Translating a Problem Into a Bill

Matha Xiong is just 13. But the Chico, Calif., girl shoulders responsibilities that most children never dream of.

Whenever her Hmong-speaking parents need her to, she assumes the role of tiny interpreter. Matha has presided over her own parent-teacher conferences and those of her 12-year-old sister. On regular visits to the doctor, she relays crucial information about her mother’s painful kidney stones.

“They use really big vocabulary, but sometimes I can figure it out,” said Matha, who arrived in this growing Northern California Hmong enclave as a baby from a refugee camp in Thailand.

If a bill now winding its way through the state Legislature becomes law, however, Matha’s duties will be greatly reduced. Written by Assemblyman Leland Yee (D-San Francisco), AB 292 would ban the use of child interpreters younger than 15 by any state or local agency or program that receives state funding.

Children like Matha are known as language brokers. And across California -- where in 2000 more than 12 million people spoke a language other than English at home -- they are their parents’ bridge to survival. The kids read bills and rental agreements. They serve as doctors’ little helpers. They even facilitate police investigations and help social workers determine whether dad hit mom and why.

Studies have shown that language brokering helps young people learn sophisticated English faster than their peers while maintaining a grip on their parents’ native tongues. But there is a growing consensus that such children are saddled with an unjust burden.

Not only can their interpretations prove inaccurate -- with sometimes tragic consequences -- they can land youngsters in traumatic situations as purveyors of intimate or troubling news. The kids are also pulled out of school to help navigate agencies that Yee and others believe should provide adult interpreters.

The bill by Yee -- a child psychologist who interpreted for his parents after immigrating from China at age 3 -- would likely become the first of its kind in the country. It passed the Assembly 42 to 30 and is working its way through the Senate.

Opponents say it will backfire on those it seeks to help by compelling strapped rural doctors to shut the door on non-English-speaking Medi-Cal patients. It could also strip away the trust that children provide to immigrant parents.

“If a patient and physician together can use a young person of a certain age to interpret and both the patient and physician are comfortable with that choice, they should be able to do it,” said Dr. Anmol Mahal of Fremont, vice chairman of the California Medical Assn.’s board of trustees. “We don’t feel we should mandate this.”

Added Costs Feared

Medi-Cal reimburses doctors about $24 for a 15-minute office visit but does not cover the cost of interpreters. A professional interpreter would probably charge a minimum of $75 for such a session, Mahal said. Services that provide telephone interpretation cost about $1 a minute.

Physicians like Dr. Krystyna Belski, a pediatrician in the Central Valley town of Oakhurst, say they can’t afford to pay those amounts. Belski has been searching unsuccessfully for a Spanish-speaking partner. While she uses AT&T;’s translation line in grave hospital cases, during office visits involving fevers and coughs, she often turns to English-speaking siblings of the babies and toddlers she treats.

“I know most of the [doctors] will simply say, ‘OK, forget it. We won’t see Medi-Cal patients who are Spanish-speaking,’ ” she said.

Others say banning the use of children as interpreters is culturally insensitive. Assemblyman Greg Aghazarian (R-Stockton) grew up translating for his Armenian mother and grandmother.

“We can’t assume that just because we have an interpreter available that someone from another culture or background will be readily open to that person,” he said. “My old Armenian grandmother -- God rest her soul -- would never have trusted” a phone translation service.

Those who would suffer most, he said, would be families who settled in less-diverse pockets of the state, where professional translators are few and far between. “What happens to the Armenian family that lives in Mono County?” he asked.

But Yee said relatives 15 and older or intimate family friends could fill the void. And some organizations pool their resources to share a translation service.

“These youngsters cannot handle the stress,” he said. “We should not rob them of their childhoods.”

As a boy in the ‘50s, Yee accompanied his mother outside the comfortable confines of San Francisco’s Chinatown to serve as interpreter. He thought nothing of his role until he became a child psychologist and witnessed traumas inflicted on other youngsters. As a newly elected assemblyman, he decided to act.

Although his bill makes an exception in situations of “hot pursuit” by police or when a person’s health or safety is in jeopardy, it is otherwise stringent, threatening to pull state funding for an entity that turns to a child for help. Yee’s bill has received support from more than two dozen groups, including the California Academy of Family Physicians, advocates for the deaf, San Francisco law enforcement associations, women’s shelters and a host of ethnic organizations.

Horror stories abound. Dr. Anne Foster-Rosales, a San Francisco obstetrician-gynecologist, recalls having to use a 12-year-old boy to tell his Vietnamese mother she had cervical cancer.

Then there was the Hmong family whose infant girl died. In seeking permission for an autopsy, UC Davis Medical Center staff turned to a sibling, who explained the procedure as “an examination.”

The family later was appalled to learn that their baby’s body had been “cut and mutilated,” said Marbella Sala, manager of medical interpreting for the UC Davis Health System, who chairs the Sacramento chapter of the California Health Interpreters Assn.

Language Barrier

There is no Hmong word for autopsy, she noted, and the sibling did not have the interpretation skills or knowledge to obtain a truly informed consent.

“They felt that not only did she die, but she died again because, in the afterlife, she’s not going to be whole,” Sala said. “They would never have consented to an autopsy. Never.”

The bill has been cheered by some children, among them Grace Zeng, a San Francisco teenager who shared her thoughts with legislators in written testimony. Grace, now 16, has served as a medical interpreter and filled out family Medi-Cal and food stamp forms since arriving from China nine years ago.

“I was always afraid that I would make a mistake and that my family would either lose our income or health care,” she wrote.

But the legislation is even more welcomed in rural places like Chico, where government agencies are less likely to provide competent interpreters.

“We have been fighting to have public agencies provide professional translators so we don’t have to rely on kids,” said Yia Lor, vice president of the Chico Hmong Advisory Council.

In one case, Chico police used a 13-year-old Hmong boy who had witnessed his father’s beating by a man yelling racial slurs to interpret at the scene. The boy had also been chased by the suspect, who then stalked and threatened the family for weeks, according to court documents.

A civil suit filed against the city and the Police Department alleges that they mishandled the case. Chico’s current police chief recently found a Hmong community member willing to serve as an on-call interpreter.

Supporters of Yee’s bill say children should not be relied upon as interpreters in sensitive situations because it is not fair to them, said Lor, 26, who as a 15-year-old in Marysville was forced to convey to his aunt during a medical visit that she had ovarian cancer.

“I wanted to translate correctly to her,” he said, “but in the back of my mind I thought, ‘Jeez, this is such bad news. I can’t even handle it.’ ”

For children like Matha Xiong, feelings are mixed. She worries that she doesn’t always understand the medical terms and sometimes chafes under the pressure but she knows that her parents rely on her.

“I’d rather help than not help,” she said.