Disaster preparedness for limited English proficient communities: medical interpreters as cultural brokers and gatekeepers.

Department of Health Services, Box 357660, University of Washington, Seattle, WA 98195-7660, USA.
Public Health Reports (Impact Factor: 1.64). 122(4):466-71.
Source: PubMed

ABSTRACT Current disaster and emergency response planning does not adequately address the needs of limited English proficient (LEP) communities. The complexities of language and cultural differences pose serious barriers to first responders and emergency providers in reaching LEP communities. Medical interpreters are potential key cultural and linguistic linkages to LEP communities. This project established a collaborative partnership with the Interpreter Services department of Harborview Medical Center in Seattle, Washington. In summer 2004, a pilot assessment of the training background and work experiences of medical interpreters was conducted that focused on training needs for disaster/emergency situations. Overall, medical interpreters identified a need for disaster preparedness training and education. Medical interpreters further reported that LEP communities are not prepared for disasters and that there is a need for culturally appropriate information and education.

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    ABSTRACT: Objectives. We investigated an outbreak of carbon monoxide (CO) poisoning after a power outage to determine its extent, identify risk factors, and develop prevention measures. Methods. We reviewed medical records and medical examiner reports of patients with CO poisoning or related symptoms during December 15 to 24, 2006. We grouped patients into households exposed concurrently to a single source of CO. Results. Among 259 patients with CO poisoning, 204 cases were laboratory confirmed, 37 were probable, 10 were suspected, and 8 were fatal. Of 86 households studied, 58% (n=50) were immigrant households from Africa (n=21), Asia (n=15), Latin America (n=10), and the Middle East (n=4); 34% (n=29) were US-born households. One percent of households was European (n=1), and the origin for 7% (n=6) was unknown. Charcoal was the most common fuel source used among immigrant households (82%), whereas liquid fuel was predominant among US-born households (34%). Conclusions. Educational campaigns to prevent CO poisoning should con- sider immigrants' cultural practices and languages and specifically warn against burning charcoal indoors and incorrect ventilation of gasoline- or propane- powered electric generators. (Am J Public Health. 2009;99:1687-1692. doi: 10.2105/AJPH.2008.143222)
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    ABSTRACT: During disasters, the needs of victims outstrip available resources. Rapid assessment of patients must be performed; however, language barriers can be an impediment to efficient patient assessment, especially if interpreter resources are limited. Dependency on interpretive services requiring technology such a telephones, cell phones, and video conferencing may be inefficient, as they may be unavailable during disaster conditions. A low-tech, portable tool that aids in communication with non-English speakers would be beneficial. The medical emergency communication (MEC) book, developed at Children's Hospital Los Angeles, has the potential to be a useful tool in this capacity. The goal of this pilot study was to compare the accuracy of a newly developed disaster-focused medical history obtained from Spanish-speaking patients or caregivers using the MEC book, compared to a control group with whom no book was used. Our hypothesis was that use of the MEC book improves accuracy of medical history taking between English-only speaking health care workers and Spanish-speaking patients better than a monolingual clinician trying to take a medical history without it. We anticipated a higher overall score in the group of subjects whose histories were taken using the MEC book than in the control group. Patient satisfaction with the MEC book also was measured. (Disaster Med Public Health Preparedness. 2013;0:1-6).
    Disaster Medicine and Public Health Preparedness 10/2013; 7(5):475-80. DOI:10.1017/dmp.2013.86 · 1.14 Impact Factor


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