I was sitting in a waiting room at my home town’s health department. I had no recollection of being there as a child; the only concrete proof of my visits were documents in a file folder, somewhere in this building.
While I waited, I tried to imagine what it felt like to be here all those years ago. Was I scared? Did I understand what was going on? Did my parents?
Finally, my name (or something close to it) was called and I stepped into the nurse’s boxlike office. There was the anticipated “sorry I butchered your name in front of everyone/oh, no worries, happens all the time” conversation. Then I signed some papers and left with my immunization records.
That was the second time I dropped in to acquire those documents. (When I applied to college, I “misplaced” the copies after being accepted.) This time I noticed something new: written among the dates and vaccinations were comments from a physician:
Fecal test positive for intestinal parasites. Child is otherwise happy and energetic.
Alone in my car, I laughed out loud.
The 2-year-old Noony was not afraid of anything, not strangers on a plane – because what is this thing you call candy?! – and certainly not intestinal worms.
I give you Life Lesson #1: no matter what parasites decide to proliferate in your gut, always wear a smile. Isn’t that what they say?
There was a point to this story. What was it again? Oh, here we go.
Health departments. I hate them, but no more than most people hate the doctor’s office. For some families, the health department is the best medical care to which they will ever have access. How often they go and whether they return for follow up care depends on complex factors, not least of all how they were treated by personnel. This is particularly true for non-English speakers.
I often wonder who translated for my parents all those years ago, when the Lao community was still very small in our town. Moreover, who reassured them that everything would be okay? Nowadays, when you enter a health department, signs everywhere ask if you need a medical interpreter. One of the newer languages listed is Lao.
And while it is actually quite common to have intestinal worms when you walk around barefoot (or crawl, as it were) in below average sanitary conditions, the thing that is special is that a Western medical professional was able to treat me. Better still, neither I nor my parents were emotionally scarred. Imagine how much more frightening a deworming adventure would be if your caregiver had no bedside manners and you couldn’t understand his/her language.
So what I’m saying is, thank you, Doctor Who Dewormed Me (I can’t read your signature). Thank you for putting my parents at ease and most likely bribing me with candy to get the task done. Thank you for however you managed to preserve their dignity as they struggled with so, so many cultural barriers.
Giving medical care to refugees has got to be one of the toughest aspects of the job. It’s hard enough when the patients speak English but have zero health literacy.
This post stems from a conversation I had with my friend Kelsey about the book The Spirit Catches You and You Fall Down. It is the true story of Lia Lee, a Hmong girl who suffered from epilepsy. Her parents struggled to comply with Western medical advice, primarily because the condition seemed to fit with their spiritual/cultural illness model.
It is a heart wrenching story that I highly recommend in the hopes that it will spark some discussion – not just about refugee health but about quality of care in the medical profession as a whole. I consider myself very fortunate that my experiences were positive and that my mother’s nursing background gave her enough health literacy to understand the benefits of complementing cultural traditions with Western medical care.