Maria Guzenko

Preparing Effective Presentations for International Audiences

If you need to give a talk about your product or service to an international audience, your slides or visual aids will likely need to be translated. Here are some ways to make sure your presentation shines in translation.

A quick reminder: in this article, I will use “translation” to refer to rendering your written content in your audience’s language. Of course, the interactive delivery of your content will need to be interpreted, and that is a separate, if related, process. Following best practices for translation will also help your interpreter team!

Use “live” text

It is a good idea to include any verbal information that needs to be translated, such as bullet points, chart labels and call-outs, or image text, as “live,” editable text and not a “flat” image. That will allow your translation team to match the typeface and formatting of the original and ensure consistency for repeated phrases using computer-assisted translation tools. If there is any content that you would like to leave untranslated, let your team know.

Leave some empty space

Depending on the language you are translating into, the resulting text may expand—be longer than the original. If you packed your slide tightly, content may move around and become hard to read. Leaving some blank space will keep the translated slides legible by eliminating the need to put the text back into position or decrease the font size.

Format intelligently

You will want to avoid spacing the elements on your slide manually. For example, avoid using carriage returns or the space bar to place various headers or paragraphs. As mentioned above, text length will likely change in translation, and the text you so carefully aligned will look sloppy as a result. Instead, use structural elements like tables, headers, and appropriate slide layouts.

Go for clarity over catchiness

Acronyms and puns may be a great mnemonic device in English, helping your audience grasp and retain a concept quickly. One well-known example from the business world is the concept of SMART goals (one possible expansion is “Specific, Measurable, Achievable, Relevant, and Time-Bound”). As catchy as these devices may sound in English, it is unlikely that your translation will have the same initial letters, rhymes, or puns, or they will have to be introduced somewhat artificially. If you know some elements of your presentation rely on wordplay, it is best to use neutral, informative phrasing in the international version.

Ultimately, it is your content and delivery that will ensure an informative, engaging presentation. Following the best practices above can help reflect that in the translated version, as well.

Why Use an Interpreter If I Speak My Client’s Language?

Sometimes a service provider has a language in common with their clients who are not fluent in the dominant language in that area. A common scenario is where a US-based provider knows Spanish on top of English. It is perfectly fine to speak that language to the client—it builds trust, eliminates the need for additional participants, and empowers the non-dominant language speaker. At the same time, it may still be a good idea to have an interpreter as part of your team.

First, not every bilingual speaker knows specialized vocabulary in both their languages. That does not mean that their language skills are somehow deficient. However, a proficient speaker of any language is unlikely to pick up specialized legal, medical, or engineering vocabulary without purposely studying it. Many polyglot professionals who got their degrees in the US admit that they can only discuss their work in English because that is the language they learned the terms of their trade in. If that is your case, an interpreter will help you with the business part of your conversation, while you may still engage in small talk and rapport-building.

Naturally, if you have the knowledge of your professional area in both languages, you can serve your client directly in the language of their preference. However, if other parties who do not speak the client’s language are present, an interpreter will make sure they are not excluded from the exchange. For example, your business partner or assistant should be able to follow the conversation and contribute to it if they so choose. Similarly, if you have a discussion with your associates in front of the client, the client should have access to that conversation. Everyone gets to speak the language they are most comfortable with, and the interpreter makes sure no one is left out.

In other words, an interpreter will let you focus on your job, without worrying about summarizing what was said for one of the parties who could not follow the conversation. An untrained bilingual speaker might gloss over some details or leave out important information, whereas trained interpreters strive to make the conversation accessible to all participants. That is why service providers who speak their client’s language should still consider using an interpreter if speakers of other languages are present.

Non-Profits and Machine Translation: (How) Should You Use It?

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If you work for a non-profit that serves speakers of languages other than English, you may find yourself using automatic translation to bridge the language barrier. It makes sense—machine translation is fast, free, and supposedly “as good as human.”

This post is not meant to dissuade you from ever using automatic translation. Instead, I would like to encourage you to use it appropriately and consider what alternatives may be a better fit in some scenarios.

How to Make It Work

Machine translation may be fine for casual, low-stakes communication that will not be publicized. Some examples may be friendly conversations and small talk, emails, directions, getting the gist of a website for your or your client’s reference. If you go that route, here are some things to consider.

Remember that Google Translator is not the only machine translation provider out there. While this service might have improved over the last decade, the output will vary depending on the language. For some language pairs, you may want to use a different provider, for example DeepL. Make a point of reading the provider’s confidentiality policy. Will it store your content on its servers as training data? If so, this option will not work for sensitive and confidential information. (Disclaimer: I do not represent or endorse any particular automatic translation provider.)

Ideally, have someone check if the resulting translation makes sense, especially if this is something your clients will refer to. Today’s automatic translation providers have shifted to neural machine translation, which may do better on fluency than prior iterations but worse on accuracy. This means that the translation may read smoothly but say something different from what you originally meant.

Write or speak in a straightforward manner that will be easy for machine translation to parse. Avoid metaphors, buzzwords, references to institutions and legal frameworks particular to your community, arcane language, and anything that may result in ambiguity and confusion. As of the time of writing this article, DeepL translated “The governor dropped the ball” into Russian as “The governor threw the ball” (Google translated the phrase literally, not picking up on the figurative meaning).

Automatic translation was not designed to be a language-learning tool. If you do use it to help your clients figure out how to say something in English, it is best to enter complete phrases rather than individual words. You will want to use this option with caution as the resulting translations could be misleading or inappropriate.

Consider Better Alternatives

Most importantly, remember that machine translation is not your only option! Here are some other ways of serving your clients.

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Written Materials

Instead of using an automated translation plug-in for your entire website, which was not written with machine translation in mind, prepare a one-page summary of your organization’s services and contact information and have it translated by a qualified professional. That way, you can be sure that the information you are giving to your clients reflects what you had in mind when you put together the English text.

Check if the information you are trying to share with your client may already be available in the language of their preference. Many state and federal agencies and major institutions like hospitals will have language access plans, which require translating important documents into the top languages of their customers.

Conversations

Similarly, for face-to-face communication, many organizations and institutions are required to provide an interpreter free of charge. For example, if you are accompanying your client to a medical appointment, it may be worth asking the front desk employee when making an appointment what options are available. If no local interpreter is available for the client’s language, consider using video or phone interpreting.

Learning English

Put together and share with your clients a list of resources for learning English. This may include podcasts, apps, or dictionaries, for example Duolingo or Randall’s ESL Cyber Listening Lab. A monolingual English dictionary for learners, like the Longman Dictionary of Contemporary English, as well as a bilingual dictionary showing words in context, like Reverso, may also help your clients build their vocabulary and decipher new words. Finally, see what in-person resources may be available in your community. Public libraries or local places of worship often offer free or affordable ESL classes.

Machine translation is a powerful and ever-improving tool for bridging the language gap. However, this technology has its limitations and may not be appropriate for every task. Consider it alongside other solutions to decide which approach will best meet your client’s needs, protect confidentiality, ensure accuracy, and honor regulatory requirements.

Tips for Getting Your Non-US College Transcript Translated

If your previous degree, diploma, or transcript is in a language other than English and you are applying to a US university, you will need to provide a translation of your academic credentials. Here are some things to consider as you prepare your translation.

Do I Need A Certified translation?

Your school’s admissions office will typically list the requirements for the transcript translations. One of the more confusing requirements may be that for a certified translation. Remember that in most US states, notaries public cannot certify the accuracy of a translation. Sometimes I get requests for translations “certified by the American Translators Association (ATA).” ATA is a professional association that does not produce or certify individual translations. It does, however, certify translators who have passed a graded exam in a specific language pair. Such a translator is called ATA-certified.

A statement by the translator, confirming the accuracy of the attached translation, will usually suffice for the purposes of certification in the US. As an added layer, the translator may get their signature certified by a notary public in their county. Again, most states’ notaries public cannot vouch for the accuracy of the translation, so they would only notarize the translator’s signature. Ultimately, the educational institution can tell you what translations it accepts.

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What About Degree Equivalence?

Differences in educational systems mean that a transcript from your home country may look different from an American one. Should the translation explain that your 5-year degree is really closed to a master’s degree than a bachelor’s? Should it calculate your grade point average (GPA) if no such information was listed in the original?

Once again, this is something you will need to follow your school’s guidance on. Some universities may require a foreign credential evaluation. Sometimes they recommend some agencies that provide this type of service. In that case, you’ll want to reach out to a credit evaluation agency, which will convert your transcript to something an American institution is familiar with, with your credit hours and GPA listed.

However, this may not be necessary in every case. If all your school requires is a translation, you don’t need to spend extra money on credential evaluation. The translation will reflect the information listed in your document, regardless of whether it typically appears on American transcripts. In all likelihood, you are not the first applicant from your country, so the US university will know that your transcript will look different. If you school does want to see an explanation of the grading scale or your GPA, you may want to go the credential evaluation route.

Can I Get the Transcripts Sent Directly in a Sealed Envelope?

Some US universities request official transcripts to be send directly by the issuing school, which is commonly done in the US. However, universities overseas may not provide that service or are even aware of it. This is something you may need to bring up to the American school.

One option is to include a cover letter with your transcript, explaining that degrees and transcripts in your home country are physical documents granted to the graduate and cannot be sent directly by the issuing institution. Another possibility is to get a credential evaluation and have that evaluation sent by the issuing agency directly to the US university. I have found, both in my experience as a college applicant with international credentials and as a translator of educational documents, that American colleges tend to be flexible with international applicants and reasonable in accommodating foreign academic documents.

My First Published Literary Translation

My colleagues might have seen this news on LinkedIn: my translation of “Tamara Khristoforovna,” a short story by Margarita Ardasheva from Russia has been published in Tupelo Quarterly.

This whimsical story of a disgruntled teacher with a hidden passion looks at being true to yourself and doing what you love. The Russian story (“Тамара Христофоровна”) first appeared in New Youth.

Tamara Khristoforovna works in Lennon Preparatory High School. She imparts high-quality, lasting knowledge, which consists of telling children that she is their mother-in-math, and they are nothing but back-alley trollops. When Tamara Khristoforovna gets really emotional, she adds that only prostitutes wear black pantyhose. What about socks and stockings of that color? The jury’s still out on that one. It is also unclear how Tamara Khristoforovna knows so much about prostitutes.

Demystifying Russian Names

If your clients or partners have Russian names, you may be unsure why there are multiple forms of the name or why the middle name is so long. Russian naming conventions may be confusing to people outside the region, and this gets compounded when people bearing these names come to the US. In this post, I will look at some sources of potential misunderstanding arising from the use of names in the Russian language—in but not limited to the country of Russia and by but not limited to ethnic Russians.

A full Russian name consists of three parts:

First or given name (imya)
Patronymic (otchestvo, more on that below)
Last or family name (familiya)

An example would be Yelena Sergeevna Malysheva. On official documents and in formal introductions, these parts may be listed as “last name—first name—patronymic (optional): Malysheva Yelena Sergeevna or Malysheva Yelena.

Full Names Vs Nicknames

The first name listed on a person’s documents will be the “full,” official form: Aleksandr, Yevgeniya, Irina, Natalya, Sergey, Ivan, etc. Unofficially, many “full” names will have at least one established corresponding pet name (think Sam for Samuel). Most speakers of Russian will know the pet equivalent for the full name or can “restore” the full name from hearing the nickname without being told explicitly. Some common pairs are given below:

Irina—Ira
Yekaterina—Katya
Mariya—Masha
Anna—Anya
Yelena—Lena (or sometimes Alyona)
Anastasiya—Nastya
Tatyana—Tanya
Natalya—Natasha
Darya—Dasha
Nadezhda—Nadya
Mikhail—Misha
Sergey—Seryozha
Vladimir—Volodya
Stanislav—Stas
Ivan—Vanya
Nikolay—Kolya
Aleksey—Alyosha or Lyosha
Pavel—Pasha
Vyacheslav—Slava
both Aleksandr and Aleksandra—Sasha
both Yevgeniy and Yevgeniya—Zhenya

In practice, a person normally has their formal name listed on their paperwork, and all their friends, relatives, and superiors will know their pet name and use that. When this person moves to an English-speaking country, however, that correspondence is not so obvious anymore. People have chosen to deal with that in different ways. Some go by their full, “formal” name, including with their friends, as I have done. Others adopt their pet name as their professional or even legal name, like the journalist Masha Gessen or sports writer Slava Malamud. A third group may pick an English name, like Katie instead of Yekaterina (Katya).

Patronymics

The second part of a typical Russian name is derived from the person’s father’s name and means “son of” or “daughter of.” Examples include Sergeevich (son of Sergey) or Andreevna (daughter of Andrey). If the father is unknown or estranged, a stepfather’s, grandfather’s, or another male figure’s name may be used. There have been cases of people using matronyms (forms derived from the mother’s name), but this practice remains uncommon.

Together, a person’s given name and patronymic serve as a polite way of addressing someone, similar to the English “Mr. Smith” or “Ms. Patel,” e.g. Yelena Andreevna or Nikolay Sergeevich. While some immigrants do retain their patronymic as their middle name, it is not truly equivalent to one in function. While a Rebecca Grace Peterson may choose to go by Grace, a Petr Ivanovich Sokolov wouldn’t normally go by Ivanovich alone (although standalone patronymics may be used as an affectionate nickname among co-workers or in rural areas).

Gendered Last Names

Many Russian last names are originally possessive adjectives derived from names of occupations, cities, animals, people, etc. As such, they have a masculine and feminine form. For example, a man’s last name is Ivanov, but the women in his family will have the last name Ivanova. This correspondence is automatic, so if, upon marrying a man called Ivan Spassky, a woman decided to take that man’s last name, her last name would become Spasskaya, not Spassky. (As far as I know, there is no established practice for non-binary people. Luckily, some last names, like mine, are “unisex” and do not have separate gendered forms.)

Of course, this Russian convention may create some issues in English-speaking countries when you have family members whose last name is a few letters off. For instance, the men of the family could have the surname Grigoryev, while the women might be Grigoryeva. I once witnessed an insurance company reject a claim because the “masculine” form of the name was listed on the paperwork for a patient who had the “feminine” form of that same name. To avoid this, some immigrant families may adopt a single spelling of their surname—usually the “masculine” form—so Anna Osetinskaya may become Anna Osetinsky. However, that’s not usually an option for visitors, students, or temporary workers, who have to keep the legal name listed in their documents.

Now you know why Natalya and Natasha are the same name to Russian ears, why related men and women have “different” last names, and why Russian “middle names” can be so long. I hope this post has helped you demystify some idiosyncrasies around Russian names.

What’s Wrong with Using Child Interpreters?

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Interpreting for your family is almost a rite of passage for bilingual children. While it may be harmless or even helpful for the family in many everyday situations, I would warn against relying on child interpreters in high-stakes situations that may have financial, legal, or medical consequences.

In my previous post I argued that bilingualism (some scholars propose the term “translanguaging” instead) is not sufficient for effective interpreting in these situations. To succeed, an interpreter needs to know how to accurately convey meaning from one language to another, how to handle contentious situations, and how to maintain professional role boundaries—hard to do when your client is a family member!

This does not imply that heritage speakers are somehow deficient. A deficit view assumes that these speakers do not have an adequate grasp on their heritage language because they learned it “socially” and not “academically.” Researchers including Dr. Nelson Flores point out that “if affluent white children were engaged in the same exact biliteracy practices they would not be positioned in this way.” Both heritage speakers and people who learned their second language in an academic setting can and should be trained—as adults—if they want to provide interpreting in high-stakes scenarios. In fact, the ATA Chronicle has published a fascinating report of how one such program for heritage speakers was implemented.

Nor am I arguing that children should never interpret—helping family members understand each other at dinner is probably fine as long as the child doesn’t mind. What I am talking about is when organizations “delegate” their legal language-access responsibilities under Title VI of the Civil Rights Act to the clients’ children, leaving the families to deal with any potential fallout. Just as you wouldn’t have a monolingual 8-year-old negotiate with your mechanic or defend you in court, it should not fall to a polyglot 8-year-old to interpret in these situations! People, including the bilingual children themselves, have suffered harm because no qualified interpreter was provided—The High Costs of Language Barriers in Medical Malpractice details the medical and legal consequences of this kind of negligence in healthcare settings.

How My Parents Almost Got Stuck with the Bill

I have a personal story, which I haven’t shared publicly until now, that illustrates why relying on your child for your language needs can quickly get messy. While purely anecdotal, it serves as my personal point of reference for the complex emotions and conflicting responsibilities a child interpreter may experience when tasked with providing language access.

When I was 12, my parents and I moved to Israel. I had only taken a few months of Hebrew before the move. I got enrolled in an Israeli middle school, where I would spend a few hours a day in a Hebrew-as-a-second-language class but, otherwise, take “mainstream” classes from day one.

On the first day of school, the first few periods were in the same classroom. Then it was time for electives. A kindly classmate tried to explain to me that I could take a lesson of my choice, perhaps math (“Matematika?” she said and, seeing the blank stare on my face, tried the Hebrew word, “Kheshbon?”). I grasped the concept of an elective fine, but I still didn’t know what electives were available, how I could sign up, and, most immediately, where I needed to go for my next class.

The nice classmate was going to an art class, so, not knowing what else to do, I tagged along. For the next two years, I ended up taking art classes without explicitly signing up for them. Don’t get me wrong, I didn’t mind the subject. But then my parents started receiving letters from the school. The letters, handwritten by one of the teachers, told my parents they owed the school for my art lessons and had to pay up ASAP to avoid any trouble. Guess who ended up translating the letters?

My parents were at a loss. After all, they had never signed me up for any paid electives! And I was too embarrassed to admit how I ended up in that class. The letters kept coming for a while. I don’t believe my parents ever addressed this issue with the school. What if the balance had been turned over to collections? What if there had been a heated standoff that I would have had to (try to) interpret? Luckily, these things didn’t happen.

Again, this incident happened in a different context. In the US, schools are supposed to provide language access to parents whose primary language isn’t English, including interpreters for parent-teacher conferences and translations of letters to the families. Schools may not always be compliant, but I’m glad the framework is there to spare schoolkids the tough role of negotiator between your parents and your school—both of whom have authority over you.

If there is one thing I’d like my readers to take away from this—if you are based in the US and are a medical provider or administrator, a public servant, a social worker, or a school employee—please find out what language access policies apply to your organization and advocate for language access for the people you serve. Children should not be responsible for handling high-stakes situations that may affect their and their families’ health, finances, criminal records, or immigration status.

Are Native Russian Speakers Always Russian?

If a person you are working with speaks Russian, would it be safe to assume they are Russian? Well, it’s complicated.

First, the term “Russian” itself is ambiguous and can mean different things. It may mean a Russian citizen (rossiyanin) or a person of Russian heritage (russky), whether or not they live in the present-day country of Russia. To complicate matters further, people from the former USSR have been colloquially referred to as “Russian,” although some of them may not identify as such.

Legacy of Russian

In fact, many people from the former USSR may speak Russian as their first or second language. There are several reasons for that:

Russian was the official language in the USSR, often privileged over local or national languages of other constituent republics.
In Soviet times (and before), people moved from the territory of Russia to other parts of the country, bringing their language with them.
Russian remains an official or common language in some Eurasian countries like Kazakhstan or Moldova.

I have interpreted for people from Russia, Moldova, Latvia, Ukraine, Belarus, and even Lithuania—a country that does not currently have a high proportion of Russian speakers. As a rule, older people throughout the region are more likely to speak Russian natively or fluently, whereas younger people are more likely to speak the national language as their first language and study other languages like English as their second language.

Some Tips

This history has several implications for individuals who work with speakers of Russian.

Your Russian-speaking client or partner may not come from Russia or be of Russian ancestry. Don’t assume and, if their country of origin is relevant to the conversation, just ask.
Conversely, people from countries of the former USSR do not necessarily speak or understand Russian. If you are arranging translation or interpreting, check what language they actually prefer.
Be mindful of how you phrase your questions. I once heard a medical provider ask me what the patient’s “nationality” was. This kind of phrasing may be dehumanizing for people coming from a region where your ancestry and nationality are a fraught subject. If all you want to know is what language your client is speaking, that’s probably what you’ll want to ask. In that case, that patient happened to be Moldovan but was speaking Russian!

How Should You Refer to the Russian Language on Your Website?

Having a website in several languages may be a good idea for many reasons from regulatory compliance to increased customer loyalty to higher sales. If Russian is one the languages on your website, here are some tips on how to make sure the language name is displayed correctly.

In English, we can just plug the name of the language into many different structures, for example “speak English,” “the English language,” or “written in English.” When localizing our website, we may be tempted to have the name of the other language(s) translated and then use the translation on buttons, dropdown lists, and sometimes even in the middle of a sentence! However, if you tried to do that with Russian, you might run into trouble. Compare the following forms.

If you speak Russian	Если вы говорите по-русски [Esli vy govorite po-russki]
User language: Russian	Язык пользователя: русский [Vyberite yazyk: russkiy]
We have information in Russian	У нас есть информация на русском языке [U nas est’ informatsiya na russkom yazyke]

You’ll notice that the word “Russian” is the same in all the English examples, but the translation of that word depends on the rest of the sentence. Here is how you can have the name of the language display properly.

Dos

Send your translation team a screenshot or, better still, a link to your website so they know where each string appears.
For the dropdown list of languages, use the word “русский” (russkiy, Russian). That is the name of the language, which should not be capitalized unless it is the first word in the sentence or unless all other language names are capitalized, too. Do not use “по-русски” (po-russky), the adverb used in “speak Russian.”
If the word “Russian” appears in a sentence somewhere else on your website, have the entire sentence translated as a whole rather than insert the translation for “Russian” into a pre-translated sentence (see my post on concatenation).

Don’ts

Avoid using flags to identify languages. Russian is used in several countries and regions other than Russia, such as Kazakhstan, Belarus, or Moldova.
Do not use a language variable in the middle of a sentence. As we saw above, the form of the word “Russian” will depend on how it’s used, so populating all instances with the same translation will result in grammatical errors.

Should You Use a Low Reading Level in Your Russian Medical Translations?

Some translation requests I have received specify that the translation should read at a 5^th or 6^th grade level. Intuitively, this makes sense—you want your audience, who may have a low level of education or health literacy, to understand your message clearly. However, this approach is based on assumptions that may not apply to Russian speakers in the US.

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Level of Education

First of all, immigrants from the former Soviet Union tend to “possess higher levels of education compared with U.S.-born whites,” according to a study by Neil Mehta and Irma Elo. The same study reports that “middle-aged and older aged [former Soviet Union] immigrants are about twice as likely to hold a college degree compared with their U.S.-born white counterparts.”

One reason for this may be the accessibility of education in their countries of origin. Another reason for their educational attainment is that there may be self-selection among recent Russian-speaking arrivals. They may be coming to the US as international students or temporary professional workers. These statuses require proof of solvency and a certain level of education.

Furthermore, it is estimated that some 70 percent of immigrants from the former Soviet Union might be Jewish. Speaking about immigrant women specifically, The Encyclopedia of Jewish Women points out that many were trained in STEM fields: “In contrast to the 16.5 percent of American women who worked as engineers, technicians, or other professionals, over two-thirds of Soviet Jewish émigré women had worked in these occupations prior to their arrival.” This means that overly simplified health communications may confuse this mostly highly-educated audience and even come across as insulting.

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Exposure to Medicine

In addition, the average Russian-speaking immigrant will have had more exposure to healthcare than an average American. In 2016, people in the US saw a doctor an average four times a year. To use Russia as a comparison case, in 2018, people there saw a doctor an average of 8.4 times annually. Whether or not more frequent visits are medically beneficial, it appears that speakers of Russian are more used to seeing medical professionals and, by extension, hearing medical vocabulary.

Furthermore, in Russia, a physical is often are required for schoolchildren, first-year college students, and job applicants. For instance, Russian children have extensive physicals at ages 7, 10, 14, 15, and 16, when they are seen by several specialists, including a neurologist, dentist, ophthalmologist, and endocrinologist, and get an ultrasound, a cardiogram, and a blood test. Again, whether such in-depth screening is medically necessary is beyond the scope of this article. Be it as it may, an average Russian will have some familiarity with the most common conditions and diagnostic tests.

Implications for Medical Communication

As a result, a Russian-speaking immigrant is likely to recognize words that may be considered specialized vocabulary in the US. For example, a person who had their blood work done many times in their country of origin will be used to the word eritrotsity (red blood cells, literally “erythrocytes”). Using a literal translation of “red blood cells”—krasnye krovyanye tel’tsa—in an attempt to make the text more accessible may have the opposite effect. In fact, I’ve once interpreted at a diabetes consult, where the medical provider said, “the organ that produces insulin,” only to have the patient say, “You mean ‘pancreas’?”

None of this means that your Russian-speaking audience will necessarily have a high level of health literacy or a good understanding of the US healthcare delivery model. That being said, Russian speakers are likely to be familiar with common biology concepts, such as names of internal organs or medical specializations. So what should you do to communicate effectively with this demographic? Consider the following approaches.

Focus on breaking down the more advanced diagnostic or treatment procedures, explaining what will happen at each step.
State the rationale for recommending a particular drug or treatment, keeping in mind that this treatment may be unfamiliar to your patient or different from what they have come to expect in their country of origin.
Define any potentially complex terms the first time you mention them. That way, you know the reader will have something to refer to if they are unfamiliar with the term.