What multilingualism? Agency and unintended consequences of multilingual practices in a Barcelona health clinic

The present research critically examines the construction of multilingualism and the implementation of multilingual practices in response to the new demands posed to public services by the arrival to the city of Barcelona of migrants from various language and cultural backgrounds. An analysis of the various modes and modalities of multilingualism in a health clinic in the city of Barcelona reveals the ideologies behind the practices and it shows how the reproduction of a particular social and institutional order is accomplished in everyday routine interactions that take place. Following Giddens (1984) on the role of agency it is possible to observe how institutional measures to incorporate multilingualism produce unintended consequences for migrants who come into contact with the health system. Language and communication appear at the center of the tensions and conflicts that arise between social actors within the institution. Ethnographic fieldwork and various types of data show the contradictions of institutional thinking and agency as well as the outcomes. © 2010 Elsevier B.V.