Medical Assistants Acting as Advocates while Undertaking Non-professional Interpreting Work in Medical Missionary Settings in Africa

Abstract

As early as 2002, advocacy work became the latest interest for agencies involved in international humanitarian aid (Coates & David 2002). Simultaneously, in the medical interpreting field, advocacy arises as a controversial ethical issue that has been discussed at length in the literature (Hsieh 2013; El Ansari et al. 2019) and incorporated in codes of ethics for medical interpreting (Tessier 2004). This paper analyzes the specific intersection of clinical duties and linguistic mediation, examining how medical assistants navigated their dual roles in a missionary setting. Drawing on the memoirs of Dr. Stoughton, a missionary doctor, it investigates how bilingual staff members—acting as non-professional interpreters—approached the concept of advocacy. The findings suggest that their interventions were driven not by linguistic ethical codes, of which they were unaware, but by their primary professional identity as medical providers. Consequently, what appears as “advocacy” or “censorship” in an interpreting context is better understood as clinical gatekeeping by nursing staff. The paper concludes by discussing the implications of these historical ad hoc practices for our understanding of role boundaries in non-professional medical interpreting.