Mam Indigenous people come to this country and have a complete language shock. As many of them come to the United States as monolingual speakers, it becomes essentially impossible for them to understand the English-based systems that govern his country, the most prevalent of those being healthcare.
The problem arises when there are not enough interpreters to meet their healthcare needs, which becomes exacerbated when healthcare service providers are not aware of the problem in the first place. By the same token, it becomes difficult for Mam speakers to become interpreters due to a lack of incipient job security.
In an attempt to rectify these difficulties, alternative interpretation services and language interpreters have been implemented, but these solutions come with their own set of problems. In furtherance of this issue, it becomes crucial to listen to the needs of the Mam community as well as put oneself in their shoes in order to begin to comprehend the urgency of the situation.
A growing population of Mam speakers
Mam is one of 30 Mayan languages spoken by half a million Indigenous people in Guatemala and Mexico. The first influx of Mam Guatemalan migrants to the U.S. started in the 1980s as a result of a counterinsurgency operation that killed thousands of Guatemalans, according to Susanne Jones, a former professor at UC Santa Cruz. As of 2020, Mam is one of the top ten languages solicited for by the Oregon Judicial Department, despite there being only one Mam qualified healthcare interpreter.
Despite the growing population of speakers in the U.S., I had never heard of the language until a few months ago. It was through Veronica Garcia, a University of Oregon global studies graduate student, that I discovered the structural barriers that Mam indigenous women experience in healthcare.
The key problems facing Mam speakers are twofold: most people in this country speak either English or Spanish, and most Mam speakers are monolingual. When these monolingual Mam speakers go to healthcare service providers, one of three situations occurs: 1) it is assumed that they are speaking Spanish and thus are provided with a Spanish speaking interpreter, 2) Mam interpretation services occur via phone or 3) a Mam interpreter is not available. While there may be exceptions, this is the reality described by most Mam speakers.
The problems with Mam interpretation
These three situations all have one root cause: a lack of Mam interpreters available in healthcare settings. The first situation is not separate from situations two and three, but rather a precursor to them, since a Spanish speaker would quickly realize that they are not speaking Spanish. The second situation – phone interpretation – seems like a good idea in theory, but has been regarded as part of the problem by many service providers who use them.
Jackie Grijalva, the program and co-located services director at Hope and Safety Alliance, a nonprofit working to combat domestic violence, sexual assault and trafficking in Lane County, detailed the problems that occur when using phone interpretation services. Principally, there are usually connectivity issues on one of the two sides, and the translation is never exact. Most importantly, however, is the lack of empathy.
“When it comes to domestic violence, it’s a very sensitive subject,” Grijalva said. “As it is, it is really hard for [victims] to come out and say it … so when they come and they are talking to a machine, basically … it’s more like a bland story.”
Garcia echoed these sentiments. Phone interpretation is not very personal, which makes it more difficult to talk about health-related topics over the phone. If the information communicated is not accurate, as it often is not, that impacts quality of care. Whether it be erroneous prescriptions, inaccurate recommendations or missing appointments, these phone services are simply not adequate for service providers to be using in replacement of an in-person Mam interpreter.
Building greater access
Why is there such a lack of access to Mam interpreting services? One explanation is that there had never been a big enough need for them until now. Grijalva confirmed that their organization started noticing a need for Mam interpreters starting in 2019. Nurturely, a nonprofit for perinatal equity in Eugene, started to hire Mam interpreters in 2021.
This is a reasonable explanation, but not the only one. Maria Aguirre, the operations and outreach coordinator for Nurturely, explained that there are not a lot of career options within healthcare for people within the Mam community due to the need to be proficient in either English or Spanish to be able to navigate the healthcare system. Furthermore, she has noticed there to be a lack of humility from healthcare professionals who are spending increasingly less time with their patients, and therefore not cognizant of their needs – an interpreter being one of them.
Bertilda Martin-Mendoza, a professional Mam Interpreter based in Oregon, disclosed that the launch of a career as an interpreter is incredibly laborious. Martin-Mendoza is a native Mam speaker born in Guatemala who immigrated to the U.S. as a child, and now speaks English, Spanish and Mam fluently. She has been interpreting professionally since 2004, but said she started long before when she was just a teenager interpreting for monolingual Mam speakers in need. She remarked that back in 2004, she knew other Mam speakers who were interested in interpreting, but did not have the resources nor financial security to continue with it.
“Interpreting is like a small business: maybe you can make some money a month, or maybe you’re not going to make any depending on your experience and capacity, it takes time.” It was not easy for her either, having to take a job during the night while simultaneously attending school.
While entirely restructuring a deeply flawed system is not as easy as it sounds, there is hope. The fact that service providers are recognizing the growing need for interpretation services is a step in the right direction. It has become abundantly clear that Spanish interpreters and phone interpretation services are not enough. Nurturely already implemented changes in their distribution of healthcare information by creating videos voiced by a Mam interpreter and spreading it through a Whatsapp group chat of Mam women. Much like Martin, Mam children that came to the U.S. at a young age can more easily pick up English and Spanish, and therefore navigate the arduous healthcare system more easily than those that came before them, with the potential to become interpreters themselves. Pueblo Unido, the company that employs Martin, is advocating for interpreters so that they can have the resources that so many other indigenous speakers did not have 20 years ago. All of these changes will go a long way in supporting the Mam community, and Martin speaks for other interpreters when she says that they could not be prouder. In the meantime, empathy is the key. Not only from service providers, but from native English speakers who take for granted what it is like to speak the same language as their doctors, dentists and therapists.