Greer, Elma 1999 Recommend Guidelines for Multilingual Materials Internet edition

Contents

Many thanks to Li Liu for her administrative assistance and to Cony Ortiz for her inspiring design. cony.ortiz-sweeney@ntlworld.com

Introduction

These guidelines have been developed through a task group of the Minority Ethnic Health Liaison Project, which is attached to the Multi-Cultural Resource Centre (MCRC). Representation and advice has been obtained from Barnardos Chinese Lay Health Project, Chinese Welfare Association, Commission for Racial Equality Northern Ireland, the Hare Krishna Food for Life Association, Northern Ireland Council For Ethnic Minorities, North and West Belfast Health and Social Services Multi-Agency Traveller’s Team, Indian Community Centre, Northern Ireland African Cultural Centre, the Health Promotion Agency for Northern Ireland, Eastern Health and Social Services Board, South and East Belfast Health and Social Services Trust, Northern Ireland Housing Executive, the Social Security Agency and the Spanish Connection.

Background

People from minority ethnic communities have been living in Northern Ireland for hundreds of years. The first Indian communities settled in the 1920’s and 1930’s, the Chinese community in the 1960’s,and the Traveller community has been here as long as the settled community. Second and third generations have been born here. At present there are an estimated 60 ethnic minority communities in Northern Ireland. These communities bring a variety of religious, cultural and linguistic traditions, contributing to the Northern Ireland community in both the public and private sectors.

Although many minority ethnic people can communicate freely in English, significant numbers are not comfortable or fluent in English and may not be literate in their mother tongue. It has been estimated that 90% of the first generation Chinese community have difficulties with English and, among others, some speakers of Urdu, Bengali, Punjabi, Hindi, Spanish, Arabic, German, French and Portuguese require interpreters.The Traveller community and other communities also have literacy needs.

Language can be at the heart of problems, leading to difficulty in accessing information and services in relation to health, social and housing needs. There is the double jeopardy of not being able to communicate and not receiving information. Access to English language classes needs to be improved for minority ethnic clients and these could be provided at the point of service delivery, such as a class on medical terms provided as part of an antenatal programme.

The provision of interpreting services and translation of materials were significant recommendations in a report on social work education provision in Northern Ireland (O’Leary, 1990). The “Speaking Out” report (a report of a conference identifying and addressing the health and social needs of ethnic minorities in Northern Ireland) stated that:

“Providers and relevant organisations should make arrangements to provide appropriate translation and interpreting services to enable access to information and services.”

There is a need for interpreters and bilingual link workers/advocates to meet the needs of minority ethnic communities throughout Northern Ireland.Some initiatives have been introduced, but there is a long way to go before we have a comprehensive service. The development of multilingual materials must occur in tandem with the development of an interpreting service, so that communication is effective and culturally sensitive. There is little point in translating a leaflet on maternity services if there are no interpreters or bilingual workers to help clients access these services.

Due to literacy levels and the needs of particularly older people and young mothers, services may be easier to explain using audiovisual materials and bilingual workers can use these. Some information also needs to be available in written form, and it is important that this information is provided effectively.

The need for guidelines in the development of multilingual materials

It has been said that there is a “ need to engage in wider discussion about appropriate policies within the health sector to improve the health of minority ethnic populations, and a need to consider how such policies can be systematically implemented.” (MCRC, 1996).

Minimal quantities of multilingual materials have been developed in Northern Ireland. However, there is a great need for increased information and for these materials to be produced in a planned manner. A survey by the Health Education Authority in England of health related agencies, suggests that translation is often an ad hoc affair (Bhatt and Trevett, 1997).Therefore, there is a need for guidelines in the development of multilingual materials so that materials are planned and disseminated in a co-ordinated manner.

The aim of these guidelines

The aim of these guidelines is to promote a strategic and coherent approach towards the development and use of multilingual materials in Northern Ireland.

The aim of multilingual materials

Any materials developed for use by minority ethnic communities in Northern Ireland should be developed in order to convey information and improve access to services.

Principles in the development of multilingual materials

If a minority ethnic community group, statutory agency or voluntary organisation wishes to develop materials for minority ethnic communities, the following principles should be adhered to:

• consult with the target audience or community at the earliest stage of production;
• check if the information you wish to translate has been developed by another agency.
• If this is the case, this information should be reviewed by minority ethnic communities and statutory organisations to check its accuracy and appropriateness in Northern Ireland;
• use a multi-agency approach to develop materials to avoid duplication and maximise community involvement, e.g. joint working with community groups, health professionals, trusts or boards, NI Housing Executive, housing associations, voluntary organisations or the Health Promotion Agency;
• a multi-agency approach requires co-ordination, leadership and clearly allocated funding;
• do not simply translate the English version as this can lead to mistranslation and cultural inappropriateness;
• the standard of translated materials should be equivalent, where appropriate, to that provided for the English speaking community;
• use results from auditing, ethnic monitoring and needs analysis in your area to determine which minority ethnic languages are appropriate for the development of multilingual materials;
• using tear off slips on existing information, in minority ethnic languages, can be a useful way of identifying needs;
• a named person should be identified in an organisation as being responsible for multilingual materials with time and resources allocated to this role;
• staff involved in developing materials should have received cultural awareness, anti-racist and communication issues training. Bilingual staff should be used where possible;
• identify staff with bilingual skills in your organisation and provide appropriate training and support to make the best of these skills;
• take into account different perceptions of health, mental illness or disability, and make appropriate modifications;
• ensure that racial and cultural diversity is reflected in all health promotion materials.

What to translate

There is an urgent need to increase the amount and use of multilingual materials in Northern Ireland. However, it is unrealistic and maybe even inappropriate to translate everything. The following have been identified as points to influence the decision of what to translate;

General points

• Charter Standards and complaints procedures;
• step by step information on how to access a service, aimed specifically at newcomers to the particular service, e.g. why and how to register with a general practitioner, the housing selection scheme;
• translate information as identified by needs analysis for particular communities;
• input from bilingual staff as to information which is needed or requested;
• extent of uptake of services;
• simple signs or instructions such as exit, toilets, queue here;
• information about how to access interpreter and bilingual workers

Points specific to health

• respond to stated community needs for particular minority ethnic communities in Northern Ireland, e.g. menopause, breast cancer, cervical smears, family planning, diet, child care and immunisations, preventative health care services, dental and eye check ups and post natal care (Out of the Shadows, 1997);
• the general health needs and strategies for the whole community in Northern Ireland (Health and Wellbeing into the Next Millennium, 1996; Well into 2000, 1997);
• need to inform the general public of specific health risks which should include minority ethnic groups;
• health promotion campaigns should include minority ethnic groups;
• epidemiological and clinical evidence about health of minority ethnic groups e.g. some minority ethnic groups are at greater risk from diabetes, hypertension stroke or coronary artery disease;

Mode of translation

With increasing advances in communication tools and information technology, it is important to consider which methods may be used to convey information appropriately to minority ethnic communities The following issues should be considered:

• bilingual link workers explaining information in a group situation or in a one to one situation is one of the best modes of translating information;
• audio/visual materials have been found to be of increasing value to minority ethnic clients;
• or an oral society such as the traveller community, information may be most effectively given through one to one lay health work or through appropriate posters or fact sheets;
• conveying information in varying languages through the media can be effective.
• internet information in minority ethnic languages, with links to appropriate web pages or databases should be a mode of translation to develop in future;
• information can be conveyed as written material. The written information should be clear, readable and culturally appropriate;
• the contents of written materials should be clear to the professionals using it, i.e. an English version of information, or a summary should be available;
• written information may be monolingual (one language) bilingual (in one Minority Ethnic language and English) or multilingual (in a range of languages). The bilingual method, with for example Cantonese on one page and English on the next page, has been stated as a preferred format (Mann-Kler, 1997)

General Approaches

It is important to ensure that multilingual materials are:

• attractive
• free of jargon
• not patronising
• relevant to the target minority ethnic group
• in the appropriate medium
• proof read by users
• culturally appropriate
• linguistically appropriate
• illustrated using appropriate images
• printed in a font size appropriate for the script or language used and accessible if targeting visually impaired e.g. font size 14 or 16 may be appropriate

Use and dissemination of multilingual materials

It is possible to have well developed, accurate and culturally appropriate materials sitting on shelves gathering dust. The following points should be considered so that materials are widely known of and used:

• materials should be made available to and distributed through minority ethnic community groups;
• these minority ethnic community groups require assistance with funding to fulfil this role;
• multilingual materials should be made available at service points, e.g. GP surgeries, hospitals, health centres, housing executive outlets, social security offices, citizen’s advice bureaux, supermarkets and to relevant professionals;
• signs locating multilingual materials, such as ‘information, please take leaflets’, should also be translated;
• statutory organisations or headquarters should be provided with a supply of multilingual materials to disseminate to staff and clients;
• a leaflet or audio/visual material should not simply be given to clients by English speaking staff, rather a bilingual link worker or interpreter should be used to explain the information and answer questions;
• discussion groups and health talks at ethnic minority community groups can be an effective way to disseminate materials.
• minority ethnic health projects should be provided with a supply of multilingual materials to disseminate to clients, e.g. MCRC Health Project, Chinese Lay Health Project;
• publicity in the media can be used to emphasise information, e.g. a new health promotion material regarding drug abuse could be publicised on television in English, Cantonese and Urdu;
• multilingual materials should be made available in libraries, leisure centres and post offices;
• minority ethnic lines of communication, such as Asian supermarkets, radio programmes, Chinese newspapers, Asian TV channel;

Evaluation of multilingual materials

It is important that feedback is given from minority ethnic clients regarding multilingual materials. The feedback should be used to evaluate the effectiveness of materials and evaluation may be facilitated in the following ways:

• use of focus groups of appropriate people to evaluate materials which have already been produced;
• use focus groups of appropriate people as a pilot study to check for mistranslation, readability and appropriateness in material being developed;
• feedback from bilingual staff;
• feedback from representatives of minority ethnic groups;
• feedback on dissemination process;
• evaluation of numbers of materials used and any change in health behaviour, or uptake of services, if possible;
• budgeting for the development of multilingual materials should include evaluation of these materials.

Conclusion

All individuals and groups of people have an equal right to accessible and appropriate care services and information. At present there is limited experience in the development of multilingual materials in Northern Ireland.  However there is a need for this to be addressed immediately. The production of multilingual materials should become an integral part of planning, and not simply a ‘special needs’ approach.

It is hoped that this booklet will be used by organisations to develop a commitment to communicate effectively with minority ethnic communities and individuals in Northern Ireland. However, an essential element in communication is the use of interpreters and bilingual link workers, and it is essential that this important element of communication is also tackled.

References

Bhatt, A. & Trevett, N. (1997) Many Voices, One Message. Guidance for the Development and Translation of Health Information. Health Education Authority.

Department of Health and Social Services (DHSS) (NI) (1996a) Regional Strategy for the Health and Social Wellbeing 1997-2002. Health and Wellbeing Into the Next Millennium (Belfast: DHSS)

Department of Health and Social Services (DHSS) (NI) (1997) Well Into 2000 (Belfast: DHSS)

Multi-Cultural Resource Centre (1996) A Literature Review Of Ethnic Minority Health And Social Needs (Belfast: Bryson House, Multi-Cultural Resource Centre, Northern Health and Social Services Board)

Mann-Kler, D (1997) Out Of The Shadows: An Action Research Report Into Families Racism and Exclusion In Northern Ireland (Belfast: Barnardos, Belfast Travellers’ Education and Development Group, Committee on the Administration Of Justice, Chinese Welfare Association, Craigavon Asian Women and Children’s Association, Indian Community Centre, Northern Ireland Council For Ethnic Minorities, Save The Children)

National Information Forum (1998) How To Provide Information Well to Bangladeshi, Chinese, Indian and Pakistani People. A Good Practice Guide (London: National Information Programme)

O’Leary, R. (1990) A Report On Social Work Education and Provision in Response to the Needs of Social Workers, Educationalists and the Minority Ethnic Communities in Northern Ireland (Belfast: Bryson house)

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