This Thanksgiving, one individual to have gratitude towards is Tisquantum, without whom Thanksgiving, and likely survival for the Pilgrims, would not have been possible. Tisquantum was a member of the Patuxet Tribe who endured immense hardship, including kidnapping to Europe where he was forced into slave labor. After he escaped, he found his way back to his home village, where he witnessed his tribe had been devastated by illness and eventually served an integral role welcoming newcomers to his homeland: he was the Pilgrim’s first interpreter.
Tisquantum not only bridged language divides, but he also shared his culture and knowledge, so his new neighbors could learn how to live, till the land, and thrive. As a pediatrician who cares for families who have joined our community from around the world, I share in this gratitude for access to interpreters. Health care providers are fortunate when we have certified medical interpreters available in person, on video, or by phone, but there are far too many instances, both inside and outside the health care setting, where interpretation should be standard of care but is either underutilized or entirely unavailable. Without interpretation, our neighbors may lose their legal rights to safe housing, employment opportunities, and sometimes survival itself. The United States needs a paradigm shift that reframes and reimagines the essential right to communication within and beyond health care.
In just one of many examples of breakdowns in communication because of a paucity of interpretation: one of my patient’s families recently arrived in our community after escaping violence in Afghanistan, expecting safety and security after they supported the United States armed forces abroad. They are a Pashto-speaking family, who, like many new arrivals, are learning English while navigating a new life in America. Unfortunately, they had unwelcome visitors – bed bugs and cockroaches – who made themselves far too comfortable in their new home. After over a year of infestation, the family finally received guidance from a lawyer who spoke English on their behalf to arrange a home evaluation from the city housing inspector. Despite this progress, the pests have remained, because it’s been impossible to take the final step of scheduling the exterminator’s visit. How do the landlord, the exterminator, the family, and the housing inspector share information to schedule the needed service? Despite our efforts to be intermediaries, breakdowns in communication have persisted. As a result, the family continues to suffer discomfort, unsanitary conditions, and higher risks for medical sequelae like asthma and eczema from unwelcome pests.
The United States has multiple legal protections that should ensure meaningful access to interpretation in and beyond health care settings. Section 1557 of the Affordable Care Act, Title VI of the 1967 Civil Rights Act, and Executive Orders specify interpretation requirements. Agencies that receive federal funding, even as subrecipients, are required to provide meaningful language access, but as the Migration Policy Institute recently reported, implementation, funding, and enforcement of these language access requirements are currently woefully lacking. While the legal support infrastructure is promising, the barriers to language services need to be lowered and practical steps need to be taken to ensure meaningful access to interpretation and translation.
The centrality of the right to communication needs to be equated to other essential rights like the rights to education and health care.
It is true that interpretation (spoken word) and translation (written word), especially when done well and with consideration of cultural context and nuance, require time and financial investments. Many of our neighbors who need interpreters today will no longer require them as they have opportunities to learn English. However, for families who currently have language barriers to access basic services to allow them to thrive, language rights are essential. Interpretation and translation costs need to be factored into budgets across services and sectors and incorporated from the outset for all federally funded services. This will require expanding funds allocated to agencies that will require these meaningful interpretation services.
There have been promising, innovative steps to expand meaningful language access across sectors. Connecticut, where I live, recently passed legislation to codify language access in education, or an “English Language Learners’ Bill of Rights,” which puts into place measures to support all parents and caregivers to exercise their right to language interpreters when communicating with their children’s teachers. This Language Bill of Rights is a first step, but we need to do more within and beyond classrooms and hospital rooms. As the recent Migrant Policy Institute report highlights, meaningful language access needs to be considered at all stages of deploying federal funds: from planning, to guidance, to budgeting, to monitoring and enforcement. We should support and expand these rights by devoting federal, state, and local resources. For example, agencies can develop interpreter lines to be readily accessed across sectors and add multi-lingual selections to automated phone trees to connect callers directly with interpreters. We need to raise awareness of this essential right so that service providers and individuals who prefer languages other than English are informed that language services are not only ethical and moral obligations, but also legal requirements.
This Thanksgiving, we can honor the Pilgrim’s first interpreter, Tisquantum, and the rich linguistic and cultural tapestry that now make up the United States by changing how we approach interpretation and translation. Our policymakers can do more to support meaningful language access by creating and funding easily-accessible interpretation and translation services and offering the funding, guidance, and enforcement to allow us all to access the essential right of communication.