Cultural Differences in Interpreter-Mediated Medical Encounters in Complex Humanitarian Settings: The Case of Emergency ONG Onlus

Cultural Differences in Interpreter-Mediated Medical Encounters in Complex Humanitarian Settings: The Case of Emergency ONG Onlus

Maura Radicioni (University of Geneva, Switzerland)
Copyright: © 2020 |Pages: 23
DOI: 10.4018/978-1-5225-9308-9.ch007

Abstract

Interpreters and mediators working in complex humanitarian settings are faced with new challenges, both linguistic and non-linguistic. As part of on-going research, this chapter reports on cultural differences in interpreting major variables in interpreter-mediated medical encounters in complex humanitarian scenarios. The author will address the importance of cultural issues in humanitarian interpreting, based on the assumption that differences in culture can be a serious barrier to effective humanitarian communication. The author focuses on the interpreters and cultural mediators working for the Italian NGO Emergency ONG Onlus, which provides medical assistance to migrant communities in Southern Italy at its Castel Volturno clinic. The aim is to highlight the importance of a shared culture between interpreters/mediators and their clients and adequately deal with existing cultural differences in order to enact a so-called “cultural compromise” between migrant patients and health professionals with the goal to facilitate prevention, health promotion and education, and treatment.
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Introduction

The cultural turn in translation studies, which started in the 1980s, contributed to a shift in the focus from language mediation to cultural mediation and helped see translation and interpreting as culturally and socially embedded practices. The role of the interpreter as a cultural agent is now widely acknowledged among scholars (Roy, 2002; Angelelli, 2004; Wadensjö, 1998). As early as 1999, Mikkelson had already clearly described the importance for interpreters of all modes and contexts to be aware of cultural differences:

It is almost universally acknowledged that interpreters working in medical and social service settings need to be acutely aware of cultural differences (hence the term “cultural interpreter” that is so prevalent in Canada), although there is widespread disagreement about what they should do with that knowledge (Carr et al., 1997). Court interpreters are also expected to take culture into account, although they are much more restricted in their ability to educate their clients about cultural differences (Gonzalez et al., 1991). What many of these interpreters may not recognise is that conference interpreters, too, consider themselves not just linguistic, but also cultural intermediaries. Seleskovitch (1978a, 1978b) and Seleskovitch and Lederer (1984) have written extensively about the link between language and culture. Perhaps Jones (1998, p. 4) sums it up best when he says that “in all of their work, (conference) interpreters must bridge the cultural and conceptual gaps separating the participants in a meeting.”

Scholars who argue that interpreters need to be culturally knowledgeable, as suggested by Mikkelson (1999), view them as cultural mediators. Because cultural differences between communicating parties may lead to conflicts, interpreters as cultural mediators are expected to resolve said potential conflicts and facilitate communication. This view corresponds to Pöchhacker’s (2008) view of contractual mediation, which “refers to mediation intended as resolution of (intercultural) conflicts, i.e. as the facilitation of cross-cultural understanding and communication beyond language demarcation” (Baraldi, 2014). This applies particularly to dialogue interpreting, specifically medical interpreting, in complex humanitarian emergencies in which awareness of cultural differences can help bridge the gap between the individuals interpreted for.

This chapter reports on cultural differences as major variables for the interpreters and mediators who work in complex humanitarian emergencies, specifically in the medical field. It addresses the importance of understanding cultural differences in interpreter-mediated medical encounters in humanitarian settings based on the assumption that differences in culture may represent serious barriers to overcome in a complex humanitarian scenario. The chapter anticipates the results of a qualitative study that will be carried out in the form of ethnography with the cultural mediators working for the Italian NGO Emergency ONG Onlus, which provides medical assistance to migrant communities in Southern Italy at its Castel Volturno clinic.

The objective of this study is to highlight the importance of a shared culture between the mediator and the client to help overcome said barriers. The focus will be on cultural mediation and the role of medical interpreters in humanitarian settings, specifically within the framework of the medical NGO Emergency in the Castel Volturno clinic of the organisation in Southern Italy. The focus will furthermore be on the extent to which cultural mediation is more effective; interpreters coming from the source culture of the clients are more trusted and recognized, due to the cultural background shared by the cultural mediators and their clients. It is worth pointing out that the study has one limitation: as of the writing of this chapter only preliminary conversations were held with the cultural mediators working at the Castel Volturno clinic of Emergency. Said conversations stressed the need for a stronger focus on culture and cultural mediators, however this trend needs to be confirmed by the future analysis on the field. The actual ethnographic observation of the interpreting and mediation activity performed by the cultural mediators working for Emergency in the Castel Volturno clinic of the organisation will be carried out at a future stage, hence the reason why there is not much evidence about the outcomes of the mediation at this stage.

Key Terms in this Chapter

Emergency Ong Onlus: A humanitarian NGO with operations in Afghanistan, the Central African Republic, Iraq, Italy, Sierra Leone, Sudan, and Uganda that provides free medical treatment to victims of war, poverty, and landmines.

Cultural Mediator: The language intermediary, hired by Emergency ONG Onlus, who is called upon to provide language and cultural mediation between Emergency health professionals and migrant patients in triadic settings, and provide social and cultural orientation to migrant patients in dyadic encounters.

Complex Humanitarian Emergency: A situation in which a civilian population is displaced from their homes by war or conflict, and one can witness a deterioration of living conditions and sometimes a significant increase in mortality, either in the short or long-term.

Humanitarian Interpreting: Interpreting practices that fall within the legal framework of International Humanitarian Law (IHL) and International Refugee Law that are aimed at enabling humanitarian organizations to communicate with public authorities and protected individuals/beneficiaries in order to allow the latter to access their rights.

Cultural Competence: A set of congruent behaviours, attitudes, and policies that come together in a system, agency, or among professionals that enable that system, agency, or profession to work effectively in cross-cultural situations.

Cultural Differences: Differences in terms of the complex web of cultural representations relating to various types of regularities or themes (e.g. orientations to life and belief, values and principles, perceptions of role relationships, including rights and obligations associated with them, various norms and conventions of communication, and institutions), which can be encountered in interpreter-mediated medical settings.

Humanitarian Communication: Communication facilitated by interpreters and cultural mediators in complex humanitarian emergencies, which occurs at the intersection between health mediation, humanitarian aid provision, and social service provision.

Intercultural mediation: The act of interpreting both language and culture, bridging and mediating between two persons with different cultural backgrounds.

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