The official languages of Bosnia are Bosnian, Serbian and Croatian.  The multiple languages of Bosnia are due to the three dominant ethnic groups:  Bosnians (44% of the population), Serbs (31% of the population) and Croats (17% of the population) and 7% represent other ethnic groups (www.bosnianembassy.org).

Interpreters who are linguistically, culturally, and socially competent, are crucial and would increase the effectiveness of visits with patients who speak little or no English.  The AT&T phone service has many drawbacks but even though on-site interpretation is important, details may be lost. The interpreter must be trained and committed to repeating every word that is said by both parties. In addition,  Vesna Sin provided a good example for why well-trained, dedicated, and well-respected  interpreters are needed. There is a 93-year-old Bosnian woman living in Utica presently, who has not received proper care for some ailments due to the lack of a knowledgeable interpreter. Vesna explained that the interpreter did not express to the doctors what the woman was requesting. He simply made decisions for her well-being on his own. Vesna said that it is frightening when  interpreters are in a position to decide important issues for a patient;  for example, what he or she thinks the patient wants or needs.  The 93-year-old woman is in good health, however, she needed cataract surgery for one eye, a special hospital bed, etc. The interpreter took it upon himself  not to express her desires to the doctors because he felt she was so old that it was not necessary.  This woman speaks no English, and is too old to learn the language, as she can not go to school, can not drive, etc.  Clearly, she needs a trained interpreter to help her get the care she and others like her deserve (interview with Vesna Sin).

Children are not equipped to perform interpretation for their elders.  Most often it has been the children who have done the interpreting for their parents or relatives. This is potentially dangerous. As one woman stated, "If you were a Bosnian woman who does not speak English but needed to go to the gynecologist, would you want to bring your son to translate for you?  No.  Therefore, you just don't go" (interview with Lidija Hamzic).

Many of the residents at St. Elizabeth’s are also from other cultures, where their first language is not English. Therefore, there is miscommunication on both sides.  It is important for the medical staff to speak slowly and clearly, further creating an atmosphere for the patient in which they feel comfortable asking the nurse or doctor to repeat him/herself (interview with Marcella Lee).  

Ways to combat the Language Barrier:
* On-site, trained interpreters should be present during all visits with patients who do not speak the language.
* Key words or descriptions of medical procedures should be written down in all the languages for which the hospital provides care.

 Information Pertaining to Bosnian Communication Provided by the Refugee Center in Utica, NY:
~It is important to remember that the following information on communication among Bosnians cannot and does not apply to every Bosnian refugee.  This is simply a generalized and simplified source of information on communication in the Bosnian culture.  We must remember that each person is an individual within an ethnic group, who may have different religious, political, social, gender and sexual backgrounds.

* A man and woman do not hold hands or touch in public.
* Touching between members of the same sex is not acceptable.
* Bosnians shake hands with the opposite sex, but it is good manners to do it very briefly.
* "Waving" motions are only used by adults to call little children.  Among the older people it is acceptable if they are about the same age, and if they are acquaintances.
* It is not considered good manners, especially among the opposite sex, to slap someone on the back.
* Talking directly about the main subject is preferable (as opposed to talking around a subject before coming to the point).
* Looking straight into someone's eyes during a conversation shows honesty and frankness.
* Losing one's temper in front of a stranger is impolite.
* Punctuality is respected, but in many cases it is not kept.
* It is good manners to greet the oldest person or family member first.