Revue Francophone sur la Santé et les Territoires (May 2019)
Représenter la dimension spatiale des contextes d'exercice des professionnels intervenant auprès des migrants : le cas des interprètes
Abstract
The article comes back on two research projects related to medical and social interpreting. The research is pluridisciplinary and involves geography, sociology and public health. It is based on a partnership with two non-profit organisations (Réseau Louis Guilloux (RLG) in Rennes and Migrations Santé Alsace (MSA) in Strasbourg), which provide medical and social interpreting services. A territorial question arises here on two levels: a first one in regard to the territory covered by the RLG and MSA actions; a second one related to the interpreters who move between different establishments according to the requests addressed to their employing association. The article is divided in three parts. The first one, developed from the point of view of public health, reflects the current issues raised by medico-social interpreting, which reveal differences between the terms the law and the realities of its implementation. The second part comes back on the cartographic representation of the deployment of medical and social interpreters in the two study areas. Finally, the third part presents sociological and territorial scopes of interventions in the field of medical and social interpreting. The public Health system and the interpreter The Health System Modernisation Act of 27 January 2016 includes a section emphasising the importance of health and social interpreters who intervene professionally in the public health system. Article 90 lays down the principle according to which ‘linguistic interpretation aims to improve access to the rights, prevention and care of people remote from prevention and care systems, taking into account their specificities. “This law shows the effects of the mobilisation of 9 French associations that have, since 2010, carried out advocacy work for the recognition of the profession of interpreter as a profession in its own right. From a public health point of view, medical and social interpreting is a major challenge in terms of reducing social and spatial inequalities in health, especially for allophone immigrant people. Indeed, it is seen as facilitating prevention, health promotion and access to healthcare for a population that is often far from the health care system. The deployment of the interpreting services from two structures: how to map it? We built a database out of MSA and RLG interpreter agendas. In order to target a precise and comparable sample, we selected the diaries of six interpreters working in the three most mobilised languages (two interpreters in Arabic, two in Russian, and two in Albanian). The distribution of their interventions follows a logic of metropolisation and, as a result, the scale of intervention of the interpreters is concentrated on the city and agglomeration Rennes or Strasbourg. MAP (coming soon) The cartography reveals working conditions marked by mobility around metropolitan territories, in a multiplicity of health or social institutions, which underlines the multiple skills of these professionals. Cartography also reveals strong territorial differentiations and even territorial inequalities at certain scales. The RLG, for example, which has set up a network of interpreters to irrigate the entire region of Brittany, sees most of its activity, in fact, concentrated in the metropolitan areas of Rennes and secondarily in Brest. The rest of the Breton territory is marginally covered, with a polarisation towards cities (Lorient, Vannes, Saint-Brieuc), even though interpreting needs exist in many other places, especially in rural areas where, on the period studied, dozens of housing solutions were opened to accommodate people. The realities of the business Medico-social interpreting is a highly feminised profession: in 2015 at MSA, 65 out of 81 interpreters were women; at the RLG, this is the case of 14 out of 19 interpreters. Then, the vast majority of interpreters, as mentioned above, are immigrants (in the sense of INSEE, that is to say that they were born foreign in a foreign country) or born in France of immigrant parents. As highlighted by the cartographic part of the study, interpreters are asked to practice in a plurality of institutions with different interlocutors, which implies heterogeneous interpreting situations and the mobilisation of a wide range of language practices (related to the medical field, asylum, early childhood, etc.). Thus, an interpreter can ensure in one day a pediatric consultation, an intervention in shelter for asylum seekers then go to a cancer department where the medical appointment will concern a diagnostic announcement. To the emotional and intellectual charges thus induced, is added the confrontation with specific or divergent expectations of the professionals. Moreover, for the interpreters, the sociospatial breakdown of their interventions is a source of great temporal uncertainty: the daily practice of their profession is punctuated by the constraints related to travel, most of which are carried out by public transit in urban areas. A comparative perspective at the European level of the place of interpretation in public health systems could better question the French specificities highlighted in the article.
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