In Somali there’s a popular term for going to the doctor: maalintii oo dhan. It means “all day.” The expression is often muttered by those who need interpretation during their health care visits in City Heights, usually after waiting several hours to be seen. Mid-City Community Advocacy Network’s Access to Healthcare Momentum Team is attempting to solve this issue through a series of workshops for the Somali, Bantu Somali, and Korean communities as the first stage to developing patient standards for quality interpretation.
These workshops are considered Participatory Action Research (or PAR), which includes several stages to find a solution. People identify what their experiences are through community-lead surveys, and based on the data, create their own guidelines for health care interpretation.
“This research is an avenue to create standards and regulations that people are satisfied with. The level of details involved in the process to empower people about their rights,” said Jama Mohammed, Organizer of the Access to Healthcare Momentum Team at Mid-City CAN. “This research provides the issue but it also provides a solution, which is what makes it so valuable.”
William Oswald, PhD., is the Associate Executive Director for Research and Evaluation at the California Endowment’s Global Action Research Center. He is leading several of these workshops based on a study of 220 women he conducted two years ago, which found nearly 80 percent of women in City Heights spoke little to no English, and about 70 percent had no idea what was going on during their health care visits
“When they were at the doctor, what their after care was, what they were supposed to do with their drugs- they just didn’t have a clue. When they signed papers they had no idea what they were signing,” said Oswald. “Women who needed interpretation waited twice as long for the doctor. The women can tell endless stories of things that happened that shouldn’t have happened because they were misunderstood.”
That initial study helped generate a conversation in the community. The Access to Healthcare team decided the people who needed help should be the people to find the answers.
“For years we have been trying to fix problems without talking to the people who live with them. And if you have faith in the intelligence of the community then really it’s about creating the space for them to articulate what the issues are and find the solutions,” said Oswald.
Isha Aweyso, 19, is one of the youth attending these PAR workshops. Her family is from Somalia, but moved to the United States from Nairobi, Kenya in 2005. Since then, they have struggled to understand health care in the U.S.
“Most people who go to clinics don’t read or write in English, so they can’t even fill out the paperwork. I was surprised to find out that everyone has to wait over a month to get an appointment with a doctor. They arrive 15 minutes early and wait over an hour to be seen,” said Aweyso. “But these PAR workshops are really interesting. I like listening to everyone’s experiences. It gives us hope and makes us feel like we can make things better.”
While casting a vision for the future of health care in City Heights, Mohammed described the type of doctor’s office he hopes will come to be. “The clinic environment would be culturally appropriate. The people who work in the clinic would be a diverse group of people who are from different backgrounds and actually represent the community.”
No matter the specific outcome of the PAR workshops, and eventually the community-lead research conducted through them, those involved have no doubt that a practical answer will be found by the people who need it the most themselves.
“It has to be in their voice,” said Oswald. “I have absolute faith in this community to figure out a solution, and it will be a good one.”