I recently returned from a trip to the hospital complex on Ellis Island, the immigration center for the New York/New Jersey area that operated midway through the 20th century. It is estimated that over 12 million people came through this small plot of land in the Hudson River. There is lots of interesting history about the island as well as the operations of the hospital but I’d like to focus on a question that one person asked on the tour “what did the hospital do for the people who didnt speak English”? @ BMC, we are no strangers to the many interpreters we work with on a daily basis though I had a hard time believing that a federal government hospital in the early 1900’s could have ever been so progressive. As it turns out, the hospital employed an army of full time interpreters who often were certified in up to three languages to help those coming to the US.
Returning to the present, the Robert Wood Johnson foundation has found that “immigrants have lower rates of health insurance, use less health care and receive lower quality of care than U.S.-born population”. We aim to mitigate the effects of this at BMC with programs focused on immigrant and refugee health, by attracting providers who focus on caring for underserved people, and by working with such a robust cadre of interpreters among a myriad of other things.
The question reminded me how thankful I am as a physician to have gotten to know so many interpreters @ BMC, who allow us to provide better care to our patients, who allow us to connect with them, and who have become friends we see every day at work. Without them, the stories our patients tell would be lost. While the smiles we share with good news are possible because of Vanda or Ron, the weight of a terminal diagnosis is carried too via Pierre or Warfa.
I thought about how difficult it can be to seek medical care even today if one doesn’t understand the language. I couldn’t imagine how difficult it would have been one hundred years ago without the massive democratization of information available over the internet and without the support of friends or family whom are allowed at the bedside now, but were kept from their loved ones on Ellis Island. Medical interpreters have been acting as vital members of comprehensive care teams that continue a tradition of providing care for those who need it most since the advent of the public health service in the United States. We are unfortunately aware that inconsistencies across the country mean that someone seeking care in Boston may have access to far more resources than other parts of the country. However, that same disparity reminds us that complacency is a betrayal to the principles of immigrant health established over a century ago
The hospital on Ellis Island did have a hospice ward and those who died there were not citizens, they were not home, and they were not with their family. However, they were given high quality care. Looking out of the window, they were afforded the best view of the Statue of Liberty on the island – a reminder of the dream that we strive to achieve, a dream that wouldn’t be possible without the help we get from the interpreters we work with.