Estonia's healthcare workers left to solve language barriers on their own

Estonia's healthcare system lacks a structured, funded translation service, leaving medical workers to find their own ways of communicating with patients who do not speak Estonian, writes researcher Jekaterina Maadla, drawing on her doctoral study.

Healthcare workers surveyed for the study agreed that translating written materials is crucial: 90 percent named medication leaflets as the most important document to translate for successful treatment. Texts on patient rights, consent forms and treatment guidelines were also considered essential. While translation agencies are preferred for written materials, respondents said they should still review and edit the translated text themselves to ensure quality.

Spoken translation is more complicated

Opinions on spoken interpretation are less unified than on written translation. Professional interpreters are rarely used; instead, healthcare workers rely on colleagues, administrators, family members or even other patients. This reflects the fact that, unlike in policing or the courts, healthcare interpretation is not funded in Estonia, despite requirements under EU directives.

The study also found differences between professions: nurses tend to rely on colleagues, while doctors prefer professional interpreters, especially during consultations. However, doctors' preference often cannot be met, since Estonia no longer trains certified medical interpreters — the last relevant master's program at Tallinn University closed three years ago.

English and Russian dominate

English is the most frequently suggested language for translated written medical texts, followed by Russian; in spoken communication, the two languages are of similar importance. At the same time, some healthcare workers resist using Russian-language signs and labels for historical and political reasons, creating tension between practical necessity and language-political attitudes.

Maadla notes that Estonian healthcare policy currently does not address this issue. Translation is not publicly funded, apart from targeted support for beneficiaries of international protection — and even there it remains unclear who provides translation, and to what extent. As a result, the current system relies largely on the goodwill and improvisation of individual healthcare workers, which the author says is neither reliable nor safe.

The issue affects a large share of society, including tens of thousands of Estonian residents with limited Estonian skills — older urban residents, labor migrants, international students and refugees. The study recommends defining which documents and situations require translation, assigning responsibility for organizing and funding it, and developing a broader translation policy.