Farrah (name changed) travelled from Iraq to Delhi for the abdominal surgery of her great-niece Basima. When Farrah is asked if this was her first time out of her country she said that it was, adding: ‘I’m not even used to stepping outdoors and now I’m here.’ Industry chambers estimate that around 230,000 foreign patients come to India each year, and their number will rise to 400,000 by 2018. The bulk of foreign patients in Delhi come from Iraq, Afghanistan and Nigeria, but there are many from other countries of West Asia, Africa and CIS too.
Many international patients like Basima speak no Hindi or English; they depend on interpreters to discuss their ailments with doctors. Private hospitals in Delhi, therefore, hire interpreters, mostly speakers of Arabic, but also those adept in Russian, French and Persian.
An ethnographic study of international medical travel to the NCR region points to the complexity involved in translation and the extra-medical care that interpreters often provide to patients. Language remains a major obstacle for foreigners despite the availability of interpreters. Interpreting is a demanding job, particularly when transmitting complex and subjective issues. It requires an understanding of medicine, a rich vocabulary to convey the nuances of feeling plus a deeper understanding of how physical and emotional states are expressed in a relevant culture. Yet some hospital administrations tend to underestimate the skills involved and do not expect interpreters to translate the relevant language perfectly. The requirements for working as a hospital interpreter are thus low; a certificate or diploma in a language is usually sufficient. No medical background is necessary; interpreters learn medical terminology during training.
Doctors, however, take a different view; they find counselling patients through an interpreter challenging. They repeatedly expressed doubts about their messages being correctly transmitted. Hospitals should not play down this uncomfortable fact. The diversity of dialects is another challenge. Most Arabic interpreters working with foreign patients are Indian Muslims who have studied Arabic but have had limited exposure to colloquial Arabic.
Ziyba is a freelance Russian interpreter whose mobile is always on. Patients call her for literally anything — to buy a bottle of water, ask for a washroom, or find out prices while shopping. She also arranges accommodation and transportation. She is available for her patients day and night, as situations demand. It is clear that Ziyba’s job as an interpreter encompasses much more than language translation; she is able to offer both practical help and emotional support to medical tourists. If a doctor asks Ziyba to convey to the family that the patient is dying, she will do so coming to terms with her own feelings. Obviously, not all interpreters go to such lengths but some do, and their support is greatly appreciated.
Patients can suffer from flawed communication even when they use an interpreter. Yet foreign patients benefit from their guidance and sympathy. Interpreters’ services come at a price, though. A foreign patient’s bill is up to 40% higher than a domestic patient’s for the same treatment.
Private hospitals catering to foreign patients underestimate the complexity of interpreting through their application of minimum standards. They also tend to overlook the extra-medical care that interpreters provide. Interpreters establish special bonds with customers that endure through time. These relationships are both personally satisfying and commercially valuable; they are likely to create more business for her and for the hospitals she works with. Hospitals in Delhi do not seem to grant credit where it is due.
Heidi Kaspar is a social geographer
The views expressed by the author are personal