A language barrier most deadly
No migraines for migrant workers from Myanmar in Samut Sakhon after case of women eating a vaginal suppository prompts mass recruitment of translators, writes Supaporn Asadamongkoln
Many migrant workers face a language barrier in Thailand but for those seeking medical attention this can have lifethreatening consequences, prompting one hospital in Samut Sakhon to recruit interpreters to ensure their safety and generally improve conditions for them here.
Packed with workers from Myanmar, Samutsakhon Hospital has employed a team of interpreters to explain everything from medical procedures to prescription labels as hundreds of workers from the neighbouring country queue up daily to see the doctors.
The hospital is overstretched and lacks sufficient manpower to provide adequate care for workers in need of treatment or who arrive to undergo medical check-up as part of the worker registration process to obtain a permit by the deadline of this June.
In one infamous example of things getting lost in translation, a doctor at the hospital was said to have prescribed medicine to a Myanmar worker, who later came back complaining the drug wasn’t of any use.
“We found out later the female patient was at her wit’s end after struggling to figure out how to use a vaginal suppository. In the end, she ate it,” said Amnouy Preukpakpoom, head of the hospital’s pharmaceutical unit.
This case set off alarm bells among staff in the pharmaceutical department, who immediately brainstormed a solution to the communication problem.
The unit has attached Myanmar-language labels on prescription drug packets and bottles, starting with vaginal suppositories.
The hospital has hired 40 interpreters to work in the “front-line” units which interact with the workers. It also deployed the interpreters to assist the mobile healthcare services which visit migrant workers in their communities in the province.
However, more interpreters were needed for the medicine-dispensing rooms, prompting the hospital to place at least two of them in the drug-dispensing unit during outpatient hours.
“When we assigned the first group of interpreters to the medicine-dispensing rooms, we were lucky they were capable. They helped to write Myanmar-language labels by hand for such medicines as eye drops, sprays and enemas. They were of tremendous help to us,” Mr Amnouy said.
“Now, we have our computer print-out, dual-language labels — Thai on one side and Myanmar on the other,” he added.
According to Mr Amnouy, the Samutsakhon Hospital is believed to be the first medical facility to come up with dual-language labelling on medicine packages.
The hospital’s IT and pharmaceutical units also shared knowledge about the labelling practice with other medical centres, he noted.
The interpreters at the medicine-dispensing rooms are temporary staff earning wages on par with Thai employees at equivalent jobs. They need to be reasonably proficient in Thai and English while their command of the Mon language, widely spoken in many parts of Myanmar, also comes in handy.
Their job description is primarily to communicate between Thai pharmacists and foreign patients as well as offer basic assistance to migrant workers employed at the hospital. However, they are barred from keying patients’ information into the computer system, Mr Amnouy said.
The interpreters typically stand close to the medicine-dispensing windows as they translate dialogue between the pharmacists and the workers. A special queue has been allocated for Myanmar workers who need assistance.
Chit Su, a 28-year-old interpreter of Mon descent, said she asks the patients’ name, illness and whether they are allergic to any medicine. After the medicine is dispensed, she explains how to use it.
She conceded it can sometimes be tricky matching the medicine, faces and the names of patients since many Myanmar people have the same name. The interpreters must be meticulous when identifying what is for who.
The hospital requires the workers to present their ID cards or passports to minimise the chance of the medicine being given to the wrong patient, she said.
“Some Myanmar workers feel confident about speaking Thai so they choose not to stand in the interpreter-assisted queue,” she said.
“However, when we asked if they understood how to take the medicine or whether they are allergic to any drugs, they were quite clueless. We make a point of telling them it would be in their best interests that they are assisted by interpreters,” Ms Su said.
Mr Amnouy said hospital staff have been sent to learn about the local culture and people’s livelihoods in Myanmar first-hand by visiting migrant workers’ communities.
Volunteers are also on hand to hold health promotion campaigns in their communities and encourage them to look after each other’s well being.
“If they are not well taken care of, that might eventually have a knock-on effect on the country’s health system,” said Mr Amnouy.
Over the past two decades, Samut Sakhon has seen one of the largest concentrations of
If they (migrant workers) are not well taken care of, that might eventually have a knock-on effect on the country’s health system.
AMNOUY PREUKPAKPOOM HEAD OF THE SAMUTSAKHON HOSPITAL’S PHARMACEUTICAL UNIT
migrant workers, particularly from Myanmar, come to work in its fishery and other industries. It has 73 migrant worker communities, each home to thousands of people.
These crowded communities are constantly at risk of public health scares and outbreaks of contagious diseases are not uncommon.
Some diseases have been discovered which were thought to have been eradicated from Thailand a long time ago, such as elephantiasis, malaria and tuberculosis.
From July to September of last year, about 300,000 documented migrant workers were living in the province, according to a labour authorities’ estimate. The actual number is expected to be considerably higher to the number of presumed illegal aliens.
Mr Amnouy, himself from Samut Sakhon, said migrant workers account for 24% of the 3,000 or so patients who visit Samutsakhon Hospital every day. The facility also offers medical checkups for those who have registered with the authorities.
He said the number spiked to 5,000 a day ahead of the March 31 deadline for illegal migrant labourers to register under a new government policy as many required a health checkup first.
This caused hospital staff to work from early in the morning until 2am or 3am the next day, he said.
After registering, the workers are entitled to free medical services from the Social Security Fund. Some choose to buy their own health insurance policies.
In some areas of the hospital, for example the maternity ward, Myanmar workers account for 55% of patients, according to statistics collected over the last three years.
Mr Amnouy said the rising number of patients is stretching the hospital’s resources and finances.
He said in March 2012, the hospital had to spend 1.29 million baht of its own money to pay for services for Myanmar workers. But that “deficit” was cut last year, he added.