enlarge Shawn Patrick Ouellette Staff Photographer

Interpreter Mahmad Nazir, right, listens to physical therapist Heidi Batchelder so he can translate for Anisa Hasanzadah, left, at Maine Medical Family Practice Center. Nazir and Hasanzadah are originally from Afghanistan.

POTENTIAL DEMAND FOR MEDICAL INTERPRETERS

U.S. CENSUS estimated that about 8,000 Maine residents spoke little or no English in 2000.

CATHOLIC CHARITIES resettles more than 200 new refugees in Maine a year, and estimates another 1,200 move in from other states.

Mahmad Nazir, a surgical technician before he fled the Taliban government in Afghanistan, fancied himself an expert of sorts on health and the human body.

But he couldn't understand more than a few words as his cousin interpreted for him during a physical exam he underwent shortly after finding asylum in Portland.

Did his cousin, who had arrived from Afghanistan several years earlier, know the long words that the doctor was using? Did the doctor fully understand his cousin?

Nazir couldn't say for sure. He just knew he had no other option.

Seven years and many adult education classes later, the 44- year-old Nazir is a medical interpreter himself and working to raise himself several notches above the typical bilingual speaker.

Last week he graduated from the first program in Maine aimed at professionalizing medical interpreters to better serve the state's growing immigrant population.

The training, offered by Portland-based Language Access for New Americans, is seen as a way to set skilled interpeters apart from the pack and lay the foundation for a certification program.

During the course of 100 hours of study spanning a year, students learned how to identify body parts in at least two languages. They were briefed on abbreviations such as UTI – urinary tract infection – and RLS – restless leg syndrome. They were taught the ethics of medical interpreting and that whatever a patient tells him in confidence stays between them – unless withholding that information puts the person at risk.

"If I know a patient has an allergy to penicillin from a previous visit, it is my job to tell the provider," even if she says she does not, said Nazir, who speaks Farsi, also known as Dari to Iranians.

Before the program, Nazir said, he would have been less sure of how to act in scenarios like that. The training will help him navigate one of the hazards of the job: Interpreters must operate in fuzzy zones because there are no rules to govern their work.

RAISING THE STANDARD

In Maine, virtually anybody who speaks English and another language can be an interpreter; no certification program for spoken-language interpreters exists at a federal level like there is for American Sign Language.

This makes picking an interpreter difficult for hospitals and other employers mandated by law to offer interpreters.

"Hopefully, this training will provide a standard of quality that people should expect from interpreters," said Dolgormaa Hersom, manager of the language access program. "I'm hoping this is a first step toward certification."

Several years ago, the state Legislature considered a bill to regulate the spoken-language profession, but decided there were too many languages – Sudan alone has dozens – and not enough training opportunities to make interpreter certification feasible, Hersom said.

So the United Way of Greater Portland worked with other foundations and businesses to launch the language access program in 2005. It started by providing a directory of interpreters with some form of training.

Those who work with the interpreter community around the state praised the program's foray into training.

Meryl Troop, head of language access and deaf services in the Maine Office of Multicultural Affairs, said the difference between having a trained medical interpreter or a bilingual family member could be whether the patient receives a complete and nuanced explanation of the appointment, or gets just the basic facts – or worse, the wrong information.

Troop worried that an untrained interpreter wouldn't know to distinguish between a "shooting pain" and a "burning pain." Inexperience might also lead an interpreter to omit the fact that a patient takes herbal medicine or tea, which could interact badly with conventional medication, she said.

Troop said she has too often heard stories of young children being asked to relay messages to their parents from...