Juana Vergara sits in Volunteers in Medicine's free dental clinic in Wilkes-Barre waiting to be seen.

The 39-year-old woman, who moved to Wilkes-Barre from Mexico 12 years ago, speaks Spanish and has trouble communicating with others asking her questions.

Vega is among a growing number of Spanish-speaking area residents who has difficulty accessing the health care system as a result of her language barrier.

The passage of President Barack Obama's Affordable Care Act is intended to lead to more access to health care for a greater population of citizens, including those who do not speak English. A challenge, officials said, is trying to bring the health care changes to limited-English speakers and hard-to-reach populations.

Volunteers in Medicine Free Medical and Dental Clinic, founded by Dr. Susan Sordoni to treat the working poor who are uninsured or underinsured, has recruited volunteer translators to assist with non-English-speaking patients, said Executive Director Kelly Ranieli. All forms distributed at the clinic are in Spanish and English. The clinic also has a few volunteers and health care providers who are fluent in Spanish, she said.

Yet, when Vergara and Maritza Vega visited the clinic, no translators were available.

Vega, 39, of Nanticoke, speaks Spanish. As she is being examined in a room at the free medical clinic, physician assistant and King's College teacher Pam MacNeely and physician assistant student Amanda Evans struggle to communicate with her.

"In most cases, it is very helpful if they bring someone, a family member or a friend, who speaks English and Spanish and could help interpret," MacNeely said. "That's the best scenario for them to bring someone with them into the room because that helps us be able to understand the patient. Most do speak some English, but it does make it difficult to get a good history and an understanding of what their condition is."

A small number of patients who speak Russian, Polish, Arabic and dialects from India also visit the Volunteers in Medicine Free Medical and Dental Clinic and it is a challenge at times to find volunteer translators who are fluent in these languages and can visit at the times of the patients' appointments, Ranieli said.

These situations are rare, she said. When all efforts have been expended, she said they request that the patient bring someone to help with translation.

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Health care lost in translation