This exploratory study examines communication and intercultural barriers faced by Spanish-Galician migrants in Swiss health care across two migration waves (1961 to 1980 and post-2008) and three generations. Drawing on ten semistructured interviews, the study explores how migration backgrounds, linguistic repertoires, and intercultural expectations shape health care experiences. Using a sociolinguistic framework combined with a thematic and discourse analysis, the findings show that the first-wave migrants, often with limited formal education, relied on Italian as a lingua franca and frequently involved their children and other family members as ad-hoc interpreters. In contrast, the second-wave migrants, who were generally better educated, were prepared for medical consultations in German and sought greater linguistic independence, though certain challenges persisted with Swiss German and interactional norms. Across both waves, multilingual health care staff, often with migrant backgrounds, played a central role in facilitating communication and trust, while professional interpreting services remained underused. The participants appreciated the longer consultations and shared decision-making in Swiss health care. However, they reported feeling emotionally isolated during critical life events, such as maternity, due to differing cultural norms. Thus, beyond language proficiency, cultural expectations shaped their perceptions of care. These findings highlight the interplay of linguistic and intercultural factors in shaping health care experiences and can potentially inform future research and policy on equitable health care access for migrant communities.
Keywords: Switzerland; communication barriers; health care communication; intercultural barriers; migration; multilingualism.