Language and Cultural Barriers in the Assessment of Enemy Prisoners of War and Other Foreign Nationals

The authors describe difficulties encountered in the assessment and treatment of enemy prisoners of war and foreign civilians during Operation Enduring Freedom and Operation Iraqi Freedom. Of prime concern was the complexity of evaluating and working with patients through translators. Secondary concerns included self-protective behaviors of and fears experienced by patients, which complicated the patient-provider relationship. Future difficulties could be reduced by training translators in medical interviewing, training providers in the skills used by translators, informing providers of command and political policy, and producing concrete, portable information in written or other forms for enemy prisoners to reduce inherent mistrust.