The agency spoke the language of the community and spent tens of thousands of dollars printing and distributing Masan leaflets in Yiddish to hang on the doors of more than 45,000 homes in these communities.
Something was lost during the translation: According to language experts consulted by CNN, Yiddish was disfigured.
The door hangers delivered to homes in Rockland County were so flawed that parts of it were "barely comprehensible" and "virtually undecipherable," said Chaya Nove, a Yiddish scholar.
"The translation is so ridiculous, it's almost offensive," she said.
"It's unbelievably sloppy," added Anita Norich, professor emeritus at the University of Michigan and Yiddish scholars. "It's annoying."
The experts said that Yiddish is also poor on two ads that point to the dangers of measles that the health department released in late 2009 in publications in the ultra-Orthodox Jewish community.
Some say the botched language is part of a larger problem: the state has had difficulty communicating effectively with its ultra-Orthodox Jewish community, and has contributed to the largest and longest measles outbreak in the United States since at least 1
Not only did the State Department of Health make the Yiddish mistakes, the agency did not succeed in applying quickly or in some cases even known methods of communication with ultra-Orthodox Jews, a community that one can not join the outside world ,
For example, the department took three months to distribute a booklet that contributed significantly to increasing immunization coverage in an ultra-Orthodox community two years ago. In addition, officials said they had recently begun using two other communication platforms – a message phone line and an SMS app – that are particularly popular with ultra-Orthodox Jews.
"To be credible, you have to spread the message about the methods a community typically uses," Dr. Irwin Redlener, Professor of Health Policy and Management at the Mailman School of Public Health at Columbia University. "And as measles spread quickly, there may be delays."
There is a lot at stake to stop this eruption.
More than 600 New Yorkers have contracted measles since October, and over the past week, state and city health officials have reported more than 30 new cases in the state. In New York City and Rockland County, the two epicenter of the outbreak, approximately 55 patients were hospitalized and 14 were admitted to the intensive care unit. Measles have spread from New York to several other states, including Connecticut, New Jersey and Michigan.
A New York State Department of Health spokesman said the ads and doorplates are just a small part of a larger campaign.
"The department continues to work with our community partners to share information on the dangers of measles and the safety and efficacy of vaccines," Gary Holmes wrote in an email to CNN. "Supporting information distributed more than six months ago and later supplemented by community feedback is a small part of a great collaboration that aims to end this outburst once and for all."
Holmes said the overall effort – which included meetings with dozens of rabbis, community leaders, parents and health professionals, as well as the establishment of a measles hotline and support for immunization clinics – cited China's growing vaccination coverage were areas where there were measles cases.
In Rockland County, for example, more than 20,000 measles vaccines have been administered since October – about four times more than in the same period in the previous two years. Other districts where measles were reported also saw an increase in vaccines this year compared to previous years.
"We work," said Holmes. "From the beginning, we understood that strong support and trust in the community are crucial," he said.
But several community leaders said the mistakes gave the impression that the state had not cared enough to get it right, and worse, they feared that the parents who hesitated about vaccines would appeal to the officials of the Health ministry doubt if they say vaccines are safe.
"You think, if that's wrong, what did you do wrong?" Aaron Glatt, an infectious disease specialist and orthodox rabbi, described the state's public relations in Yiddish as a good idea suboptimal execution.
"Talk to Your Nutrition Adviser on Health Care"
CNN asked three Yiddish scientists to analyze the Ministry of Health's Yiddish materials: Nick Block, assistant professor at the Boston University's German Studies Department, Isaac Bleaman, who will be assistant professor this fall for linguistics at the University of California at Berkeley; and Chaya Nove, a Ph.D. candidate in theoretical linguistics from the Graduate Center of the City University of New York, who has published articles on Yiddish in journals, such as Block and Bleaman. [19659002AlthoughthethreescholarsarefluentinliteraryYiddishtheyspecializeinthelanguagespokentodayinultra-orthodoxJewishcommunities
They analyzed the door hangers distributed in mid-November and two advertisements that appeared in three November and December releases
The experts said there The two ads were understandable despite the mistakes and their messages were clear. The door hanger, however, had hardly a single error-free sentence, and parts of it are completely incomprehensible.
The cost of distributing the faulty materials was substantial: more than $ 33,000 for the placement of the two displays and more than $ 23,000 for the printing and distribution of the doorplates.
Sometimes the mistakes were downright funny. In the door hanger and in one of the ads, "Talk to Your Doctor" is translated into Yiddish as "Talk to Your Nutritionist."
This mistake was corrected in a booklet distributed by the state months later.
Also among the mistakes: Instead of saying to call the state hotline, the bouncer and the first ad in Yiddish say "Summons 1-888-364-4837" with "Summons" as noun.
"It's like a court summons, like a summons, it makes no sense," said Block, who is a professional Yiddish translator.
This error was corrected in the second ad.
The door hangers have mutilated important information during an outbreak: the list of symptoms.
The Yiddish experts said they had never heard of the phrase used for "common cold." In addition, Yiddish lists "red sad eyes" when it says "red watery eyes," and the word used for "rash" would be unknown to many of today's Yiddish speakers.
"It's just a word salad," Bleaman said about the jumbled translation. "Not only that, but some of the words in the salad are misspelled."
These spelling mistakes are numerous. The word "sneeze" has an additional letter. In the question "Who is most at risk?" The word "risk" is misspelled. Even the word "measles" could not escape: on the door hanger it is written in three directions.
And then there are the grammatical errors. Topics do not match verbs. The words are correct, but in the wrong order. Prepositions appear where they do not belong, eg. For example, a translation reading "Questions about measles or the vaccine?"
"Yiddish is ridiculously bad, which is unfortunate because a measles outbreak is a serious matter," Bleaman said.
He and the other Yiddish experts found that apparently someone with inadequate knowledge of the Yiddish language used Google translators and then optimized the translation. Bleaman said that when he published the English version of the material in Google Translate, it had made some mistakes in the translation of the Ministry of Health.
Holmes, spokesman for the department, emphasized that the two ads are understandable.
He said that these ads were "understandable but not optimal" and that the officials had made changes to Yiddish materials that came later because "simply was not enough".
How did the errors occur?
Holmes said his agency hired a licensed translation service, Language Service Associates, to translate the materials from English into Yiddish. The cost of translating the three documents was more than $ 900.
In an e-mail, Melisa Eskin, vice president and director of corporate compliance and government relations at Language Service Associates, said that the company "fully committed to the translation and accuracy of the information it provided."
"Please remember that there are often different views and preferences when translating a text," Eskin added. "Because of this, language experts from the same source document can produce different, but equally valid translations, and these differences between professional and academic translators are most likely to occur in languages that come from a variety of geographic locations and sources, including Yiddish and Spanish."  But the experts CNN consulted said the mistakes were mistakes, regardless of geographic differences or sources.
"These mistakes are not dialectical differences in the Yiddish language," said Nove.
Holmes said that the health department usually takes a translation from a licensed service and passes it on to a native speaker in the community, whether it's Yiddish, Spanish, Haitian Creole, or any other language.
But he said that did not happen with the door signs and the first advertisement.
"Sometimes there are time constraints and there is not always the opportunity" to do so from a community member, Holmes said.
When someone pointed out a few mistakes in one of the publications, the health department withdrew the ads.
"We are committed to ensuring that our materials are not only culturally competent, but that they best achieve our goals," said Brad Hutton, Deputy Commissioner for Public Health. "We always follow the community's advice and improve the product."
The agency then ran a new ad from Rabbi Hersh Horowitz, managing director of the Community Outreach Center in Monsey, New York.
Although this ad is an improvement, the Yiddish experts still believe it to be buggy.
Horowitz said in a statement: "The [New York State Department of Health] has approached me and I have been happy to assist and provide some ideas for revising some of their materials, most of which were incorporated into the final product by the DOH that the remainder of the language should convey the message more than adequate and should not serve as an excuse for not vaccinating or undermining the commendable efforts of the Ministry of Health. "
The department used a different service than months later, I translate another measles booklet. The Yiddish experts say that the booklet contains no errors.
A 2017 measles outbreak in that state made 75 people ill, mostly children in the state's Somali community. It took about three months.
"When something is sent for translation, we check it again and again," said Doug Schultz, an information officer for the department. "It always has to be correct, always."
Fatuma Sharif-Mohamed, a community outreach planner in the Somali department, added that "if the language is wrong and the community comes back, it hurts."
One of the Ministry of Health's key partners in the fight against the outbreak was the Minnesota Children's Hospital, which looked after the majority of sick children.
After Somali posters were posted in the hospital, a Somali hospital employee noticed a single spelling mistake: a letter in a word was wrong.
The hospital removed the posters and ordered new ones.
"It would have looked like we were sloppy or did not understand or did not care," said Patricia Stinchfield, a nanny and senior director of infection control at the hospital. "This is not the picture we would like to portray."
Some members of the ultra-Orthodox Jewish community in New York indicated that the grammatical and spelling mistakes in the two ads did not pose a real problem.
"I do not think it matters whether or not there are mistakes," said Chanie Sternberg, president and CEO of the Refuah Health Center, which is responsible for Rockland and the surrounding counties. "I think the idea of raising awareness is very clear, and that's the heart of the problem as far as I'm concerned."
Binyomin Mermelstein, an official in an ultra-orthodox village in Rockland County, said the errors in the ads are "minor" and would go unnoticed by many in his community.
"So they spell something wrong – OK, they wrote something wrong, I do not see a problem," said Mermelstein, treasurer of the village of Kaser. "I try to write things for people in our community, and I do not know the grammar or rules that you need to apply, and people sometimes laugh at how I write, but that makes no difference."
However, he added that the door hangers were "bad" and should never have been distributed.
A booklet is ready and waiting
Posters, signs and doorplates are only part of the communication of a public health message.
Another method may seem outdated, but it has proved victorious in the ultra-Orthodox community: a booklet.
"It definitely had an impact," Polinger said.
The result: In the current measles outbreak, Ezras Choilim treated only 12 cases in a population of more than 20,000 people.
"We had a case about every two to three weeks, it was not epidemic," said Tamy Skaist, deputy director of the health center.
The New York Department of Health knew about the booklet; In fact, the Agency funded its creation in 2017 with a grant from the CDC.
However, in the current outbreak, the agency did not distribute the leaflet until January, when the outbreak lasted three months. Holmes, the spokesman, said the process of printing and distribution took several months.
Find the Right Platform Seven Months After Onset of the Disease
So far, the Department of Health has not used two other media platforms that are extremely popular in the ultra-Orthodox Jewish community: an SMS app and a news phone line.
Ultra-Orthodox Jews often use WhatsApp to exchange headlines. Smooth, the infectious disease doctor and rabbi, calls it "kosher Facebook," because it keeps out material that could offend religious Jews.
Like the booklet, the other platform seems to be outdated by most Americans: a telephone line that allows callers to hear presentations on news and current affairs.
Such phone lines are also popular in the Somali community of Minnesota, and the state health department used them extensively during the 2017 outbreak to get Somali doctors and nurses to give lectures on the lines that encourage vaccination.
"You need to use the media, the methods that are right for your audience," said Schultz, the ministry of health ministry spokesman in Minnesota.
Hutton, deputy commissioner for the New York Department of Health, said last month, his began Agency to focus on the use of WhatsApp and message phone lines.
But this effort came six months after the outbreak broke out.
The physician and rabbi Glatt hopes that New York can learn from the success in Minnesota and one of its own villages.
"Kudos to the Ministry of Health for trying to be culturally appropriate," he said. "It was a learning episode, and hopefully everyone can learn from their mistakes and make it better next time."
John Bonifield and Debra Goldschmidt of CNN have contributed to this story.