By Laura Girresch, St. Louis Post-Dispatch, December 7, 2006

A doctor at St. Louis Children''s Hospital was visiting a Spanish-speaking woman who had just had a baby, and he tried to tell her that her infant had jaundice.

As he searched for the Spanish word for yellow, which is amarillo, something close to "animal," came out, and that was all the woman needed to hear to think she had given birth to an animal.

Hysterical for about 45 minutes, she calmed down when the hospital called interpreters from a department at Barnes-Jewish Hospital to the rescue, said Barbara Bogomolov, a registered nurse and manager of a department called Refugee Health and Interpreter Services.

That department now provides interpreters full-time for St. Louis Children''s Hospital.

As the number of immigrants being treated in area hospitals increases, area health care professionals, including doctors, nurses, technicians, and medical students, are taking language classes to help them communicate better.

Washington University reports increased demand for its medical Spanish course. At the University of Missouri at St. Louis, a Colombian faculty member is teaching a medical Spanish class that started last month. And St. Louis University is setting up its first Spanish class for medical students, which will start early next year.

Bogomolov''s department has 31 people ready to speak 19 languages and dialects, ranging from Albanian to Vietnamese. The department interprets about 15 medical situations a day.

Spanish medical classes have been around for years, but workers are taking classes more often to communicate effectively with patients in an increasingly ethnically diverse St. Louis area.

According to the U.S. Census Bureau, between 2000 and 2005 the Hispanic population in the St. Louis metropolitan area grew by about 26 percent, to about 50,000. At the same time, the Asian population grew by 28 percent to about 48,000.

The foreign-born Bosnian population in the area, one of the nation''s largest, grew by 111 percent in the same time frame, to about 14,500 last year.

While classes in Spanish are available locally, Bogomolov said medical workers have to go to bigger cities to find training in some languages, such as Bosnian or Russian. Another option is to get private training from a tutor.

Bogomolov said that at Barnes-Jewish, the most in-demand languages are Bosnian, Russian and Spanish. At Children''s, the languages are Spanish, Vietnamese and Arabic. She said the fastest-growing group showing up in the hospitals is Russian-speaking Turks.

Bogomolov said medical schools are realizing they have been lacking in cultural diversity and competence. Also, she said many students are "sitting in a classroom next to a doctor that''s tri-lingual and want to learn."

Breaking the ice
Dr. Bernard Camins is an instructor of medicine at Washington University, and he treats patients at Barnes-Jewish Hospital. He specializes in treatment of infectious diseases, and many of his HIV patients speak several different African languages. He said he would have to learn several languages to be able to communicate with all of them.

Camins, who learned some Spanish growing up, takes a medical Spanish course in the evening. Even after just a few classes, he said, he feels comfortable chatting with his patients at the beginning of the visit. He uses an interpreter, but he can follow the conversation.

"I might actually exchange pleasantries in Spanish," he said. "I am comfortable as long as they speak slowly. It''s nice, more like an ice-breaker, I think."

Sarah Chen, 21, a senior pre-medical student at Washington University, is taking a medical Spanish class there.

She says there''s a good chance she''ll return to Texas, where she''s from, to work as a doctor. She thinks Spanish will be necessary in Texas, where there is such a large Hispanic population.

"I think the newer generation of doctors are" taking language classes for their work, she said. "The older generation, not so much.

"I think it has to do with the globalization of society. They''re recognizing the need for having the bilingual, trilingual ability, and they''re pursuing that a little more."

Chen''s mother speaks Chinese and Taiwanese but little English, so Chen says she is sensitive to people who need help because of language and cultural barriers.

Overcoming barriers
Health experts say those barriers need to be overcome.

Certain ethnic minorities, including Hispanics nationwide, have a disproportionately higher rate of some diseases than whites. Experts think that increasing medical workers'' knowledge of language and culture is one way to boost health care and fight the disparities.

If you can''t speak the language to your patient, "your odds of providing quality care are very short," said Dr. Ernest Moy at the Agency for Healthcare Research and Quality. Moy is one of the nation''s leading experts in health care quality and access. He said understanding the culture of patients is equally important, especially for recent immigrants.

He said there are some challenges in providing care for Muslims because of expectations and differences based on religion. He added that some Asian cultures also pose challenges because of a different concept of health care.

Moy said that because of the sheer number of Hispanics in the country, learning Spanish and learning about the Hispanic culture "is clearly where you get the biggest bang for the buck."

Nathalia Garcia is a periodontist and the new medical Spanish teacher at UMSL. She says it''s vital for doctors to be able to clearly communicate with the people they treat. "The closeness you can have with your patients is fundamental."

Languages spoken by interpreters at Barnes Jewish Hospital and St. Louis Children''s Hospital: Albanian • Af-Maymay • Arabic • Bosnian • Cantonese • French • Croatian • Dari • Ethiopian • Farsi • German • Hungarian • Japanese • Krahn • Korean • Kurdish • Liberian • Mandarin • Romanian • Russian • Serbian • Somali • Spanish • Urdu • Uzbek • Vietnamese • American Sign Language