by Sarah Spagnola
CNNC Summer Intern
Putting down roots in the United States is no easy feat for immigrants and refugees. New arrivals must navigate a labyrinth of challenges, from adjusting to a new educational system to finding employment. One challenge, though, is truly life-and-death: getting access to quality, affordable healthcare. The already difficult barriers of language and culture can pose an even greater challenge when someone needs a doctor.
That’s where IHAP comes in. The Immigrant Health ACCESS Project works with the Latino and Montagnard communities in Greensboro to ensure that those in need of health care have access to it. IHAP provides interpretation for clients and healthcare professionals, encourages healthy living through community education workshops, and connects clients in need with affordable healthcare.
“I have this client who needed help with a specific cancer screening, and the whole thing was going to be like $1,500,” says Krycya Flores Rojas, IHAP’s Latino Health Outreach Coordinator. “And she’s uninsured and has no access (to health care.) And I started looking for programs that would help her. And because of my work she got it for free.”
Challenges
Challenges remain in the implementation of a medical safety net for refugees. Making and keeping doctors’ appointments becomes more difficult when community members lack drivers’ licenses or access to public transportation. Linguistic and cultural differences can make communication with doctors and nurses difficult. Finally, some immigrants and refugees may have trouble finding employment and thus be unable to get health insurance.
“We still have many people that need access to healthcare that have big needs and technically no affordable chances unless they pay for treatment out of pocket,” says Krycya. “If you go for a doctor’s visit and get some exams, that might be $500, and that’s the rent — they don’t have the money to pay the rent and that.”
Workshops and More
IHAP also facilitates community wellbeing through regular educational workshops. Workshops cover a variety of topics, from nutrition to pregnancy. AmeriCorps member Wier Siu is hosting an “Empowering Women” workshop from 9:00 a.m. to 11:00 a.m. throughout July and August at 1305 Mayfair Avenue. The workshop provides women with nutritional information and helps them build their English vocabulary . Additionally, IHAP participates in a variety of community health fairs and clinics that provide free or low-cost screenings or procedures, including the Adult Dental Clinic.
“Paying $30 versus $200 or more for a procedure is a real blessing for the community,” says Krycya. “The Latino community is very thankful to have access to that clinic through the Guilford Community Care Network.”
The daily caseload for IHAP usually revolves around basic health access issues such as interpretation or renewing patients’ Orange Cards, which demonstrate eligibility for low-cost community health care through the Guilford Community Care Network. In addition, IHAP occasionally deals with what Asian Lay Health Advisor Snow Rahlan-Joyce describes as “heavy cases:” clients who have serious conditions requiring more continuous care.
Heavy Cases
“They need your attention 3-4 times a week,” says Snow of her heavy cases, “including home visits, follow-up appointments, contacting the pharmacy, changing appointments, referrals, and working with other agencies.”
IHAP deals with 3-5 heavy cases per quarter. Some of these are patients in need of end-of-life care. Many times family members of patients with terminal illnesses don’t understand how death is handled in United States culture. Likewise, many health and end-of-life care providers don’t understand how various immigrant and refugee cultures deal with grief.
“We work closely with Hospice and Kids Path to help families understand how that is handled in this country,” says Snow. “So at this point it’s more of an understanding of culture — helping the population we serve understand American culture — and also helping American healthcare providers understand how they (other cultures) deal with grief stages.”
Rewards
Working in healthcare is no easy task. Cultural misunderstandings often arise between clients and healthcare providers, and the structure of the local healthcare system is constantly in flux. Despite this, the job has a definite upside.
“What keeps me motivated and going is that you can change people’s lives with one single phone call,” says Krycya. “It’s not always ‘one phone call and everything is sold,’ but if we work hard at what we do, we can see results and change people’s lives.”