”I’m there just to interpret, not to give advice,” said Valdez, guest relations representative at Baylor University Medical Center in Dallas. ”Translating medical terminology can be a tongue twister.”

Without her help, health-care providers and Spanish-speaking patients with limited English proficiency would be at a loss for words.

Patients at other U.S. hospitals aren’t as fortunate. Fewer than a quarter of these facilities are staffed with skilled interpreters, the journal Pediatrics reported in 2003. And most of them don’t have adequate training.

The good news is that hospitals, social service agencies and interpreter associations are taking steps to improve the numbers. They are determined to launch, sustain or expand interpreter services for an increasingly diverse pool of patients.

Almost one in five people, or 47 million of those age 5 and older, spoke a language other than English at home in 2000, up 15 million from 1990, according to the U.S. Census Bureau.

Meanwhile, the number of Spanish speakers surged 62%, rising from 17.3 million in 1990 to 28.1 million in 2000.

”The need for interpreters in the health-care setting is high,” said Elaine Quinn, administrator of cross-cultural programs at the Texas Department of State Health Services in Austin

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