Every day, in countries across the globe, hundreds of thousands of immigrants, refugees, native peoples and those who are deaf and hard of hearing seek healthcare services from providers who do not speak their languages. How will they communicate, if not through an interpreter? Over the past several decades, a combination of political, social, logistic, and economic pressures have transformed an ad hoc activity performed by family members and friends into a unique sub-field of the interpreting profession, with its own code of ethics, standards of practice, training programs, and (in some countries) certification. This is a field that is rapidly growing, changing, and struggling to define itself in the context of not one, but two complex industries. This chapter will provide a survey of the field of healthcare interpreting in countries which

have become destinations for migrants and/or refugees, using the experience of spoken language healthcare interpreters in the United States to illustrate a pattern of development. It will examine the pressures that have influenced the growth of the field, the work of healthcare interpreters, training and certification, and a number of other critical issues. The chapter will end with some speculation as to the future direction of language access in

healthcare in migrant and refugee destination countries, as well as a short list of recommended readings.