This makes providing health services even more complex, as plain language becomes even more important. You not only have to adapt for education level but also for language. Cree language services are not widely available, unlike french since it is an official language.
Complicating matters is that Cree is spoken in 3 different dialects in the James Bay area (see map). There dialects are categorized as n,l, or y based on the Cree spelling of the word "no". In the Attawpiskat area the word no is "mona", in the Moosonee/Moose Factory area it is "mola", and in the quebec area it is "moya".
For people with limited English then you not only need someone who can translate Cree but also in the proper dialect. Often times it will be a relative who is asked to translate, but if this isn't available it makes communication quite difficult. The other issue with having a relative translate is there may be a breach of confidentiality as the patient does not feel comfortable with their relative in the room. If anyone has attempted to speak through a translator it is not so simple. Some words are difficult if not impossible to translate.
If a relative is not able to translate, and neither is anyone on staff it can cause significant complications. For myself as a dietitian it isn't so much life or death, but it does add another dimension to communication. When speaking in your second language everything takes a second longer to process (as I know from speaking mediocre french). It is also easy to misunderstand, or not pick up on key words. It is important to double check, and ensure that messaging is clearly understood in this context.
JK
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