The research project from the Universitat Jaume I de Castellón (Spain) analyses the practice of mediation in two public hospitals in the Valencian Community through cases that involved a team of mediators over two years.
After working in CRIT research group on issues of intercultural communication, the project coordinators, Francisco J. Raga and Dora Sales, agree that this study seeks to have an applied approach in regard to mediation and interpretation in health field. This is a proposal for what is known as "action research", consisting in setting up a team of mediators that could work in public hospitals and who constantly provide feedback through their work and reflection. "Through the work of the mediating team we analyse real cases to extract some reflections, since mediation is a process of reflection: how to address a situation and how to act at a particular time", says Dora Sales, member of CRIT research group.
The selection of mediators took into account the geographical environment where they had to act and the cases that demanded further attention. Thus, over its three-year duration, the project hired two intercultural mediators with previous experience and knowledge of the Arabic language and culture to work for nearly two years in the Hospital La Fe in Valencia and the General Hospital in Castelló, since a significant casuistry in reproductive health issues was observed.
The first step was to present the service to both patients (through posters and leaflets distributed by the hospital), and to medical staff, who were sent a briefing note through the Department of Communication, in addition to call meetings to seek staff involvement.
At the hospital, mediators remained in the SAIP (Patient Attention and Information Service) and from there they went to the consultation or emergency call which demanded their presence.
The number of interventions in which mediators were involved increased over time and their work and implication were keys to solve some of the critical situations that took place. Hanane Haij, mediator in the General Hospital in Castelló, recalls the case of a Moroccan woman, admitted for emergency when she was about to give birth. The birth was complicated and, for cultural reasons, she did not accept the figure of a male midwife: "It was a tense situation where I was in constant contact with the medical staff and the patient's husband and, thanks to my proximity and understanding of their culture, the medical staff could explain the seriousness of the intervention and the fact that parents should give in for the health of the mother and baby to be born, in the absence of female midwives available at the time".
The collaboration between the Department of Translation and Communication at the UJI and the SAIP from the General Hospital in Castelló began in 2005, through an agreement established with the Directorate General of Quality and Patient Attention whereby students of the Higher Education Course in Intercultural Mediation and Interpretation in the Health Field, run for several editions at the UJI, have made interpretation and translation practices of different languages and intercultural mediation. With this experience, the SAIP fostered the creation of the Intercultural Mediation Commission in Healthcare (CMIS), whose main objectives include the elimination of cultural and communicative barriers in health care, and to promote information, education and intercultural reflection among health professionals.
So far, the work of the intercultural mediator is not recognized professionally "and the current crisis, as well as the fact that mediation is often associated in a pejorative way to immigration, further complicates its acceptance as such", laments Dora Sales.
The last action in which the authors of the project are working, funded by the former Spanish Ministry of Science and Innovation, is writing a book with interventions that reflect on the practical dilemmas of intercultural and interlingual mediation in the health field.