Breaking the Barrier

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January 1, 2021 - Le Havre, France.

“New year, new me!” According to my camera roll, New Year’s Day was the last time I was able to document myself having normal skin. After just nine days, my once soft and clear skin that I had always prided myself on was covered in tiny papules and rashes. As the condition of my skin continued to worsen, it did not take long before my camera roll became flooded with images of my skin and corresponding screenshots to potential “Google explanations.” Never having experienced skin issues or allergic reactions before, I did not know what was going on, what to do, or who to go to. I’ll just figure this out on my own, I thought.

Fast-forward to February. Over the past couple weeks, I began to see some progress with my skin after switching to hypoallergenic products. I thought that I was in the clear and that my skin would be back to normal in no time, but this could not have been further from the truth. My face and neck soon became covered in the same bumps as before, with my eyes swollen shut like glue. Those around me quickly took notice of the redness and fresh scars around my eyes, and the severe rashes that peeked behind my mask, running down my neck. Beyond the physical discomfort came the great sense of isolation and emotional fatigue, which seemed to make my flare-ups even worse. At this point, I was afraid of my own reflection and desperate for help.

After years of studying French, I realized that I was not equipped with all the vocabulary I needed to explain my history and symptoms the way I would have in English. The added stress and nervousness did not make communication any easier. With a few translated notes typed up on my phone for guidance, I still found myself stumbling on my words trying to explain my situation to the pharmacy. I spent several weeks going back and forth to the pharmacy for help, eventually spending over €100 on ineffective skin products. I was finally able to connect with a general physician that was able to assist me. With some translation help from my teacher, I was able to get the guidance and medication that I needed to heal. Although we never really figured out the cause of my intense allergic reactions, even after returning to the US, the feeling of being heard and understood was enough to relieve me. The non-stop cycle of trial and error was over and I finally began to feel comfortable in my own skin again.

Having a strong support system made all the difference in my path to healing, both physically and emotionally. I often think back to my time in the Emergency Department and the free medical clinic, remembering the number of non-English speaking patients that were in my shoes, along with the familiar feeling of distress and frustration many of these patients faced up to this point. I realized how lucky I was to have had such a strong support system and affordable resources during some of the most physically and emotionally taxing few months of my life in a foreign country. Unfortunately, this is not the reality of at least 67.3 million people in the United States that do not speak English at home or the 80 million patients in the United States that lack health literacy for various reasons, including the language barrier. Recent studies show that the language barriers in healthcare often lead to miscommunication, patient dissatisfaction, and poorer health outcomes. Although many healthcare institutions have interpretation services available, the added cost and lengthened treatment time make the ability to understand seem like a luxury, especially when receiving treatment is already so costly.

Over this past year, the need for understanding medical and scientific information has become more important than ever. Apart from introducing many new words into our daily vocabulary, COVID-19 has also shown us how the lack of health literacy, misinformation or misunderstanding could be fatal. According to the Washington Post, “the people most likely to have low health literacy include those dying in greater numbers from covid-19: older adults, racial and ethnic minorities, nonnative English speakers, and people with low income and education levels.” In a disease like COVID-19, where unity is vital, it is important to protect our most vulnerable populations by ensuring that correct information is communicated clearly to all.

Although it is impossible to become fluent in a new language overnight, we can all help overcome the language barrier in healthcare by taking small steps in our language-learning journeys. Brush up on the language you studied in high school. Relearn medical vocabulary in your target language. Take the leap and start from scratch. Your effort to understand and support these patients during their most vulnerable experiences of their lives will mean the world to them and, most importantly, will act as a catalyst on their road to recovery.

Steph’s (unsponsored) tips on how to begin your language-learning journey:

1. Look for free resources; learning a new language should not cost you a fortune.

   1. Seek out language learning accounts on Instagram that show daily vocabulary, grammar, and pronunciation.

   2. Download Duolingo, a free app that allows you to complete activities that help with grammar, writing, vocabulary, and oral skills at your specific language level.

   3. Watch YouTube videos for grammar and pronunciation explanations and stay engaged in the language by watching Youtubers in your target language with subtitles.

   4. Seek out library books in your target language.

2. Participate in a language exchange or practice with friends, either in-person or virtually.

   1. Tandem is a free app where you can learn languages by chatting with native speakers.

   2. Connect with friends or family that speak your target language.

3. Take a formal class.

   1. If you are able to incorporate it into your course schedule, contact your foreign languages department for level placement. Practice with students in your class and take advantage of resources, such as tutoring or office hours, to solidify the material.

   2. Take a class at a community college or with a private tutor/company.

4. Make it part of your everyday life. Learning a new language is usually a difficult task, but with consistency and more exposure, it becomes much easier.

   1. Listen to music in your target language, read the lyrics and translations. There are plenty of ready-made playlists on Spotify and YouTube.

   2. Re-watch your favorite movies with the audio and subtitles in your target language

   3. Look around and try to name as many things as you can in your target language, either in your head or out loud.

About the author:

Steph is a graduate from Rowan University with a B.S. in Biological Sciences, a minor in French, and concentrations in Honors and Pre-Med Studies. She recently completed a 7-month English teaching program in France, where she gave a variety of presentations to high school students about health, social and lab sciences, technology and all things related to food and American culture. During her free time, she loves making music, cooking, and studying new languages/cultures. She is passionate about mentorship, education, community service, and public/global health and plans to incorporate these areas into her career as a physician someday.

Sources:

Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020, April 30). Implications of language barriers for healthcare: A systematic review. Oman medical journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201401/.

Baur, C., From Centers for Disease Control and Prevention, Ostrove, N., Woloshin, S., From the Veterans Affairs Outcomes Group, Schwartz, L. M., Rudd, R. E., From Harvard School of Public Health, Padmanabhan, H., Spring, F. S., Burnette, J. C., Group, F. A. H., Rosenfeld, L., University, F. N., Berkman, N. D., International, F. R. T. I., Sheridan, S. L., Donahue, K. E., Halpern, D. J., … Jr., D. P. M. (2011, July 19). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine. https://www.acpjournals.org/doi/abs/10.7326/0003-4819-155-2-201107190-00005.

Glicksman, E. (2020, August 2). Health illiteracy is nothing new in America. but the Pandemic magnifies how Troubling it is. The Washington Post. https://www.washingtonpost.com/health/health-illiteracy-is-nothing-new-in-america-but-the-pandemic-magnifies-how-troubling-it-is/2020/07/31/091c8a18-d053-11ea-9038-af089b63ac21_story.html.

McHugh, P. (2019, October 29). 67.3 million in the United states spoke a foreign language at home in 2018. CIS.org. https://cis.org/Report/673-Million-United-States-Spoke-Foreign-Language-Home-2018.