Page 270 - Handbooks of Applied Linguistics Communication Competence Language and Communication Problems Practical Solutions

248 Celia Roberts

1984) which suggests that a “broker” is more independent than an interpreter in
initiating action in an encounter. The term “brokering” focuses on the consul-
tation as an intercultural event and not just on narrow issues of linguistic trans-
lation. Although the role of children in these intercultural encounters can lead to
the kind of problems mentioned above, research on children as brokers showed
a more mixed picture (Green, Free, Bhavnani and Newman 2005). The child
brokers often felt ignored and, contrary to good practice for professional inter-
preters, wanted to be treated as full participants in the consultation. But they
also felt there were benefits to child brokering in terms of the responsibility it
gave them and the help they could offer their families.
The interpreter-mediated consultation can produce its own misunderstand-
ings and this may be in part due to the health professionals’ own competence in
working with interpreters (Blackford 1997). Some patients prefer to communi-
cate directly with their doctor and there is some evidence that patients are sus-
picious of cultural mediators who may talk for them. Uncertainty about how talk
is interpreted may lead to mistrust that can slide into negative assumptions about
the group that speaks that language (Collins and Slembrouck in press).
Collins and Slembrouck’s study looks at alternatives to the face-to-face in-
terpreter-mediated consultation: the use of translated medical terms and phrases
and the use of telephone interpreters. In this ethnographic linguistic study of a
local community clinic in Belgium, Collins and Slembrouck show that there is
considerable unease with all these different strategies among the staff of the
clinic. A manual that consisted of key phrases, symptoms and diseases was
translated into those languages where there were few or no informal inter-
preters. However, this was found to be cumbersome and created its own
linguistic and interactional problems. Doctors preferred direct and unmediated
consultation where possible.

6. Intercultural communication in the majority language

While many of the broader cultural issues of a diverse society have been treated
in the sociological and sociolinguistic literature on health settings (see above),
the interactional dimension has received less attention. Discourse analysis
methodology has been used to focus on interactional differences and on mis-
understandings in Australian settings (Pauwels 1991; Cass, Lowell, Christie,
Snelling, Flack, Marrnganyin and Brown 2002; Manderson and Allotey 2003), in
South Africa (Crawford 1994) and in comparing doctor–patient communication
in the USA and Japan using quantitative discourse analysis (Ohtaki, Ohtakia
and Fetters 2003).
The rest of this chapter will draw on interactional sociolinguistics (Gumperz
1982, 1996, 1999, Gumperz and Cook-Gumperz in this volume) and on the de-