Positioning of volunteer interpreters in the field of public service interpreting in Spanish hospitals

237 Pages·2012·2.27 MB·English

Positioning of volunteer interpreters
in the field of public service
interpreting in Spanish hospitals

A Bourdieusian perspective

A thesis submitted to the University of Manchester for the
degree of Doctor of Philosophy in the Faculty of Humanities

2012

María Ascensión Aguilar Solano

Centre for Translation and Intercultural Studies
School of Languages, Linguistics and Cultures
Table of Contents
TABLE
 OF
 CONTENTS
  2

APPENDICES
  5

ABSTRACT
  6

DECLARATION
  7

COPYRIGHT
 STATEMENT
  7

ACKNOWLEDGEMENTS
  8

INTRODUCTION
  9

CHAPTER
 ONE
  18

THE
 ATTITUDINAL
 AUTONOMY
 OF
 THE
 PROFESSIONAL
 HABITUS
  18

1
  INTRODUCTION
  18

2
  FIELDS
 OF
 SOCIAL
 PRACTICE
  20

2.1
  FIELDS
 AS
 STRUCTURED
 SPACES
 OF
 SOCIAL
 POSITIONS
  22

2.2
  FIELDS
 AS
 ARENAS
 OF
 SOCIAL
 STRUGGLE
  22

2.3
  FIELDS
 AND
 THE
 FIELD
 OF
 POWER
  24

2.4
  THE
 BOUNDARIES
 OF
 FIELDS
  26

2.4.1
  Doxa
 as
 the
 unquestioned
 boundaries
 of
 fields
  27

2.5
  THE
 DYNAMICS
 OF
 FIELDS:
 AGENCY
 AND
 STRUCTURE
  28

3
  CAPITAL
 AS
 THE
 FIELD
 ASSETS
  29

3.1
  ECONOMIC
 CAPITAL
  30

3.2
  CULTURAL
 CAPITAL
  31

3.2.1
  Linguistic
 capital
 as
 a
 sub-­‐type
 of
 cultural
 capital
  32

3.3
  SOCIAL
 CAPITAL
  33

3.4
  SYMBOLIC
 CAPITAL
  34

4
  HABITUS
 IN
 SOCIAL
 PRACTICE
  35

5
  THE
 PROFESSIONAL
 TRAJECTORY
 OF
 THE
 HABITUS
  38

5.1
  ATTITUDINAL
 AUTONOMY
 OF
 THE
 PROFESSIONAL
 HABITUS
  39

6
  CONCLUDING
 REMARKS
  46

CHAPTER
 TWO
  48

THE
 FIELD
 OF
 PUBLIC
 SERVICE
 INTERPRETING
 IN
 THE
 SOUTH
 OF
 SPAIN
 AND
 THE

HEALTHCARE
 INTERPRETER’S
 HABITUS
  48

1
  INTRODUCTION
  48

2
  A
 SOCIOLOGY
 OF
 INTERPRETING:
 STATE
 OF
 THE
 ART
  51

2.1
  THE
 SOCIAL
 FIELD
 OF
 PUBLIC
 SERVICE
 INTERPRETING
 AS
 PART
 OF
 THE
 BROADER
 FIELD
 OF
 TRANSLATION
 AND

INTERPRETING
  51

3
  RECONSTRUCTING
 THE
 FIELD
 OF
 PUBLIC
 SERVICE
 INTERPRETING
 IN
 THE
 SPANISH
 SOCIAL
 SPACE
  58

3.1
  ASSESSING
 THE
 STAKES
 OF
 THE
 FIELD:
 LINGUISTIC
 VS.
 CULTURAL
 CAPITAL
  62

2
3.2
  THE
 PUBLIC
 SERVICE
 INTERPRETER’S
 HABITUS:
 IN-­‐BETWEEN
 SERVICE
 PROVIDERS
 AND
 SERVICE
 USERS
  66

3.3
  AGENTS
 ACTING
 AS
 INTERPRETERS
 IN
 THE
 SPANISH
 HEALTHCARE
 SYSTEM
  72

3.4
  THE
 EFFECT
 OF
 THE
 DIVERSITY
 OF
 AGENTS
 ON
 THE
 INTERPRETER’S
 HABITUS
  74

4
  CONCLUDING
 REMARKS
  77

CHAPTER
 THREE
  78

METHODOLOGICAL
 TRIANGULATION
 OF
 FOCUS
 GROUPS,
 PARTICIPANT
 OBSERVATIONS
 AND

AUDIO-­‐RECORDINGS
 OF
 INTERPRETED
 INTERACTION
  78

1
  INTRODUCTION
  78

2
  TRIANGULATION
 OF
 DATA:
 PARTICIPANT
 OBSERVATION,
 INTERPRETED
 INTERACTION
 AND
 FOCUS
 GROUPS

  78

2.1
  PARTICIPANT
 OBSERVATION
  80

2.2
  AUDIO-­‐RECORDINGS
 OF
 NATURALLY
 OCCURRING
 DATA:
 INTERPRETER-­‐MEDIATED
 INTERACTION
  81

2.2.1
  The
 researcher’s
 presence
 during
 the
 interaction
  82

2.3
  FOCUS
 GROUPS
  83

2.3.1
  Why
 focus
 groups
 in
 the
 current
 project
  86

3
  DATA
 COLLECTION
  88

3.1
  CARRYING
 OUT
 PARTICIPANT
 OBSERVATION
 IN
 A
 HEALTHCARE
 SETTING
  88

3.1.1
  Documentary
 and
 photographic
 data
  89

3.2
  AUDIO-­‐RECORDING
 OF
 INTERPRETER-­‐MEDIATED
 INTERACTION
 AND
 DAILY
 ROUTINE
 VISITS
  90

3.3
  FOCUS
 GROUPS
 AND
 ACCESSING
 VOLUNTEER
 INTERPRETERS’
 SELF-­‐PERCEPTION
  91

3.3.1
  Why
 piloting?
  91

3.3.2
  The
 focus
 group
 guide
  92

3.3.2.1
  Logistics
 of
 focus
 groups
  93

3.3.2.2
  The
 questioning
 route
  94

3.3.3
  The
 role
 of
 the
 moderator
 as
 note-­‐taker
  100

3.3.4
  Debriefing
 session
  102

3.4
  THE
 DATA
 SAMPLE
  102

3.4.1
  Sample
 composition
  102

3.4.2
  Sample
 size
  104

3.5
  ETHICAL
 CONSIDERATIONS
  105

4
  DATA
 ANALYSIS
  107

4.1
  TRANSCRIPTION
 CONVENTIONS
  107

4.2
  ORGANISATION,
 CODING
 AND
 ANALYSIS
 OF
 DATA
  108

4.2.1
  Coding
 and
 Analysis:
 Identifying
 categories
 to
 define
 interpreters’
 positioning
 in
 the
 field
 of

healthcare
  108

5
  CONCLUDING
 REMARKS
  111

3
CHAPTER
 FOUR
  113

INSTITUTIONALISATION,
 LEGITIMISATION
 AND
 BUREAUCRATISATION
 AS
 EXTERNAL

MANIFESTATIONS
 OF
 THE
 POSITIONING
 OF
 VOLUNTEER
 INTERPRETERS
 IN
 THE
 SUB-­‐FIELD

OF
 HEALTHCARE
 INTERPRETING
  113

1
  INTRODUCTION
  113

2
  VOLUNTEER
 INTERPRETING
 IN
 THE
 COSTA
 DEL
 SOL:
 THE
 CASE
 OF
 THE
 HOSPITAL
 CLÍNICO
 AND
 THE

HOSPITAL
 COSTA
 DEL
 SOL
  114

3
  VOLUNTEER
 INTERPRETERS
 AS
 INSTITUTIONAL
 AGENTS
  118

3.1
  SYMBOLIC
 TRAITS
 OF
 INSTITUTIONALISATION:
 LEGITIMISATION
  118

3.2
  ORGANISATIONAL
 TRAITS
 OF
 INSTITUTIONALISATION:
 BUREAUCRATISATION
  139

4
  CONCLUDING
 REMARKS
  149

CHAPTER
 FIVE
  151

ALIGNMENT
 AND
 AUTONOMY
 AS
 INTERNAL
 MANIFESTATIONS
 OF
 THE
 POSITIONING
 OF

VOLUNTEER
 INTERPRETERS
 IN
 THE
 SUB-­‐FIELD
 OF
 HEALTHCARE
 INTERPRETING
  151

1
  INTRODUCTION
  151

2
  ALIGNMENT
 OF
 VOLUNTEER
 INTERPRETERS
  151

2.1
  INTERPRETERS’
 ALIGNMENT
 WITH
 THE
 HEALTHCARE
 INSTITUTION
  152

2.2
  INTERPRETERS’
 ALIGNMENT
 WITH
 PATIENTS
  160

3
  ATTITUDINAL
 AUTONOMY
 OF
 VOLUNTEER
 INTERPRETERS
  167

3.1
  THE
 INTERPRETER
 AS
 THE
 PATIENT’S
 SPOKESPERSON
  169

3.2
  THE
 INTERPRETER
 AS
 INFORMATIONAL
 GATE-­‐KEEPER
  176

3.2.1
  Monolingual
 dyadic
 interaction:
 Interpreter
 vs.
 Patient
  178

3.2.2
  Mono-­‐directional
 translation
  184

3.2.3
  Information
 screening
  190

3.3
  THE
 INTERPRETER
 AS
 LANGUAGE
 CONDUIT
  193

3.3.1
  Doctor
 corrects
 interpreter’s
 rendition
  194

3.3.2
  Doctor
 completes
 interpreter’s
 utterances
  196

3.3.3
  Doctor
 takes
 over
 interpreter’s
 turn
  199

4
  CONCLUDING
 REMARKS
  202

CHAPTER
 SIX
  204

CONCLUSIONS
  204

1
  DISCUSSION
 OF
 FINDINGS
  205

2
  IMPLICATIONS
 AND
 LIMITATIONS
 OF
 THE
 PRESENT
 STUDY
  216

3
  AREAS
 FOR
 FURTHER
 RESEARCH
  218

BIBLIOGRAPHY
  222

Final word count: 84,593
4
Appendices

Appendix I: Photographic data
1. Daily Report Book
2. Interpreters’ Archives
3. Interpreters’ Award
4. Interpreters’ ID
5. Interpreters’ office
6. Interpreters’ shift sheet
7. Patients’ library
8. Patients’ lists
9. Petrol claiming form

Appendix II: Ethical Clearance documents
1. Aprobación Comité Etico
2. Consent form in Spanish
3. Consent form in English
4. Participant information sheet for focus groups in Spanish
5. Participant information sheet for focus groups in English
6. Participant information sheet for IMI in Spanish
7. Participant information sheet for IMI in English
8. Research Ethics Declaration
9. Research Ethics statement for first stage
10. Research Ethics statement for final stage

Appendix III: Focus Group Guide
1. Concept tree
2. Focus group guide

Appendix IV: Documentary data
1. Feeling ill? Get to Spain quick
2. Interpreters’ Handbook
3. Mediadores en la Babel hospitalaria
4. ¿Que le duele qué? Comunicar para curar
5. Sol y prótesis de cadera

Appendix V: Transcriptions
1. Transcription Conventions
2. DRV 1
3. DRV 2
4. FG 1
5. FG 2
6. FG 3
7. FG 4
8. IMI 1
9. IMI 2
10. IMI 3
* Appendices are included on a CD with the thesis.

5
Abstract
17th April 2012
The University of Manchester
María A. Aguilar Solano
PhD

Positioning of volunteer interpreters in the field of Public Service
Interpreting in Spanish hospitals: A Bourdieusian perspective

This thesis sets out to investigate the field of public service interpreting in
southern Spain, with a particular emphasis on the position of volunteer
interpreters working at two different healthcare institutions. It looks at the power
relationships that develop between agents that hold different degrees of control
and autonomy, especially in a context where individuals hold different forms and
volume of capital in each encounter. Drawing on Bourdieu’s Theory of Practice,
the study offers an in-depth examination of a group of volunteer interpreters as
legitimate agents of the wider field of public service interpreting and the sub-field
of healthcare interpreting, while looking at their impact on the structures and
ethics of the larger field. This is the first project to employ Bourdieu’s theory in a
sustained case study of a healthcare context where volunteer interpreters operate
as legitimised institutional agents. One of the peculiarities of the two settings
under examination is that volunteer interpreters seem to have acquired a high
degree of institutionalisation, which provides them with a large volume of
symbolic capital and allows them to take part in the field as legitimate members of
the healthcare team, often occupying similar positions to those adopted by doctors
at the top end of the field hierarchy.

The study adopts an ethnographic approach based on a triangulation of
data: participant observation of volunteer interpreters, audio-recorded interpreter-
mediated interaction and focus-group interviews with volunteer interpreters. The
primary data that informs the thesis consists of four focus groups carried out with
volunteer interpreters in two different Spanish hospitals. The additional use of
participant observations and audio-recordings make it possible to examine not
only interpreters’ perceptions but also actual behaviour in authentic encounters,
and to compare interpreters’ perception of their positioning with the actual
positions they often occupy in the field.

6
Declaration
No portion of the work referred to in this thesis has been submitted in support of
an application for another degree or qualification of this or any other university of
other institute of learning.

Copyright Statement
I. The author of this thesis (including any appendices and/or schedules to
this thesis) owns certain copyright or related rights in it (the “Copyright”)
and s/he has given The University of Manchester certain rights to use such
Copyright, including for administrative purposes.

II. Copies of this thesis, either in full or in extracts and whether in hard or
electronic copy, may be made only in accordance with the Copyright,
Designs and Patents Act 1988 (as amended) and regulations issued under
it or, where appropriate, in accordance with licensing agreements which
the University has from time to time. This page must form part of any such
copies made.

III. The ownership of certain Copyright, patents, designs, trade marks and
other intellectual property (the “Intellectual Property”) and any
reproductions of copyright works in the thesis, for example graphs and
tables (“Reproductions”), which may be described in this thesis, may not be
owned by the author and may be owned by third parties. Such Intellectual
Property and Reproductions cannot and must not be made available for
use without the prior written permission of the owner(s) of the relevant
Intellectual Property and/or Reproductions.

IV. Further information on the conditions under which disclosure, publication
and commercialisation of this thesis, the Copyright and any Intellectual
Property and/or Reproductions described in it may take place is available
in the University IP Policy (see
http://documents.manchester.ac.uk/DocuInfo.aspx?DocID=487), in any
relevant Thesis restriction declarations deposited in the University Library,
The University Library’s regulations (see
http://www.manchester.ac.uk/library/aboutus/regulations) and in The
University’s policy on Presentation of Theses.

7
Acknowledgements
This thesis was made possible thanks to the volunteer interpreters at the Hospital
Clínico and Hospital Costa del Sol, in Málaga. My deepest gratitude goes to them,
not only for their collaboration in this project, but also for the community
interpreting service they have been providing for over twenty years.
I would like to thank Dr Luis Pérez-González and Dr Morven Beaton-Thome
for all their ideas and comments, especially in the early stages when the field
seemed so broad. I am very grateful to my supervisor, Professor Mona Baker,
because she always encouraged me and gave me the motivation to work harder
and perform to the best of my ability. Her comments, suggestions and corrections
were invaluable for this dissertation and her guidance and professionalism have
been exemplary.
This final product would have not been possible without some wonderful
friends who contributed to refine the raw material: Stuart Green, Ruselle Meade
and Tom Phillips. To Andrés Lozoya, for rescuing my work. To Anna Homan, best
friend. You helped me so much. It would have not been possible without you. I will
always be indebted for all of those hours listening to interviews and proofreading
again and again. I have to make a special acknowledgement here, to Brian Rosa,
best companion, best friend. Not only did you cope with me at this tedious stage,
via endless hours of moral support and encouragement, but also you took the
time to read my work and shaped my sometimes-not-so-good English. You have
been a great inspiration to me—the radical turn of the project carries your
trademark. Can’t wait for new, enriching conversations. I’ll return the favour in
due time.
To Moira Inghilleri, for inspiring me and easing my way toward the next
stage. I look forward to it. I would like to quickly mention some great friends who
accompanied me during the past few years, and who, one way or another,
contributed to my sanity and wellbeing: Leila, Dolores, Rosana, Sole, Donn, Kelly,
Alfonso, Farah, Laia, Anabel, Mayte, Esther, and those others who I failed to
mention. Forgive my memory.

A mi padre, por su incondicionalidad y su fortaleza.

8
Introduction

The number of immigrants arriving in Spain has been growing steadily since the
early 1990s. By the end of December 2010, an estimated 4,926,608 foreigners had
been granted residence in the country, representing 10.7% of the total
population.1 This section of the population consists of a mixed group of residents
who are attracted to Spain by a variety of factors, ranging from better economic
conditions to milder weather. Andalucía is the third most popular region among
immigrants, attracting 7.7% of foreign residents, due to its geographical position
as the closest region to Northern Africa and its mild climate. However, this figure
does not reflect the influx of undocumented migrants who make their way to the
Southern Coast every year.2 Additionally, Spain also attracts millions of tourists
every year. According to the Ministry of Industry and Tourism, between January
and December 2010 52.7 million tourists visited Spain.3 This means that a very
large non-Spanish speaking sector of the population requires access to social
services in Spain, including healthcare, and because these individuals do not
necessarily speak Spanish they must depend on the mediation of public service
interpreters.
Despite these figures and the need to provide fair access to healthcare
services for all,4 hardly any financial assistance is offered to support the provision
of interpreting services, and there are no national or regional policies being put in
place at the institutions where interpreting is required.5 Consequently, those in

1 See Anuario de Estadísticas 2010 (Statistical Yearly Report Book 2010) published by the Spanish
Ministry of Work and Immigration. Available at
http://www.mtin.es/estadisticas/anuario2010/index.htm (last accessed November 2011).
2 These figures, as estimated by the Spanish Government, only reflect the number of undocumented
migrants who are deported to their countries of origin; they do not include migrants who remain
irregularly in the country. See Balance de la lucha contra la inmigración ilegal 2010 (Fight against
illegal immigration report 2010) published by the Spanish Home Office. Available at
http://www.lamoncloa.gob.es/nr/rdonlyres/98a8e368-cebf-478e-af34-
9587bd8cb3af/136523/bal_inm_ilegal_2010_mir.pdf (last accessed November 2011).
3 See Balance del Turismo en España, Año 2010 (Evaluation of Tourism in Spain, Year 2010)
published by the Spanish Ministry of Industry, Energy and Tourism. Available at
http://www.iet.tourspain.es/en-en/paginas/default.aspx (last accessed November 2011).
4 Tribe and Keefe (2009, p. 43) provide a list of existing legislation that addresses access to healthcare
services: European Convention for the Protection of Human Rights and Fundamental Freedoms
(1950); the United Nations Convention of the Rights of the Child (1989); Human Rights Act (1998);
Race Relations Amendment Act (2000); the Disability Discrimination Act (1995) and the Disability
Discrimination Act (2005).
5 See “Developing a Public Health workforce to address migrant health needs in Europe”, funded by
the International Organisation for Migration and the European Commission, looks at the situation of
migrants in countries of the EU, including Spain, and aims to facilitate their access to healthcare
services. In the particular case of Spain, providing access to interpreting services does not seem to
be a viable solution; training medical professionals to be aware of linguistic and cultural barriers is
considered more realistic. Available at http://www.migrant-health-
9
charge of healthcare services often do not have access to interpreters (even less so
to interpreters who are specialised in healthcare interpreting), and ad hoc (family
and friends) or volunteer interpreters generally have to provide the mediation
required in these contexts (see Sales Salvador, 2005; Valero Garcés & Cata, 2006).
This, together with an already diverse group of patients, creates an environment
marked by unbalanced relationships among participants. In Bourdieusian terms,
the position of the healthcare interpreter becomes key to understanding the
structures of the field6 of public service interpreting in the Spanish healthcare
context (henceforward the sub-field7 of healthcare interpreting).
The diversity of agents in the sub-field of healthcare interpreting, the
complexity of the interaction that takes place between healthcare personnel,
patients and their relatives, and the ensuing power relations that emerge in this
particular setting all render the analysis of the positioning of interpreters highly
complex (Campos López, 2005). The boundaries of the interpreter’s position in
healthcare settings are constantly (re)shaped through the negotiation of complex
issues such as confidentiality, neutrality and the evolving relationships between
doctor-interpreters—where interpreters may be seen as institutional agents
(Bolden, 2000; Davidson, 2000); and interpreter-patient—where one of the
relevant issues is that interpreters are often members of the patients’ “guest-
culture” (Baraldi & Gavioli, 2008, p. 80) or “embedded in the patient community”
(Beltran Avery, 2001, p. 13). This fluidity often means that different agents,
including the interpreter him or herself, will envisage different (ideal) positions to
be occupied by the interpreter on different occasions, hence placing the
interpreter in a liminal space characteristic of “zones of uncertainty” in Bourdieu’s
terms (Bourdieu, 2000, p. 157; Inghilleri, 2005b, p. 2).8
In order to understand and describe the degree of complexity characteristic
of these settings, it is necessary to use a flexible theoretical framework that allows
all these elements to be taken into consideration in order to offer a more reliable
account of the structures and composition of the social activity under

europe.org/files/capacity%20building%20in%20healthcare_background%20paper(2).pdf (last
accessed November 2011).
6 The concept of ‘field’ is used throughout this thesis in a Bourdieusian sense, as will be explained in
section 2 of Chapter 1 in greater detail.
7 Bourdieu uses “sub-field” in several publications to refer to a sector of a wider field; in this
particular case, I use “sub-field” to refer to the sector of the field of public service interpreting that
takes place in healthcare settings (see Bourdieu, 1983, 1985).
8 “Zones of uncertainty” are social spaces where positions are “ill-defined” and the expectations of the
habitus as regards the position it ought to occupy are not met, thus generating a problematic gap
that allows agents to bring in their own dispositions and shape the field activity (Bourdieu, 2000,
pp. 157-158). This conflicting gap can be a positive experience that will transform the “translatorial
habitus” identified by Simeoni (1998, p. 16).
10