The publisher Routledge is well known for its Handbooks and I was glad to see the publication, in 2021, of The Routledge Handbook of Translation and Health, edited by Şebnem Susam-Saraeva and Eva Spišiakovà. The title of the introduction, “Beyond Translation Studies and Medicine: Initiating Exchanges between Translation Studies and Health Humanities”, emphasises the need to explore the relationship between Translation Studies and Health Humanities, rather than Medicine per se. Indeed, the editors make it clear from the outset that their book does not merely focus on medical translation, but rather on the relationship between translation and health. This perspective makes it possible to broaden the themes discussed. As such, and the reading of the book confirms this, readers who wish to cover a vast array of diverse topics related to health and translation / interpretation will be quite satisfied.
This initiative is welcomed, as it has many merits. Notably, it brings together researchers from very different backgrounds. In the introduction, the editors emphasise the difficulty of the undertaking: they explain that they were not able to find researchers who could address what they considered essential topics, despite the enormous importance of health-related translation around the world and throughout history. Interestingly, they underline the challenges involved in reflecting on translation and interpretation in the health field in a period marked by the COVID-19 pandemic, during which the book was partly produced — a time of crisis that should lead us to question various communication practices, including some which were previously well established and which were challenged by the urgency of the situation.
In addition to the two editors, the book brings together a further 29 authors, who produced 23 chapters, divided into four sections. The majority of the authors (22) reside in Europe, while 9 are from other parts of the world (Canada [2], the United States [5], Brazil [1], South Korea [1]). European contributors include scholars from Belgium (1), Denmark (2), Ireland (1), Italy (3), the Netherlands (1), Norway (5), Poland (1), Scotland (4+1 [Austria]), Spain (3). Most of them are well established in their respective careers, some of them are at the beginning of theirs, while others are already retired. They come from a variety of backgrounds and therefore examine the topics covered from different perspectives. Professors teaching translation or medical interpreting are less represented than researchers motivated by activism, feminism and gender studies, starting with the book editors. Two authors focus on terminology and two others address technology-related aspects of translation. It should be noted that the authors make every effort to define the concepts they use, they outline future research perspectives and provide the reader with endnotes as well as bibliographical references.
The first section, entitled Travels of Medicine from Ancient to Modern Times and comprised of three chapters, addresses historical aspects of medical translation. Three topics are discussed: translation from Greek into Arabic (9th century CE) as well as from Arabic into Hebrew (12th-14th centuries) (van Dalen, US), translation of Western texts in East Asia in the late 19th and early 20th centuries (Kang, South Korea), and the importance of translation in the dissemination of academic medical research in the past and present (Quijada Diez, Spain). Van Dalen focuses on the practices of prominent translators and provides insight into the dynamics of medical translation in the two time periods studied, as well as its significance for various communities. Kang highlights aspects of the dissemination and reception of Western medical practices through translation, including power relations and the influence of the goals of the actors and institutions involved in knowledge mediation. Quijada Diez, for her part, offers a historical panorama in which the emergence of the printing press marked a turning point. She is also interested in current practices in the dissemination of medical knowledge and she underlines the global importance of English in this specialised field.
The second section is entitled Translation in Medicine and Medical Sciences. In the first chapter, Buysschaert (Belgium) reviews a number of difficulties related to medical terminology, providing examples from different languages. He also describes certain discourse-related challenges found in different types of communication and addresses various technological aspects related to terminology management. In addition, he provides numerous references to useful websites. Karwacka (Poland) tackles the issues of quality, readability and accessibility, which are important factors in patient safety, and which influence the quality of health services. These factors take on even more importance when conducting clinical trials. She rightly points out the conflicts between expectations and reality as well as the tensions between literal and semantically accurate translations. In a similar vein, Brøgger and Korning Zethsen explore the interlingual and intralingual translational dimensions of medical information, from a patient-centred perspective which focuses on comprehensibility. According to the authors, medical terminology is not solely responsible for the difficulties encountered by patients and translators; discursive practices may also hinder understanding. The effects of the increasing use of and reliance on machine translation cannot be ignored. Haddow, Birch and Heafield (Scotland) provide an overview of machine translation, reviewing its different paradigms and assessing recent developments. They discuss how MT can be used and integrated into a workflow and they analyse two different projects. Montalt (Spain) focuses on the intersection of the medical translation field and medical humanities, an interdisciplinary and cross-cultural field. After a historical overview, the author describes the current situation, arguing that the usual context requiring professional medical translation is frequently linked to a specific framework derived from positivist presuppositions of modern medicine. He pleads for a greater presence for medical humanities, which could take greater account of individuals and their personal histories. At this intersection, language professionals could be particularly helpful. Finally, Ødemark, Fraas Henrichsen and Engebretsen (Denmark) explore the concept of knowledge translation in relation to knowledge diffusion within medicine. Initially approaching the issue from a historical perspective, the authors argue that the concept could be enriched by insights from Translation Studies, to the point where science and translation become inseparable.
The third section, entitled Translation and Interpreting in Healthcare Settings, brings together contributions that focus on specific situations or communities. Downing (US) discusses community interpreting. He provides a general description of practices before turning his attention to medical and healthcare interpreting and the specificities of the settings in which it is practiced. Antonini and Torresi (Italy) present the underresearched practice of children working as interpreters or translators within their immigrant families (Child Language Brokering). The authors discuss the legal implications of this practice and point out that the literature on it is mostly found within the theoretical framework of human rights, equality and quality of care as well as in medical ethics. They then describe a case study from Italy. Dean (U.S.) examines ethical issues of medical or healthcare interpreting that arise when patients do not speak the language of healthcare providers. This contribution focuses on different ethical codes used and their content. Lázaro Gutiérrez (Spain) looks at practices where the interpreter provides his or her service by telephone. Although remote interpreting offers certain advantages, it also presents specific difficulties, notably the lack of any specific context. Moreland and Swabey (US) reflect on interpreting in healthcare settings with deaf people. They argue that these communities are characterised by a diversity that is sometimes underestimated.
The fourth section, entitled Areas of Health, includes nine chapters that deal with a wide variety of translation or interpretation situations, some of which could have been included in the third section (the chapters by Nilsen and Bot). Here, a number of extreme situations are addressed. Caldwell (Ireland) discusses translation and interpretation in disaster situations, the definition of which has been proposed by the United Nations Office for Disaster Risk Reduction (UNISDR Annual Report 2017), but whose conceptual boundaries are not always clear. The author emphasises the importance of language and communication — and therefore translation and interpretation — for the survival of victims. Sandset (Norway) focuses on translation in epidemic situations, specifically during Ebola epidemics. He reflects on the concept of translation in such a context and examines the issue from three points of view: the management of the epidemic on the spot; an analysis from anthropological perspectives; and the transfer of knowledge between languages and/or cultures. Nilsen (Norway) examines interpreter-mediated communication with children from the perspective of both practice and research. The author emphasises the importance of taking into account the particular needs of children, compared to adults. Spišiakovà (Scotland/Austria) looks at disability in translation. The author highlights the activism that has worked against the marginalisation of people with disabilities in line with equal rights concerns. Both chapters by Nilsen and Spišiakovà point out at areas that are too often understudied. The authors plead for a greater visibility of approaches which could lead to a more inclusive society. Baldo (Italy) discusses queer feminism and sexual health. In this chapter, invoking Feminist theories which are influential in some regions of the world, the author takes a deliberately activist approach to the need to challenge patriarchal notions of health and forms of censorship. The collective dimension of translation is addressed, for example in relation to the role of volunteers and activists. Bessaïh (Canada) discusses women's health. She contrasts her definition of this term with that adopted by various international organisations and recalls the notions of ‘agency’ and ‘empowerment’. She then looks at the characteristics of discourses on health and the body. Finally, she analyses two major internationally known texts, Our Bodies, Ourselves and The Vagina Monologues. Susam-Saraeva (Scotland) and Carvalho Fonseca (Brazil) focus on maternal and neonatal health and present projects which intervene in this field in different ways but which have in common a feminist approach, in opposition to patriarchy and capitalist exploitation. The authors raise the difficulties that come with interpreting in maternal and neonatal contexts and pay particular attention to childbirth narratives and the translation of (text)books on pregnancy and childbirth. Bot (Netherlands) is interested in dialogue interpreting in mental healthcare. She also underlines the difficulties that patients encounter when they do not share the language with their caregivers. She puts forward the concept of ‘therapeutic talk’, defined as the “interactions that take place between a variety of mental health workers [...] and their patients” (370-378). Using numerous examples, she illustrates the challenges at the heart of these situations and offers insights for interpreter training. Desjardins (Canada) concludes the book with a chapter on translation and nutrition, an area which, in her opinion, is under-explored. She raises the issue of access to vital information in relation to various communities (immigrants, First Nations), using the example of the translation of Canada's Food Guide. She also reflects on the effects of machine translation and the challenges posed by the cultural component of nutrition.
The variety of topics and situations covered in this tome makes it quite fascinating. Feminist and activist perspectives are dominant, which makes sense given the theoretical orientations of the book editors. The book opens many doors to rarely discussed topics and is a plea for a greater role for language professionals within health care. The reader is able to grasp the deeply human issues at the heart of translation and interpretation in healthcare settings. However, some important aspects of medical translation are not discussed in depth: the training of language professionals in this field is not directly addressed, although it is mentioned in a number of chapters, nor are the specific challenges faced in the labour market due to the increasing automation of practices and the growing influence of translation multinationals. It should be noted that the bibliographies contain many works published in academic journals not specifically devoted to translation. This is consistent with the difficulties encountered by the Handbook's editors in finding authors for addressing some specific areas and noteworthy topics in this field (6). It is also consistent with our own perception of the need for interdisciplinary perspectives in research on specialised translation.
Sylvie Vandaele
Université de Montréal
E-mail: sylvie.vandaele@umontreal.ca