Language as a pillar of cultural safety: evaluating hospital-based healthcare workers’ knowledge of First Nations languages and interpreter services in East Arnhem Land, Australia

Communication is a key determinant of health, yet in Australia’s Northern Territory (NT), First Nations language speakers usually receive medical care in English. The NT is a region of exceptional language diversity and vitality, with approximately 50 distinct First Nations languages spoken. At Gove District Hospital in East Arnhem Land, NT, 91% of First Nations peoples primarily speak an ancestral language, chiefly Yolŋu Matha, with a smaller proportion speaking Anindilyakwa, Burarra and others. Many would benefit from access to an interpreter during healthcare encounters. This study aimed to assess healthcare provider knowledge of local languages, and their use of professional interpreters. An exploratory, electronic, anonymous survey was distributed to clinical staff at Gove District Hospital, capturing demographics, knowledge of language names and dialects, confidence in pronunciation and spelling, and interpreter use. A purposeful sampling strategy targeted doctors, nurses, and allied health professionals. Exclusions comprised employment for < 1 month, employment in an administrative role, as an Aboriginal Liaison Officer, or students. Responses were analysed using descriptive statistics and qualitative template analysis. Of an estimated 100 eligible staff, 56 participated (33 nurses, midwives, managers; 16 doctors; 7 allied health). Almost all (96%) identified at least one major local language, but only 18% felt confident pronouncing names and few could name dialects. The language identified correctly most often was Yolŋu Matha. 50% identified Anindilyakwa and none named Burarra. Spellings varied widely. While staff acknowledged the benefit of using interpreters, < 60% had used one, and just over half knew how to book one. Reported barriers included interpreter unavailability and time pressures. Reliance on Aboriginal Liaison Officers or family members raised concerns about confidentiality and accuracy. Staff expressed frustration at limited interpreter access, and a desire for training in local languages. Findings reveal substantial gaps in linguistic knowledge and interpreter utilisation in a region of major language diversity. Addressing these issues requires systemic and individual change, including accurate language documentation in health records, employing interpreters, and intercultural communication training. Recognising and respecting patients’ first languages is central to culturally safe care, and essential for improving health equity for First Nations peoples.