, with clear definitions and role competencies. As we move forward toward certification and accreditation, let us also not lose sight of the fact that we must be heard as titles are established, and ensure that the processes, as well as the title, reflect the work of interpreting in community and public service settings.


A history of community

interpreting in Canada

In the 2002 article “Community Interpreting: a profession in search of its identity,” Roda Roberts defined three main subdivisions in interpreting: conference interpreting, court interpreting and community-based interpreting. Historically set against the backdrop of the more established subcategories of conference and court interpreting, community interpreting in Canada had struggled to find its position as a critical industry member since it started gaining higher prominence in the early 1980s. While diverse sectors of public services have stressed that interpreting services are crucial to service provision, most notably health care and legal services, the overall field of community interpreting continues to remain largely unregulated. But change is transpiring, and in the process, our conceptualization of the role of the community interpreter is emerging, mainly through the presentation of title designation.

Community interpreters work across public services and therefore must have the capacity to prepare for working in a variety of settings. Interpreting in community settings means that an interpreter moves between different service contexts as well as different terminology contexts.

In Canada we have taken a generalist approach to all interpreting activity that is done at a community level. Consequently this has meant that the umbrella of community interpreting has incorporated all interpreting activities, regardless of sector (health, legal and public services). Legal in this sense is assuming the broader definition encompassing both in and out-of-court interpreting activities. Court interpreting in Canada enjoys legislative protection under the Canadian Charter of Rights and Freedoms Section 14, which states “A party or witness in any proceedings who does not understand or speak the language in which the proceedings are conducted or who is deaf has the right to the assistance of an interpreter.” There is an accreditation process through the Canadian Translators, Terminologist and Interpreters Council (CTTIC), and their provincial affiliates, but nonetheless legal interpreting is still at times considered part of community interpreting. This association between court and community is frequently made because many of the same practitioners who work in court also work across all sectors at the community level. Moreover, court interpreting in Canada continues to wrestle with many of the same issues that other sectors of community interpreting are facing: issues of professional conduct, professional competencies and professional recognition. The alliance between court and community is not intended to minimize the significant advances and sector-specific challenges and realities of court interpreting, but instead to align resources and present a united front — an action that ultimately will benefit court as much as community interpreting. 

The rise of institutionalized community interpreting

The most active definition of community interpreting that is used in Canada comes from the 2010 Healthcare Interpretation Network’s National Standards Guide for Community Interpreting Services: “Bidirectional interpreting that takes place in the course of communication among speakers of different languages. The context is the provision of public services such as healthcare or community services and in settings such as government agencies, community centres, legal settings, educational institutions, and social services.” This definition is echoed in ISO 13611:2014 Interpreting — Guidelines for Community Interpreting, recently published in November 2014.

The increased prominence of community interpreting in the 1980s coincided with a marked change in the face of Canadian immigration, which experienced a dramatic shift from mainly European immigrants in the first half of the century to an influx of immigrants arriving from Asia, Africa, the Caribbean and Central and South America in the latter part of the century. In fact, research conducted by Larry Bourne and Rose Demaris (published in The Canadian Geographer in 2001) revealed that countries in these regions were providing almost 90% of the immigrants to Canada by the 1990s. As Canada welcomed newcomers from nontraditional source countries, workers in the service of assisting newcomers began to notice a growing need for language access to public, health and legal services. Initially the response was a typically ad hoc one in which family and friends “helped.” As noted by Uldis Ozolins in the July 2010 issue of The Journal of Specialised Translation, “the need to respond to linguistic diversity, especially through immigration or asylum seeking, is rarely planned for by host societies.” This ad hoc response was sustained by the aid organizations giving “help” as much as by professionals working within the various mainstream sectors that were attempting to work with non-English or French speaking clients. Access to services through language support was a job done by any bilingual individual, regardless of how marginal his or her language skills were. 

The inflow of immigrants was not felt evenly across the country, however. Immigrant settlement patterns during that post-1980 period generally favored the provinces of British Columbia, Ontario and Quebec. In the early part of the twentieth century, community-based responses, mainly through religious organizations and ethno-specific groups, sprung up to provide support to newcomers. As the century progressed, the sector began to see the development of a more coordinated effort through the implementation of nonprofit services for immigrants and refugees. It was primarily through these nonprofit organizations that community interpreting first gained a foothold. Initially listed as part of the job description for immigrant settlement workers or administered through small project grants, interpreting services were at the time run as bilingual or multilingual volunteer-based services, until the sector eventually recognized that the role of the interpreter was much more complex and dynamic than the existing approach afforded it. That community interpreting in Canada emerged from the immigrant and settlement services, rather than from the interpreting profession itself (conference or court), explains the complicated path that this division of interpreting has experienced. Our European colleagues have come to the same point in the road at a much faster pace, in a much shorter time. Settlement services are advocacy-based services. As a consequence of being assumed within the role of the settlement worker, community interpreting was, by extension, assigned with the responsibility of advocacy and cultural facilitation. Moving away from this to a more clearly defined description of interpreter as language facilitator proved challenging and caused considerable tensions within the sector.

In addition, the rise of community interpreting was definitely an institution-led field — one in which the needs of the institutions were primary and the requirements of the profession secondary.  This genesis has been at the core of why community interpreting has not been able to find a higher status within the field, even though, according to a 2007 Industry Canada report, it has been one of the fastest growing segments of industry. This institution-led historical context is also the main reason why community interpreting has been assigned so many roles, from cultural navigator to cultural liaison to advocate to language facilitator. Institutions looked initially to the bilingual volunteer, and subsequently to the interpreter (once the role had gained more prominence the sector transitioned from volunteers to paid interpreters) to help them in understanding their “new” clients, the diversity of cultures and different styles of communication and engagement that they were facing.


Toward title designation

Community interpreters are also known as public service interpreters in Europe. According to Paola Gentile, a PhD Student in interpreting studies at the University of Trieste in Italy, the title change arose “to avoid confusion with the conference interpreters who work at the European Union — previously known as the European Community.” But apart from those two labels, which are well understood within the field, community interpreters are generally recognized as professionals who work across sectors in community settings. After all, as Pascal Rillof, president of the European Network for Public Service Interpreting and Translation puts it, “medical interpreting is one kind of community or public service interpreting. Moreover, what the medical interpreter actually does is not fundamentally different from what an interpreter does in other related fields: social service, welfare organizations, employment agencies, prisons, court of law, schools and so on.”

It is interesting that these added classifications (medical and community) have become a part of the dialogue in community interpreting, whereas we do not see these divisions in other categories of interpreting. Kiran Malli, director of the Provincial Language Service, a department of the Provincial Health Services Authority in British Columbia, questions this as well: “I am not sure why anyone would think that the notion of language specialist changes at the community interpreter designation.” Conference interpreters and court interpreters each have one designation. Is the community interpreting industry once again relinquishing its right to self-determination? If we don’t expect the same distinction for conference interpreters, then why are we making distinctions for community interpreters? As Malli notes, “We seem to be creating silos in an already fragmented industry. Interpreting is interpreting is interpreting. The context changes but the skills remain the same.”

The professional duty of any interpreter is to prepare for upcoming assignments using core competencies, acquired skills and occupation-based techniques, and to seek ongoing professional development. For community interpreters, the reality is that they often do not have the luxury of time or advance notice to prepare for upcoming assignments. Moreover, community interpreters must work across sectors in order to create a viable business that allows them to generate an adequate income — often crossing sectors within the same day. Title segmentation will not offset these realities. Understanding and incorporating the realities into the training, certification and examination structures is perhaps a better approach. Besides, as noted earlier in this article, community interpreters are primarily immigrants and refugees themselves (at least in Canada, but I would venture that it is the case in most regions), is it necessary to erect additional barriers to employment? “The creation of two categories requires the candidates to take two exams, which in itself creates a barrier to employment,” notes Elizabeth Abraham, vice president of Critical Link International. “Given the high cost of the exams, most interpreters will choose one, which means they are limited in the settings in which they can provide services.”

“Community interpreting must do a service to the interpreter as well as the industry — by acknowledging that on a day-to-day basis community interpreters work across sectors and must do so with a talented fluidity,” says Rillof. While title segmentation in community interpreting may be an attempt to create clear distinctions between settings, in reality it might actually result in driving practitioners away, or risk noncompliance in an industry that is already fragmented. Further divisions in community interpreting will require that interpreters go through more than one certification process and exam, creating greater costs and unnecessary barriers, and doing a disservice to the very talents that keep this industry thriving.