Résultat de la recherche
Dolmetschen, Vermitteln und Schlichten im vielsprachigen Basel: Umgang mit Diversität und Fremdsprachigkeit – Umfrage unter Leitungspersonen öffentlicher Institutionen
Survey among senior staff persons of public institutions in the city of Basel, Switzerland on coping with diversity and foreign languages
Background. As European countries become more diverse, so do the client populations in public institutions. Switzerland has, like all modern societies, been affected by major cultural and social changes, characterised by a pluralisation of lifestyles, ways of life, languages and value systems. For Swiss society as a whole and for its public institutions, this raises questions about how this pluralistic society can be held together and, more specifically, how the integration of members of immigrant groups can be supported. Integration is to be understood here as the creation of an institutional framework for social pluralism and the establishment of equal rights and non-discrimination. In practical terms, this means that everyone living in Switzerland should have equal access to the services of public institutions and that the services that these institutions offer should take into account the needs of different communities. One instrument that can contribute effectively to the inclusion of immigrant communities is intercultural mediation. By this we include three forms of mediation: linguistic mediation (interpreting), cultural mediation and conflict mediation. How do public institutions deal with diversity characterised by migration and foreign languages? Basel, one of the larger Swiss cities, is a case in point. With a high proportion of foreigners among the resident population (31%), Basel’s public institutions have been dealing with the increasing diversity of their clientele in different ways. One of them is the use of interpreters, cultural mediators and conflict mediators.
Aim and methods. The aim of this study was to examine the practices, experiences and problems of public institutions in Basel in relation to linguistic mediation, cultural mediation and conflict mediation. We undertook a cross-sectional survey using a convenience sampling approach and addressed self-administrated questionnaires to senior staff of public institutions, including health, social, education and legal services. Data collection was carried out between March and November 2004.
Results: In total, 193 senior staff persons participated in the survey. Their estimates of the proportion of migrants in their institutions varied from 33% in health services, 60% in social services, 72% in educational institutions, up to 74% in legal and police services. Senior staff also estimated the proportion of foreign language speakers, i.e. those clients that have little or no language proficiency in German. High and very high proportions of foreign language clients were found: 18% in health services, 35% in social services, 44% in education services and 71% in legal services. The estimated use of intermediaries varies widely: while most public institutions used interpreters (32% of them regularly, 49% occasionally), this is not the case with other intermediaries: institutions use intercultural mediators infrequently (9% regularly, 14% occasionally) and conflict mediators only sporadically (4% regularly, 7% occasionally).
Senior staff were also asked what type of intermediaries they used when they had to find someone that could translate between provider and client of a given language. They indicated whether they opted most often for a qualified interpreter (paid, professional, trained), a bilingual employee (someone working in the respective institution who speaks the foreign language), a client relative (family member or friend of the client who serves as an ad-hoc interpreter), and other non-professional interpreters (including volunteers such as interpreters appearing on internal lists). It appears that for most foreign-languages, professional interpreters were primarily used in about half of the public institutions. However, the use of client relatives, bilingual employees and other non-qualified intermediaries is also frequent. A the same time, senior staff rated the quality of client relatives as mostly poor or just fair, the quality of bilingual employees as fair, and the trained and professional interpreters as good or excellent.
Conclusion. Public institutions’ senior staff members are well aware of the increasing diversity of their clientele. While interpreting services appear to be routinely available in the major part of public institutions, intercultural mediation and conflict mediation is less frequent. The proxy solutions of intermediaries (client relatives, bilingual employees and non-trained interpreters) abound and are at the same time deemed of suboptimal quality. Nevertheless, we conclude that intercultural mediation offers a means of integrating immigrants, in that institutions which set up mediation services improve access to public institutions for foreign language speakers and ensure equity for diverse populations.
Ein Gesundheitsmonitoring von MigrantInnen: Sinnvoll ? Machbar ? Realistisch ?
Die vorliegende Machbarkeitsstudie informiert über die Verwendbarkeit und Tauglichkeit von bestehenden Datenbanken für die Evaluation der Gesundheit von MigrantInnen und arbeitet verschiedene Szenarien zum Aufbau eines Monitorings des Gesundheitszustandes und –verhaltens von MigrantInnen aus. Szenario 1 schlägt vor, eine schon existierende Gesundheitsbefragung durch ein Modul migrationsspezifischer Fragen zu erweitern. Szenario 2 beinhaltet ein sogenanntes Patchwork-Monitoring, in dem schon bestehende Datenbanken migrationsspezifisch untersucht werden. Szenario 3 umfasst Entwicklung, Aufbau, Stichprobenbildung von fünf ausgewählten Migrationsgruppen und die Durchführung einer Gesundheitsbefragung von Personen mit Migrationshintergrund, unter besonderer Berücksichtigung migrationsspezifischer und sprachlich angepasster Fragenkataloge
Caring for migrant and minority patients in European hospitals: a review of effective interventions
Social changes in European societies place migration and cultural diversity on the European political agenda. The European initiative Migrant Friendly Hospitals (MFH) aims to identify, develop and evaluate models of effective interventions. It has the following objectives: To strengthen the role of hospitals in promoting the health of migrants and ethnic minorities in the European Union and to improve hospital services for these groups. This report reviews models of effective intervention in the medical literature and provides the background information needed to enable partner hospitals taking part in the MFH initiative to select and implement suitable interventions. The interventions reviewed in this study are grouped in four areas: Communication, Responsiveness Empowerment of migrant and minority patients and communities. Monitoring of the health of migrants and minorities and the health care they receive.
Barrières linguistiques et communication dans une policlinique de médecine
Wie steht es mit der Verantwortung, sich mit dem Gesprächspartner communis – «gemein» – zu machen, wenn der fremdsprachig ist? Wie wird die Verantwortung für die Kommunikation wahrgenommen, wenn Sprachbarrieren bestehen? Und wie sieht diese Verantwortung im Gesundheitsbereich aus? Im Universitätsspital Genf wurde dies im Rahmen eines Pflegequalitäts-Projektes untersucht. Die Studie zeigt, dass Französisch nur in 36% aller Fälle die Muttersprache der Patienten war, welche die medizinische Poliklinik während zwei Monaten (1999) aufsuchten. Zudem sprach mehr als ein Drittel der Patienten, entsprechend den Angaben der Ärzte, nicht fliessend französisch. Die Auswertung der von Patienten und Ärzten ausgefüllten Fragebogen ergab folgende Resultate: Fremdsprachige Patienten bewerteten die Kommunikation in der Sprechstunde dann am besten, wenn ein qualifizierter Dolmetscher zugegen war, weniger gut, wenn auf eine Drittsprache ausgewichen wurde, und noch weniger gut, wenn Patientenangehörige Ad-hoc-Übersetzungsdienste verrichteten. Auf der Ärzteseite wird die Kommunikation mit französisch sprechenden Patienten durchwegs besser bewertet. Was die Kommunikation mit fremdsprachigen Patienten angeht, werden oft höhere Bewertungen der Kommunikation angegeben, wenn der Arzt allein dem Patienten gegenübersitzt (d.h. also eine «Verkehrsprache» benützt), im Durchschnitt jedenfalls höher als wenn ein Dolmetscher anwesend ist. Am wenigsten gut kam auch hier, und zwar mit weit grösseren Unterschieden, die Kommunikation mittels Angehöriger weg. Die Zufriedenheit der Ärzte mit den qualifizierten Dolmetschern war sehr gross (8,8 im Durchschnitt, bei einer Skala von 1-10).