Hedvig Skirgard, a Swedish linguistics student who came to Leipzig for her postdoctoral studies, had only been in Germany for a few months when she needed to see a doctor. The resulting experience still concerns her today, after several years of living and working in Germany.

“My doctor recommended a few specialists,” she said. “I contacted them using Google Translate and the little German I had acquired. I asked them if they could speak English with me, but none of them could. I asked if they could. there was an interpreting service available – there was not. A specialist suggested “I couldn’t have brought a friend or family member to interpret for me: I didn’t. no family here or friend that I feel comfortable bringing to an intimate medical discussion.

The strangest thing, she recalls, was the impression she had that doctors didn’t seem to know what to do when they didn’t speak the same language with their patients. “Could I be the first immigrant in my town to undergo a medical procedure without mastering German? Surely not?”

Skirgard certainly wasn’t. The Federal Statistical Office found in 2023 that around 15% of people living in Germany do not primarily speak German at home. And yet, as Skirgard was a little perplexed to discover, there are few systems in place when health care providers encounter non-German patients, and many doctors don’t know what systems exist. Eventually, Skirgard found a useful database of doctors who speak different languages ​​– even though her own doctor didn’t know it.

“It was stressful and scary, and I hope it doesn’t happen to anyone else. I know of other cases that went less well,” she said. “Physicians feel harassed and pressured to provide care outside of their comfort zone and capabilities.”

Healthcare translation required in other countries

It appears that the majority of German doctors would agree: in May, the doctors’ conference of the German Medical Association voted in favor of two motions demanding free professional interpreting services – on the grounds that the lack of such services made it more difficult for them to carry out their duties. jobs.

“Every day we doctors treat patients whose native language is not German,” one of the motions reads. “Often, communication is only possible with the help of family or colleagues from the medical profession, nursing staff or service personnel. This unprofessional linguistic mediation is not only a burden for the translator, but also for the medical team and patients, and it complicates the diagnosis or appropriate treatment.

Such services are not a new idea. In other European countries, it is up to the health system, rather than the patient, to find a common language. In Skirgard’s native Sweden, there is a centralized system that allows doctors to book a conference call with an interpreter if they have an appointment with a non-Swedish patient. In Norway, patients have a legal right to receive information about their health and medical treatment in a language they understand, while the Irish Health Service has issued guidelines on how doctors should find interpreters .

In Germany, doctors and patients often have to manage as best they can – sometimes relying on charities and volunteers like Communication in Medical Settings, a Leipzig-based academic group that arranges interpretation for appointments. -you to the doctor, mainly more refugees and asylum seekers.

“We see ourselves as a filler for a translation that should be done and paid for professionally,” Paulina, of Communication in Medical Settings, told DW, who preferred not to give her last name. “But we see that there is a gap, because neither the state, nor the health insurance companies, nor the doctor’s practices, nor the hospitals will take responsibility for covering the costs.”

“Nice to have” or “necessary to have”?

It turns out that Chancellor Olaf Scholz’s coalition government is aware of the problem and promised in its 2021 coalition contract that national health insurers would cover the translation costs. A spokesperson for the German Health Ministry confirmed to DW that this was still part of the plan and would recommend that the coalition parties introduce it into the health care strengthening law.

But this has not yet happened and it appears to have been blocked by disagreements within the governing coalition. Bernd Meyer, professor of intercultural communication at the University of Mainz, has been studying issues of language, integration and culture for many years and has co-authored a book of recommendations on language in public institutions. He was invited to the Bundestag last year to explain why this measure is so necessary.

“Everyone says this is a problem and needs to be solved,” he told DW. “But there is a problem in policy implementation.” Although he asserted that providing such services would be relatively inexpensive, given the overall cost of the health system, his understanding was that the coalition had, as Meyer put it, decided that translation services were considered a ” nice to have” rather than just a benefit. “need to have.”

“Essentially this has been blocked in the whole discussion about the budget and the debt brake,” he said, referring to the mechanism that forces the government to balance the books and imposes strict limits to new loans.

Germany is a multilingual society

As Skirgard and others have pointed out, Germany is working to attract a skilled workforce. According to the German Economic Institute (IW), around 570,000 jobs cannot be filled in 2023, putting businesses in difficulty. In September, Scholz signed a skilled labor agreement with Kenya to help close this gap.

Of course, some would say that German is the official language and anyone who lives here simply has to learn it. “Oh, I agree, it’s 100 percent true,” Skirgard said. “But when someone comes from Kenya in the first month and breaks a bone, shouldn’t they receive treatment before taking an intensive German course? I think that if Germany wants to be a country that attracts skilled immigrants, then translation could be a solution” “a need” and not a “nice to have”.

Indeed, as researchers like Meyer often point out, the reality is that Germany is a multilingual society. Many people rarely live in German: during his research in a hospital, Meyer met a 60-year-old Portuguese man who had suffered a heart attack, had virtually no knowledge of German, and who had worked for more than 30 years in a German slaughterhouse.

“He would carry halves of pigs all day and in the evening he would go to a Portuguese social club and watch football,” he said. “He just never had much contact with the Germans. Why should he have? His life was good. He never had any reason to learn German.”

Although, as a linguist, Skirgard learned German during her four years here, she also rarely uses it in her professional life at the university where she works. “You can say it’s bad and it shouldn’t be, and I can totally understand that point of view,” she said. “But that’s the situation, so how do you deal with what’s happening rather than what you want to happen?”

Edited by: Rina Goldenberg

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