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K'asesek'opetik. Health interpreters

A model of intercultural communication that facilitates indigenous communities' access to the public healthcare system through awareness raising and interpreter training.

Municipality

MX
San Cristóbal de las Casas, Chiapas,

Category / Sub-Category / Topic

Healthcare, Hospital Management

Type of investment needed

Grant

Associated SDGs

The challenge

Mexico has a significant proportion of indigenous population, mainly located in the center, east, south, and southeast of the country. According to the National Institute of Indigenous Peoples (INPI) and the National Institute of Statistics and Geography (INEGI), Chiapas has the largest population of indigenous language speakers, with a record of 1,500,000 people as of 2020. The state's predominant indigenous languages include tseltal, tsotsil, ch'ol, zoque, tojol-ab'al, mam, kakchiquel, lacandon, mocho, jacalteco (popti'), chuj, q'anjob'al, and akateko.

In collaboration with the main local hospitals and within the framework of the 2022 Local Innovators Program, it was identified that one of the barriers to achieving quality care and dignified treatment is communication. Although 3 out of 10 people in San Cristobal de Las Casas speak an indigenous language, the healthcare system does not have personnel who can act as interpreters, thus preventing quality communication between healthcare professionals, indigenous language speakers, and their families.

The project

The initiative aims to effectively and timely satisfy the health information needs of the population, with a view of equality, non-discrimination, and respect for the dignity and freedom of individuals, through the incorporation of Tseltal and Tsotsil-speaking interpreters in the healthcare system. This will facilitate communication processes and promoting the exercise of human rights in coordination with public health personnel. The right to use the native language is also a necessary guarantee for the fulfillment of other rights, recognizing cultural and linguistic diversity.

The initiative focuses on three strategies:

  • Training and continuous capacity building of health interpreters.
  • Training, awareness-raising, and preventive and informative campaigns with health personnel and the community to design strategies that reduce communication barriers.
  • Interpretation service to the indigenous language-speaking population during illness processes and their transit through public health services.

Know more...

San Cristóbal de Las Casas is a municipality in the state of Chiapas, Mexico. According to the 2020 INEGI census, the city's population is 215,000, of which 35% speak an indigenous language. The most spoken languages are Tsotsil (55,000 inhabitants), Tseltal (18,000 inhabitants), and Chol (2,000 inhabitants). Today, San Cristóbal de Las Casas is a cosmopolitan municipality considered the intercultural capital of Chiapas.

One of the biggest historical debts and injustices that persist in the municipality is the lack of attention from public institutions to the indigenous population in their own language. This is particularly serious in the health sector. Every year, hundreds of thousands of people attend health centers and hospitals where they cannot communicate effectively, which negatively impacts diagnoses, treatment, and follow-up. This situation, in addition to generating mistrust in public institutions, affects the health of the indigenous population and deepens inequality.

The positive impact of the Ixchel project has been significant and decisive with more than 4,500 accompaniments, of which 60% were granted to women and 40% to men, ranging in age from 15 to 60 years. Ixchel is based in the municipality of San Cristóbal de Las Casas and has a presence in the three second-level hospitals that provide care to people in the Los Altos de Chiapas region, consisting of 17 municipalities that speak Tseltal and Tsotsil: Aldama, Amatenango del Valle, Chalchihuitán, Chamula, Chanal, Chenalhó, Huixtán, Larráinzar, Mitontic, Oxchuc, Pantelhó, San Cristóbal de las Casas, San Juan Cancuc, Santiago El Pinar, Tenejapa, Teopisca, and Zinacantán.

People who have requested accompaniment from the health interpreter team have shared that there is greater confidence to ask questions about the processes and procedures that are carried out in hospitals, in addition to feeling heard by healthcare staff. Hospitals have reported greater capacity to make better diagnoses, a reduction in the time needed to seek an external translator that impacts care, a decrease in interruptions to treatment, as well as substantial improvements in productivity and dignified treatment indicators.

Therefore, we are facing a historic opportunity for indigenous language speakers to have the right to effective access to public health services and at all times receive care in their language. By acting together, government, civil society, and citizens, we will achieve that indigenous languages are valid, just like Spanish, for any public matter or procedure in the health system in Chiapas.

Given that the Ixchel project has generated acceptance, interest, and demand for the service in the health sector, it has been identified that the present initiative can strengthen it through the integration of a greater number of health interpreters who are fluent in Tseltal and Tsotsil in second and third level hospitals in the region. All of this through collaborative work with the Mexican Social Security Institute (IMSS Bienestar) and the Ministry of Health (SSA).

Our work focuses on three strategies:

  • Continuous training of interpreters in health:

Activity 1: Having a call for health interpreters.

Activity 2: Hiring interpreters and providing ongoing training.

Activity 3: Strengthening the "Model for the Training and Continuous Education of Health Interpreters" already implemented in the Ixchel project.

  • Training, awareness-raising, and preventive and informative campaigns with healthcare personnel and the community to design strategies that reduce communication barriers.

Activity 1: Linkage and coordination for the training of healthcare personnel.

Activity 2: Design of training courses for healthcare personnel.

Activity 3: Training for people in priority areas of healthcare services regarding human rights, gender perspective, interculturality, and dignified treatment.

Activity 4: Implementation of communication campaigns in hospitals and the community.

  • Interpretation service for the indigenous language-speaking population during illness processes and their transit through public health services.

Activity 1: Disaggregated systematization of the information of the accompaniments carried out in each of the hospitals.

Activity 2: Preparation of a report on results and improvements.

Activity 3: Quarterly meetings with the municipal and state change network.

Direct results

Continuous training and education of interpreters in health.

  • 10 training sessions for the team of 12 interpreters on priority health topics
  • 80% of the interpreter team accredited and certified
  • 30 printed manuals "Interpreters in Health"

Training, awareness-raising, and preventive and informative campaigns with healthcare personnel and the community to design strategies that reduce communication barriers.

  • 9 training workshops for health personnel
  • 3 informative campaigns (in the hospital) in Tseltal and Tsotsil for service users.
  • 9 Tseltal and Tsotsil spots directed towards language speakers to promote the health interpreter service in second-level hospitals in San Cristobal de Las Casas
  • 50% of health personnel trained in priority areas of hospitals.

Interpretation service for the indigenous language-speaking population during illness processes and their transit through public health services.

  • 1 disaggregated database of the accompaniments carried out by the interpreter team in hospitals. 4 meetings with the municipal and state change network.
  • 1 disaggregated database of the accompaniments carried out by the interpreter team in hospitals.
  • 4 meetings with the municipal and state change network.

Expected impact

  • 100% of public second-level hospitals in San Cristóbal de Las Casas have health interpreters by 2024.
  • 5000 annual accompaniments carried out by the health interpreter team in hospitals by 2024.
  • 50% of second-level hospital areas make use of the health interpreter service by 2024.

  • Secretary of Health of the State of Chiapas
  • Mexican Social Security Institute (IMSS Bienestar)
  • Secretary of Government of the State of Chiapas
  • Gender Violence Alert against Women (AVGM)
  • State Commission of Human Rights (CEDH)
  • State Congress of Chiapas
  • Federal Chamber of Deputies
  • Birth Council for the Prevention of Discrimination
  • National Institute of Indigenous Languages (INALI)
  • Indigenous Professional Center for Counseling, Defense, and Translation, A.C.
  • Fermín Reygadas Robles Gil, legal representative of Cántaro Azul (fermin@cantaroazul.org)
  • Liliana Lopez Arellano, coordinator of the Ixchel Project: Health Accompaniment (liliana_lopez@cantaroazul.org)
  • Lorena Gaspar Gaspar, coordinator of the K'asesek'opetik Initiative. Health Interpreters (lorena_gaspar@ixchelsalud.org)

Investment

(*): In kind/pro bonus

(**): Financing

Goods and inputs
Funds
Needed
Covered
Solicited

Kit de papelería e impresión material pedagogico (*) (**)

u$s 7000.00

u$s 2000.00

u$s 5000.00

Kit tecnológico (proyector, computadora, cámara fotográfica, equipo de video, bocina, Ipad) (*) (**)

u$s 5000.00

u$s 0.00

u$s 5000.00

Vehículo (*) (**)

u$s 25000.00

u$s 0.00

u$s 25000.00

Kit trabajo equipo intérprete (gafete, chalecho, cubre boca, filipinas, ipad, gel antibacterial, sanitizante) (*)

u$s 5000.00

u$s 5000.00

u$s 0.00

Services
Funds
Needed
Covered
Solicited

Combustible (**)

u$s 5000.00

u$s 0.00

u$s 5000.00

Hospedaje (**)

u$s 5000.00

u$s 0.00

u$s 5000.00

Transporte (**)

u$s 5000.00

u$s 4000.00

u$s 1000.00

Alimentos (**)

u$s 3000.00

u$s 1000.00

u$s 2000.00

Renta de oficina y espacio (*)

u$s 12000.00

u$s 12000.00

u$s 0.00

Especialistas en psicología para acompañar los procesos de salud mental / contención emocional (*)

u$s 10000.00

u$s 10000.00

u$s 0.00

Human resources
Funds
Needed
Covered
Solicited

2 especialistas en facilitación de procesos (**)

u$s 34000.00

u$s 24000.00

u$s 10000.00

12 intérpretes en salud (**)

u$s 220000.00

u$s 20000.00

u$s 200000.00

1 especialista en salud (*)

u$s 12000.00

u$s 12000.00

u$s 0.00

1 especialista en comunicación (**)

u$s 12000.00

u$s 2000.00

u$s 10000.00

1 especialista en interpretación (*)

u$s 12000.00

u$s 12000.00

u$s 0.00

1 especialista en audio y video (**)

u$s 12000.00

u$s 0.00

u$s 12000.00

Capacitación de la Secretaría de Salud a equipo intérprete (*)

u$s 5000.00

u$s 5000.00

u$s 0.00

Acreditación y certificación INALI al equipo intérprete (*)

u$s 5000.00

u$s 5000.00

u$s 0.00

Others
Funds
Needed
Covered
Solicited

Gastos de administración (**)

u$s 12000.00

u$s 5000.00

u$s 7000.00

Mantenimiento vehículo (*) (**)

u$s 3000.00

u$s 0.00

u$s 3000.00

TOTAL AMOUNTS:

u$s 409000.00

u$s 119000.00

u$s 290000.00

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