SPAN 375 - Entrevista

Zach and Valeria are doing an interview about medical issues. Valeria had a good experience with healthcare but has seen problems with communication and access for non-English speakers. Without insurance, it is difficult to find medical care and many end up in the ER. Dental care is also important but often overlooked. Valeria emphasizes the need for more healthcare professionals who speak Spanish. She believes everyone deserves equal care and wants to promote diversity in the medical field. Valeria has worked in an office providing education on diabetes and promoting preventive screenings like Pap smears and mammograms. She believes in the importance of interpreters to ensure proper care. Hello, my name is Zach and I am here with my partner, my classmate, Valeria, and we are going to do an interview about medical issues and things like that. First, how are you today and how do you feel about the interview in general? I am very well. I am excited to do this interview and talk about health here in the United States. So, we have a few questions and we don't have to follow them directly. We can do it as is or at random. So, to begin with, what has been your experience with the health system in the United States since today? For me, personally, I have had a good experience with my health care. Since I was little, my mom took me to the doctor. When we didn't have our elementary school, she took us to the Department of Health for our routine vaccines, which is very important. And as an adult, I have had a good experience with all the doctors that I have had. In other aspects, the bad experiences because I have worked in the health system. I have seen some things that I don't think are good for our patients or things like that. Especially working with patients who don't speak English. It could be Spanish or other languages. I have had experiences in a place where I worked where they didn't treat patients who didn't speak English well. If they didn't have an interpreter, they didn't take the time to grab the phone to use the interpreter. They just said, oh, it's here for certain things. We're just going to put it there, prepare the patient, and do what we have to do without explaining anything to the patient. Or letting the patient explain if they have a question or a problem. I know that those things do exist in many places, and it's something that isn't good for any patient who wants to be heard. And it's very important to have good communication with the patients. So, as linguistic barriers rather than cultural competence that is missing. Yes, yes. And have you experienced any barriers in accessing medical care? Or have you met someone who has had difficulties accessing good medical care? I haven't had any barriers. Well, yes, when I didn't have medical insurance. Because I didn't know that there were some offices where they accept you without medical insurance. And they put you on a scale according to what you earn in income. And I think that's a very big problem, especially for anyone who doesn't have medical insurance. They don't know where to go for their medical care, and they leave everything at the end. Or when the symptoms have already worsened, they go and look for medical care in the hospital or anywhere they can find it. And according to that, also not having medical insurance causes problems where many of the patients who have chronic problems go to the hospital. And that's why the waiting rooms in the hospitals are full of patients who are not, I'm not saying that they are not sick. They are sick, but they are chronic diseases that should be treated in an office so that they have their follow-up. While in the hospital, in a perfect world, it should be only for emergencies. People who have had these emergencies of chest pain, stomach pain, who can't take it, who are going to have surgery, things like that. Sometimes a cough could be another big problem, but that's why it would be ideal to start in the office. Where your primary doctor will examine you, if you've had this problem for a long time, they do other tests and all that. Our health system is very broken, and there needs to be a lot of changes. I think it's going to take a long time to be done, but that's one of the biggest problems. And if everyone had their care that goes to the doctor every year, whether they have insurance or not, like not having insurance, give more information or give more promotion of the type of offices there are, that if they can provide that care for people who don't have medical insurance, that would be very important to promote that. Because if there are a lot of offices, you could go to the other offices, they also accept people who don't have insurance, but they're going to charge you what they usually charge for a patient, whether you have insurance or not. They call them community health centers. And there are these types of offices everywhere. Here we have one in Harrisburg. There's one in Charlottesville that I know of. There's an office in North Virginia. I think there needs to be more promotion of this type of offices, especially for everyone who doesn't have medical insurance. And the offices that I've had experience with these have interpreters. Sometimes they have them at home. Sometimes, well, they always use an interpreter on the phone. Or they even have nurses, providers who speak other languages, whether it's Spanish or some other language. So you've seen how all the walls come together, one on top of the other, and the great importance of primary care and how that can help prevent many diseases. I agree. What do you think, in addition to everything you've said so far, that can be improved to have a good health system, like the ideal? In a perfect world? Well, it depends on what I think, because we all think differently. Ideally, it would be that everyone could get the same type of medical care. That we were all the same. That we could all go to the doctor. That everyone could get the surgery they need. And not depending on whether we have money or not to pay for it. Because I've also seen many people who have put their health aside because they don't have money. They can go to the doctor, but they don't have the money. Even people who have medical insurance say, they're going to charge me thousands of dollars for the deductible I have to pay. It's better if I don't get the surgery. It's better if I put up with the pain I have. It's better if I get to the point where they do have to go. And sometimes the time passes that they could have done something simpler, but it becomes a bigger problem. And they end up paying a lot more money than they would have paid at the beginning. Yes, but it's not just the individual's fault, but the system also imposes these decisions on people without coverage or whatever. Yes, yes. And that delay, as you've said, only leaves room for the problems to increase. Yes, yes. And are there more problems with specific care, like dental services or mental health services? With dental services, I feel like a lot of people don't think about the teeth. And the teeth are something very important. Because from there, you eat, you feed, but also if you can have an infection in one of your teeth, or an infection because a tooth fell or a tooth broke, this infection can even get to other parts of the body. Especially the heart, which causes more problems. I feel like dental care is something very, very important. Sometimes it's the first thing people see when they smile or something like that. They see their teeth. In the personal aspect, I think it's something important. And it's also something that a lot of people don't take care of their teeth. They don't go to the dentist. It's something that we put behind. We say, it's not so important. As long as I have my teeth, it doesn't hurt, I'm fine. But there can be problems growing up, cavities or things like that. Especially, I've seen a lot in children, when their parents don't take them to the dentist. Sometimes they say, oh, they're going to grow baby teeth or something like that. But their teeth are rotting. And when the baby's teeth are rotting, that can cause problems to the adult's teeth. So, I think we also have to do a lot of promotion in educating people about dental care. Yes, I agree. It's very easy for people to think that oral hygiene has no value. Or that it's something very simple or whatever. Yes, yes, yes. And have you done any dental work? Do you think the dentist taught you well in your treatment? Finding the appropriate dentist is something very important. I've always gone to the same dentist. Since I was a child, I lost my dental insurance. And then I got a different one that didn't cover my dentist where I went regularly. And I fully trust them because they've always done a good job. The dentist does a good job and makes very good recommendations. But at that time, I had another dental insurance. I went to another dentist. And the truth is, you can see the difference between dentists and the work they do. There, I didn't feel like my teeth were being cleaned when it was an oral hygiene. They also did x-rays of my teeth to see if I had cavities or things like that. They mentioned a cavity. The dentist didn't come in to explain what was going on. And they just told me, call to schedule your next appointment to fill out that cavity. And coincidentally, I went back to my other dentist because I trust them more. They never mentioned anything about a cavity. You also have to be very careful. Because adults only have a few teeth. Some people want to make more money or want to do unnecessary procedures. And it's okay. Sometimes we're afraid to ask for a second opinion. There's nothing wrong with asking for a second opinion. Coincidentally, the other day, I met someone who was afraid to ask for a second opinion. And when I sat down to talk to that person, she even started crying, saying that she felt bad if she was going to ask for another opinion from another dentist. But she didn't feel sure that this dentist was telling her the right thing. And it's important to have that freedom. That's why we have the freedom to ask for an opinion. I'm not saying that you're going to hurt her feelings or anything. But it's your own health. And it's you. It's your body. Yes. Nobody is going to take care of your body more than you. Exactly. Yes. We have that human touch and also the importance of knowing our rights in the medical field. Yes. Yes. Yes. And do you think that the community here in Arisenburg offers sufficient services to the citizens, and more specifically, to the Latino community? I feel that they do offer good care, because I know that in the hospital they have interpreters in person, and they also have them on the iPad, which they call Sally. Also in the offices, there are many offices that have hired interpreters. Also, there is promotion. I have heard of many programs that are called Healthy Families. There are many programs that, I don't remember all the names, but there are many programs that do help the girls who are pregnant, who no longer have their first child, or something like that. Also, health promoters, who do some programs where they help people learn about diabetes, or about other health problems, or things to do more activities, or promote dental things, things like that. In community health centers, we have one here in Arisenburg. We also have the health department, where they can go and get vaccines. The community health center, I would love for it to be bigger, for there to be more doctors. In itself, there is more need for places that accept people without a medical insurance, that they can put them on a ladder, so that the patients can go to medical care without having to pay so much money. Like the elements of equity, because their health is also important. Yes, yes. Have you needed an interpreter for any of your family members on medical appointments? Yes, I have interpreted since I was very little. I have interpreted for my family and for friends. I do say that it is not very good to have your children interpret, because they have not developed, they have not learned the words well, especially the medical words. I always remember that once I interpreted for a friend of my mother's. I did not know how to say menstruation in Spanish. I was just saying period, period, and she did not understand me, because I did not know how to say that word in Spanish. I did not know how to explain myself, and I think she was getting frustrated. I did not know anything. I do not remember how old I was, I was about 13 or 14 years old, but I felt bad because I did not know how to interpret. But it is very important to have someone who knows what you are saying, or understands the concept, or can ask for help on that, because between the interpretation or translation, some vital information can be lost. You could be talking about something to the patient, and they do not understand or confuse more. I have heard from some people who interpret at home, and they are telling them, they gave them the wrong information on how to take the medication or what medication was being taken, and that is also crucial for one's health. The difference between life and death. Yes, yes. And as you said, that puts the children in the middle of the situation, but without the competition, because the medical vocabulary is always changing. Yes, yes. And the children are still developing, they are learning everything, they know all the words. Yes, the stress, and sometimes the topics are not appropriate for privacy or whatever. Yes, yes, yes. And do you think there are enough health professionals who speak Spanish here in Harrisonburg? Here in Harrisonburg, there are many in certain places, but in other places there are not so many. It depends. It depends on where you work. In the hospital, there are more or less, and they have interpreters, which is good. In the offices, in certain offices there are many people who speak Spanish, but then there are other offices where there are not even one person who speaks Spanish. The statistics that I have seen of the nurses in the United States, only 7% are Hispanic, and that is a very, very small percentage, especially for the Hispanic community that is growing and growing here in the United States. So it's something, I like to promote health and things like that, or that people who are interested in working in the health sector, I like to say that you can do it, that you can do it, that you don't stop at anything, because sometimes I'm not going to tell you that everything is easy, or with a lot of flowers, or everything. It's difficult, but it's important to be able to help the community and our community. It's not that I don't want to help the rest of the community, but when you see a Hispanic patient and you speak to him in Spanish, you feel so good about being able to provide that comfort of having a disease that understands you, that can explain everything to you well. Because having an interpreter, some things can be lost in translation, or you don't feel very well that the interpreter is listening to you, or something like that. And also the interpreter on the iPad. Sometimes they can't hear you very well, you can lose some words or things like that. I've seen in certain situations where the patient was saying something to the doctor, but the interpreter didn't interpret it well, and they didn't understand each other, but when you have an interpreter in person, it's different. And if the information is very serious, or whatever, it helps to have that human touch in person, instead of on the internet or on the iPad. Yes, and someone who can be there. Because in taking care of someone, you also have to have a lot of... You have to care about people, have that heart to serve people. Because you can't be someone who's just like that, because we're there to support you during those difficult times as well. And I also think it makes a big difference when you have someone who speaks your own language. So, for you, practicing medicine has a sense of social justice. Not just for the Hispanic community, but also in the general sense. Yes, because we all deserve the same kind of care. We all deserve to be treated equally. Society is always changing. You can always say that maybe there will always be racism, or that someone will look at you and say, I don't want her to be my nurse because she's of that race, or she's Hispanic, or she's from another country. And I'm not going to say that I haven't had patients who have confronted me because I'm Hispanic, or something like that. They've even told me that I've had prejudices against Americans, or something like that. And honestly, I don't have prejudices against anyone. I want there to be equality, and I'm always going to treat all my patients equally. Because we all deserve that respect. And if they don't give us respect, that's their problem. Exactly. Yes. It shouldn't affect us how we provide them with their care. Exactly. Because they still deserve medical care. And that's where that touch comes from. Yes. And do you think there are ways to promote entering the medical field for Latinos and Hispanics in general, or ideas? I would like there to be more programs like doctors or nurses, or something like that. Especially for Hispanics, to go to schools. Yes, to schools. To the preparatory school, especially, because that's where you're going to find everyone in one place. And to be able to explain what health care is, or how it is to work in health care. To give that motivation. Because sometimes some people just lack a little motivation. Or to see someone doing something that they want to do. Something like that. And that's very important. I would like there to be more programs like that. Or maybe they can't think of it as an option because they don't see enough Latino providers. Yes, yes, yes. And the information on the statistics of how we're growing. And that it's possible. There are a lot of programs, too. And there's a lot of financial help. Because I know that a lot of students think that they can't do it because there's no money. Or because they can't pay for it. Yes, but it's important to be able to... I would like there to be more programs to promote that. Like more tools and resources in general. Yes, yes, yes. Because I remember when I started, I'm the first generation to go to school in my family. And I didn't know where to get financial help. What classes I had to take. Things like that. And I would have liked to know or to see more programs. Or that they would have come to the school to explain everything. Things like that. It's very important. Instead of doing everything alone. Yes, and there learning. Yes, yes. There learning. You can't say that I even threw a semester away because there were classes that I didn't have to take. But you learn. Exactly. And do you think your work is providing important services? And can you talk about your past or present work? Yes, yes. I think so. When I worked in an office, yes, we provided a lot. Especially care for diabetes for our patients who were pregnant. The importance of diabetes during pregnancy. I had to teach about diabetes during pregnancy. And that helped me a lot to see that some people weren't thinking correctly or weren't informed correctly about diabetes during pregnancy. And I liked to be able to do those lessons, to help them understand. And to explain to them that when you have diabetes, you don't have to stop eating everything. You just have to eat everything in moderation. It's not a matter of prohibiting yourself. More aware. Yes, more aware of everything you're eating and portions. And that's very important. Especially because sometimes food is a big part of culture. Yes, yes, yes. And also about the promotion of Papa Nicolau, things like that, the mammogram. That's very important. And I've seen that some offices do promote it. Because I've seen people who haven't gone for 25 years to get a Papa Nicolau. And when they came, that was another problem, or it became another problem. Because they were late. Yes, because they were late in their check-ups. But yes, there is a lot of promotion around here. I've seen good things, like the interpreters they provide in the offices. That's very good. Because I, as a nurse, I like that there are interpreters because I can do my job as a nurse. I can continue being a nurse. And I like that there are interpreters who can come in. After I help the patient, I attend him, and the doctor comes in with an interpreter. Instead of doing both at the same time. Yes. Exactly. Yes. And do you think there are laws that can help, like medical services can help the general population? I think so. I don't know if there are laws, but... Or maybe more organizations. Yes, I wish there were more organizations promoting health. Because sometimes that's something we don't see. Well, I don't watch TV anymore, or there are no more commercials or things like that. But doing more campaigns about what primary care is, what it means, like a map of when I should go to the hospital, or when I should go to my primary doctor. That would be something very important too, because sometimes there is confusion about what you should go to the hospital, or the primary doctor, or what you can expect. Also, having education about what to do in certain situations. Also, promotion of mental health, because there is a lot of depression right now. Especially after the pandemic, things like that. And I know that among Latinos, it's not something we talk about a lot, or we say, oh, I don't have time to have depression. And you just keep it all in there until one day it explodes. I wish there was more promotion, more information about mental health. Because it's something very important. Some people think that doesn't exist, or it's something that's not talked about among Latinos. It's like, oh, I don't want to talk about that. And if Latino people do it, they have to do it on their own, without talking about it. And that's hard. It's hard because you don't have that support from people around you. Or they see you as if you're really sick. Because it's something more invisible. Yes. But depression or mental problems do exist. We just have to talk about them. So, more information, more organizations, and informing people so they can have more autonomy in their decisions. And it's okay to ask for help. We're not less for asking for help. Exactly. Well, is there anything else you want to add? No, just that health is something very important. And I like to talk a lot about health and how people need more education. They need to be more empowered in their decisions and be able to ask for the help they need. But I hope that medical and dental care improves in the next few years. It's my wish, yes. Yes. But we'll see what happens. But each one of us can put our grain of sand in the process. Exactly. Progress is still progress. It doesn't matter if it's more delayed. Yes, yes. Well, it was a pleasure. And thank you for being here and sharing your time and your words. Thank you very much. Thank you. Come on. There we go. Thank you. Thank you.