Tuesday, December 15, 2009

Traduttore Traditore

  1. Reflections on the Certification of Healthcare Interpreters in the United States

The ancient Roman expression: “Traduttore Traditore” (Translator Traitor) calls to the fact that the art of translation can turn into a gross distortion of the original message, and that the act of transmitting a message from one language into another is fraught with the possibility of errors and private agendas, steeped in a history of deceit and betrayal.

It is truly a paradoxical journey that ultimately recognizes interpreting (the oral form of translation) as one of the oldest and most honorable professions “documented in stone since the time of the Pharaohs.” So how did it develop? What shaped it? Where is the frontier between self-interested lies and fastidious accuracy?

Ah, the irony of the human condition, of conflict, language and history.

Historically, translation and interpretation are professions often tied to the making and business of war and peace, of devastating loss and unbridled greed. Consequently, the matter of how these finally became respectable professions is embedded in the history of international conflicts, in questions of justice and peace-making.

Perhaps the most poignant historical example is the extraordinary role played by interpreters at the 1945 Nuremburg trials of Nazi war criminals that “set forth as a principle of international law that crimes of war and crimes against humanity would not go unpunished. The Nuremburg Trial was also the first official international gathering in which simultaneous interpretation was used. However, when 42 volumes of the transcripts containing an estimated six million words were published, not a single word was devoted to the role of interpreters.”

Ergo, a history of unrecognized and heroic labor that marked a future of anonymity and a profound lack of appreciation.

Fast forward. Since the advent of the Civil Rights Act of 1964, healthcare interpreting -a vitally important specialty in the field of interpretation- has been impatiently waiting in the wings for recognition, acceptance and legitimacy. While in the legal field, court interpretation became a certified profession little more than a decade after the Civil Rights Act under the Federal Court Interpreters Act of 1978, healthcare interpreting has lingered in the shadows.

In the meantime, at stake has been the essential need for competent and accurate communication between a patient and her doctor. Anyone who ever traveled abroad and got sick in a country where they didn’t speak that language, understands how frightening and potentially lethal this can be. Yet untold millions of people suffer this fate unnecessarily due to a lack of trained and certified healthcare interpreters.

Millions of messages between patients and those who would heal them, have been silenced, misunderstood and misrepresented. To give an example, until very recently it was perfectly acceptable in healthcare to use child interpreters, family members, other patients and unqualified staff -from the kitchen to the parking lot- to serve as conduits for life or death communication.

Now at last, the legitimate process of certification for healthcare interpreters -the professional benchmark for meticulous accuracy in transmitting communication between languages and between cultures and worlds in medicine- is in the process of being born, conjured and crafted by interpreters themselves and their allies.

Why is this important? Because until now, the voice and knowledge of the healthcare interpreter has been prominently absent throughout a profession too often appropriated and defined by people outside of the profession, people who speak only one language and know very little about the act of interpreting or what the interpreter experiences in the act.

Subsumed in the complex world of a national managed healthcare system in flux, dwindling resources and insurance and billing issues, the voice and contributions of healthcare interpreters have often been treated as a mere inconvenience. This is in part due to the power relations that exist within a healthcare environment where professional certifications are clearly necessary, and where the uncertified interpreter has been invisible at best and a necessary nuisance at worse. We have been strangers in our own land. But all this is about to change.

I arrived in Chicago last week in the throes of a bitter wintry blizzard. Perfect metaphor for the purpose of my trip. For the first time in the history of healthcare interpretation in the United States, there is a valid effort to achieve a healthcare interpreter certification driven by the practitioners and allies of the profession itself, and this is as it should be.

Invited by the new Certification Commission for Healthcare Interpreters, I attended a convening of subject matter experts, all healthcare interpreters. Our function was to make an unpaid contribution to the process of producing a job task analysis and to contribute freely to the body of knowledge in healthcare interpretation.

In other words, for the purpose of informing the creation of a healthcare certification, interpreters with all their vast wealth of unspoken and rich knowledge, are at the helm of defining what it takes to do the job, something that has never been done before in healthcare.

We represent the broadest possible spectrum of healthcare interpreting practitioners: varied cultures, ethnicities and races, women and men, young and elder and in-between. We represent the major languages of our profession as well as dialects and the rarer languages, also known as ‘languages of lesser diffusion’ in linguistic parlance. Some of us work for public health care systems, others work in the private sector including agencies and companies. Our youngest emissaries are in their 20’s and the eldest of our tribe is 79, charming, wise, witty and sharp as a tack. Our collective knowledge represents what only trained and seasoned interpreters can know: How to do the job well and how to represent the profession.

We examined every aspect of what it takes to do this job from the interpreter's point of view. We put our cards on the table of candid discussion and widely varying experiences in one of the most intense professional encounters I have ever had the privilege to be part of. We had honest differences and similarities that had to be mediated by consensus and a brilliant facilitator. No stone was left unturned.

The birth of the Certification Commission for Healthcare Interpreters (CCHI) heralds the most legitimate and interpreter-centered effort to date that intends to open the doors for a profession burdened with neglect, misunderstanding, and political and profit-driven agendas, a profession that is critical to the lives of patients all over the country.

For me, what is most welcome and needed in the CCHI’s certification process is that it is prominently transparent, highly ethical and best of all, it is vendor-neutral. It is a process in which actual healthcare interpreters are at the center of the effort, rather than money or personal gain.

In an age of flagrant profiteering, scams and swindles, the certification of healthcare interpreters is a baby in the cradle of burning necessity and moral obligation. It is an urgent response to the utterances of a terminally-ill patient, a child in unbearable pain, a rape victim in the emergency room, all waiting to be understood in their greatest time of need, since 1964.

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©2009 María Elena Gaitán
All Rights Reserved

Sunday, November 30, 2008

Music: The New Public Health Indicator

In a recent public ceremony, the Harvard School of Public Health announced on November 10 that the second-annual Q Prize (named in honor of music empresario Quincy Jones), was awarded to Dr. José Antonio Abreu, founder of "EL SISTEMA", Venezuela's groundbreaking national classical music program aimed at children at-risk, and to Gustavo Dudamel, who among other luminaries has emerged from El Sistema as the most phenomenal and electrifying young conductor of our time.

"El Sistema" has demonstrated the incredible power of music in Venezuelan Society, and has now been identified as a public health intervention that fosters healthy child development," according to Barry R. Bloom, Dean of the Harvard School of Public Health. Studies have documented the impact of El Sistema in preventing youth violence and drug abuse among young people living in the most impoverished of circumstances. But it has done much more: it has given thousands of young people pride in their accomplishments and a place of honor in their communities resulting from this construction of a system of youth orchestras as a method of inclusion, validation and social benefit. They not only have access, they are purposefully privileged, and considered a matter of national pride.

But Music in Public Health?

The powerful notion of music as an element of public health, is as predictable a truth as it is a groundbreaking idea. We often associate public health with communicable diseases or domestic violence. But to classify music as an element that fosters healthy child development is a pronouncement so shocking that the idea itself indicates how much work we have yet to accomplish. To date, music and health in our society have been disconnected, except in alternative practices. No one goes to Kaiser and receives a prescription for 20 minutes of Vivaldi or Coltrane a day. Health Departments do not require counties to form youth orchestras. No one is fighting for music as a line-item on the state's health budget. At the federal level we've been living in a medieval environment so thoroughly anti-human and anti-intellectual, that there is barely a commitment to health, let alone to the arts. So the very concept of music, specifically to classical music, as a health indicator will need to be understood, digested and integrated into the public conscience, dialogue and sphere.

Fortunately we have the 30+ years of Dr. Abreu's "El Sistema" experience in Venezuela to learn from and value. Further, Gustavo Dudamel has been appointed as the Los Angeles Philharmonic's new conductor, creating another 18-million cracks in an institution with a history of pernicious exclusion that would not have allowed its audiences to grow, unless it began to value its future in terms of the real masses of people who live in Los Angeles. This shift has happened in part due to outgoing conductor Essa-Pekka Salonen's vision and he deserves our sincere thanks.

To date child and maternal health are tracked based on indicators such as:

• Child Death Rate
• Infant Mortality Rate
• Juvenile Crime Arrest Rate
• Median Income of Families With Children
• Percent Low Birth-Weight Babies
• Percent of 2-Year-Olds Who Were Immunized
• Percent of Children in Poverty
• Percent of Low-Income Children Without Health Insurance
• Percent of Families With Children headed by a Single Parent
• Percent of Female-headed Families Receiving Child Support or Alimony

Now we can begin to envision the presence of music in a child and a community's life as part and parcel of the concept of "well-being", something essential we cannot do without.

This is nothing less than revolutionary in a society that has given itself a lobotomy by eliminating music and arts in public education particularly since the Reagan Era, placing arts access squarely in the domain of only those who could afford it. And what has this gotten us as a people? Can we honestly say we value our children (or for that matter our adults) more than other countries when we have excluded them from the creative, social and artistic development to which human beings have had access since the beginning of time? We have devalued them. And the bottom line is that our children, as a whole, are too often alienated, dysfunctional and living within the limitations of materialism and other ghetto mentalities that drive them not to care about themselves (why should they?) let alone about the communities in which they subsist.

This is a special time in history in which we have the possibility of making systemic changes long overdue. Along with reversing our wasteful behaviors that have contributed to everything from global warming to the appropriation of water sources, we need to embrace the fact that there is a quickly widening gap between the "have everythings" and the "have nothings", spurred by Wall Street's unbridled corporate greed, at last exposed as obscene and without limit.

Possibly now we will again consider music as a fundamental element of our humanity. An essential life-giving force we cannot do without. Something our children and our communities have always needed as an integral part of existence, ritual, spirit and flow.
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©2008 María Elena Gaitán
All Rights Reserved

Thursday, May 1, 2008

Foods From The Americas: Amaranth, The Outlaw Grain


Once banned by Cortez and the Catholic church, amaranth is still a fairly unknown high-protein grain that could easily figure into the solution to world hunger. Instead, amaranth became an outlaw, an illegal alien grain in its own homeland. This was likely triggered by the high esteem in which the plant was held by indigenous people, and rightly so.

For hundreds of years amaranth all but disappeared from the face of the earth except in the highlands of Oaxaca and to the south among the Maya people where its cultivation most probably began some 10,000 years ago. Together with corn, chile and beans, amaranth was a key part of the near-perfect core diet of the the Mayan and Aztec civilizations. Diverse varieties were cultivated all the way to the South American Andes where the Inca people live to this day. High in protein and the essential amino acid lysine, today amaranth has found its way to Europe and is even consumed in India where it is known as rajeera, or the king's grain.

Despite its near extinction, the hardy-survivor amaranth can be found in contemporary cooking from granola to pancakes and is once again important despite its illicit past. Yet during the conquest, punishment for the criminalized cultivation of amaranth included cutting off the hands of those who dared to plant it. So why did this beautiful nutritious and mystical plant elicit such savage response from the invaders?

Called huautli in the Nahuatl language of the Aztecs, it was a primary crop not only important as food, but central to the spiritual and ritual life of the community. Its precious seeds and leaves were nutritious and therapeutic. It was an offering to the gods as well as the ingredient used to bathe newborn babies. It was mixed into a paste and transformed into miniature reproductions of the child's future attributes: a bow, an arrow, the hunter's instruments, or perhaps a flower or an animal spirit-guide. The use of amaranth for healing may also account for its valuation as a sacred plant par excellence.

When the Spanish arrived, their Catholic priests were horrified to find that amaranth was considered a deity and used in religious ceremonial rituals. It was consumed and mixed, according to some sources, with the blood of people who were sacrificed, and was perhaps a tad too close to the religious ceremonial ritual of the holy eucharist, the Catholic ritual that consecrates the body and blood of christ and is also eaten. But that was not savage. That was ok. On the other hand some scholars have said that the eradication of amaranth was really a military strategy intended to weaken the Aztec people to allow for an easier conquest, since amaranth was also an important part of the diet of warriors.

Today from Mesoamerica to East of The L.A. River, from street vendors to neighborhood bakeries you can find amaranth sold as the popular treat called alegría, the Spanish word for happiness or joy. Interesting that this delicious high-protein sweet made from the forbidden toasted amaranth seeds, with peanut and other nuts, mixed and held together by the sweetness of honey, made in a circular form, the shape of the sun and the circle of life, should be called alegría, happiness or joy. No blood this time. Plenty of that ingredient was spilled by the invaders.
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© María Elena Gaitán, 2008 All Rights Reserved

Tuesday, April 29, 2008

Wisdom


For years now a favorite obsession has been my contemplation of the giant stone Olmec heads found in the southern Gulf Coast region of Mexico. To gaze upon these brother and sister heads (and who's to say they are not also women?) has given me the great pleasure of reflecting on the ancient and magnificent cultural bridge between the people of the Americas and the people of Africa, a coming and going between the two from the beginning of time.

Recently an artist friend told me that the larger than life sculpted African heads signify wisdom. Undeniably then, these heads honor knowledge and the Indian-African holders of knowledge who first inhabited the ancient Mexican Olmec cradle.

In his book, They Came Before Columbus, author/scholar/poet Ivan Van Sertima offers us a lifetime of research pointing to the early presence of Africans in the Americas, specifically in Mexico. There is no written history of the voyages that took place between these people, between these continents, voyages alighted on the swift ocean currents. Why? Because both Africa and the Americas suffered from the systematic destruction of our books, the burning of our sacred archives by colonial powers. The word was lost. The history of that truth burned at the stake.

But while there is no archival proof that Africans were in the Americas, or for that matter that indigenous Americans traveled to Africa before Columbus, through the tenacity of thinkers like Van Sertima the truth still lives. We have found our ancient links and are again connected like a double helix.

It is typical of conquerors to arrive in a so called 'New World', possess the land, and destroy the previous histories of the conquered people. This is what happened in Africa and in the Americas. This is what happens today. To hear the current news media spin about the downfall of Black and Latino relations, you would think we had nothing at all in common beyond the dehumanizing constrictions of prison life, drug wars and inevitable turf animosities. Anything to make a buck by selling negative news. Who profits from throwing gasoline on the fire, rather than make the fire dance in memory of who we have been to each other, of who we still are: kin, lovers, neighbors, friends, family, choir, song, bones, water and earth.
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© María Elena Gaitán, 2008 All Rights Reserved


Welcome to East of The L.A. River


Dear All,

Welcome to East of The L.A River, a blog that has been long in coming.

I'll explore things that catch my eye and ear as well as the ocassional note about the world of language, culture, the arts, healing and food.

More than anything I am a musician. And even though I don't always play for an audience on a stage with fancy lighting and the finnicky stage manager, music is at the heart of how I see and interpret the world.

Years ago I spoke to Roger Bobo, principal tuba player with the Los Angeles Philharmonic. At the time I was looking for a tuba teacher for a young student whose family could not afford private lessons. In our conversation we both lamented that the public school system in Los Angeles had given itself a lobotomy by getting rid of the arts. And although a few aspects of the arts have trickled back into the lives of L.A.'s children, for the most part the doors of access to arts education in Los Angeles remain slammed shut. With every budget crisis emanates the old howling, the cry for getting rid of the frills, for getting rid of the things of the soul, for getting rid of the arts.

Still, among the tenacious beauty of thorny cactus flowers and potted geraniums overflowing in recycled bathtubs and coffee cans, through the miracle of oral tradition, in the obsidian of ancient memories and the vibrant energy of a volcanic youth, the people and their arts continue to thrive East of the L.A River. We are inevitable.


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© María Elena Gaitán, 2008 All Rights Reserved