“Imagine moving to a completely new place, where the culture, healthcare system, and even the doctor’s office, feels foreign to you—and on top of all that, you are unable able to understand what is being said about you.”

I arrive at the Nationalities Service Center [NSC] office, looking for the newly arrived family of refugees from Nepal who are scheduled for blood tests. I don’t see them and try calling them on the cell phone number their case manager has given me. They don’t understand and speak little English. After a few minutes, I call them back using a Nepali interpreter and remind them of their appointment. The family finally arrives, and we walk the ten or so blocks to Jefferson lab for blood tests. I help them register, waiting while blood gets drawn. We pack up and head back to NSC, where I call an interpreter once more and give the family a health orientation, explaining what healthcare is like in the United States. 45 minutes later, the family can finally go home.

Whew! It’s just 10:30 AM, and I’ve already done so much to ensure that one new refugee family is accessing the medical services they need, with the hopes that they are developing the necessary tools to navigate the U.S. healthcare system on their own. Three things that I’ve learned from my experience of working at a refugee resettlement agency: (1) every task takes a little bit longer and requires a little bit more patience when you are trying to communicate with those from different cultural and linguistic backgrounds, (2) this kind of work can be exhausting, but it is always incredibly rewarding and fulfilling, and (3) there is never a dull moment at NSC.

One of the most simultaneously overwhelming and fulfilling times at NSC occurs each day right around noon, when the ESL (English as a Second Language) classes let out, and there are what feels like dozens and dozens of people crowding about in the lobby. Whenever I come out from the health team office at this time, I am greeted (and sometimes bombarded) by my clients—whether it is a request for a dentist appointment; a need to schedule a sick visit; an inquiry about the time of an upcoming physical therapy appointment; or just a warm greeting from an old client, I am always kept busy. This is something I love about what I do—the constant hustle and bustle and the consistent challenge of communicating across cultural and linguistic barriers. I must make an effort each day to navigate through communication barriers and misunderstandings by speaking clearly and concisely, in terms that my clients will understand.

When it comes to health care in particular, it is crucial that my clients are able to communicate their needs and understand what is being said to them. It is important that they feel empowered to express themselves in a language which is comfortable and familiar. When such a language is not English, doctor’s offices and pharmacies and other places are sometimes less than willing to accommodate—either refusing to provide interpretation, neglecting to translate paperwork that they are asking patients to sign, or by treating non-native speakers like they are non-existent by referring to them in the third person. All of this, in my mind, is unacceptable and disempowering for the refugees that I serve. “Imagine moving to a completely new place, where the culture, healthcare system, and even the doctor’s office, feels foreign to you—and on top of all that, you are unable able to understand what is being said about you.”

As I have become more comfortable with the day-to-day responsibilities of my AmeriCorps service at NSC, I strive to develop my advocacy skills, particularly in regards to language access. One of my goals for the rest of my service year with the Philadelphia Health Corps is to develop a better system to reward those clinics that do offer great interpretation services and to motivate others to become more conscientious about language access. I also hope to find a way to translate the documents that patients are signing before going to the lab or seeing the doctor, so that they are fully informed and understanding of what they are signing. I am thankful that my role at NSC leaves a lot of space for advocacy and for ensuring that my clients are treated just as well as native English speakers would be.
 

This post was written by PHC member Megan O'Brien.
Megan serves at Nationalities Service Center as a Refugee Health Associate.