In 2021, Diana Ramirez was in the dark. Her electricity had been shut off. A Spanish-speaker living in rural Marion, North Carolina, she needed help but her options were limited. She felt desperate. Then, she remembered a Facebook post she had seen from an organization called Centro Unido Latino Americano. Relieved, she reached out and connected with Laura Zapater, a community health worker.
“I went with her to the office for the electric company and I helped her interpret,” Zapater said in a February interview.
Once the lights were back on, Diana learned that she could also access help for other concerns: COVID-19 testing for herself and her son, food boxes, and access to health care for herself, having already enrolled her child in Medicaid.
Through an interpreter, Diana told the NCMJ that she typically sought health care at the emergency room. Because she did not speak English, she wasn’t able to call and make doctor appointments or explain the kind of care she needed. Her experiences at the hospital were hit or miss; sometimes she felt well taken care of, but often she did not. Most often, any language interpretation that was available was conducted virtually, which was not ideal for health care.
Through Centro Unido Latino Americano, Diana connected with McDowell Access to Care and Health (MATCH), a local safety-net organization that provides health and other services to any McDowell County resident in need. A Spanish-speaking MATCH representative who regularly visits Centro Unido Latino Americano helped set Diana up with a doctor.
Now, Diana says, “When I’ve needed an appointment, I just call and they help me make it.”
Community Health Workers Fill Geographic and Language Gaps
Zapater moved to McDowell County in 2019. She is originally from Spain, where she worked in the hospitality sector. After COVID-19 hit, she applied for an office manager position at Centro Unido Latino Americano, but Executive Director Margarita Ramirez thought her people skills would make her a great community health worker. So, she joined the team to help with pandemic-related work.
Through this work, Zapater learned the impact of the language barrier on the health and well-being of the large Hispanic and Latino community in the region.
“Not speaking English, it’s very hard for them when they need to access to any health services,” Zapater said. “I know a lot of hospitals provide interpretation, but it’s not the same to talk to somebody one on one.”
Building trust is an important aspect of any clinician-patient relationship, and it can be even more vital when there is a language or cultural barrier. That’s where Zapater says community health workers come in.
“Sometimes, if you are there in between [during] that process, helping them to get the care that they need; they feel better, they feel safer, they feel that trust and that confidence.”
Because communication can be difficult for this community, Centro Unido Latino Americano heavily utilizes social media to get its messages out in both English and Spanish. The organization advertises community events and new programs, provides health and well-being tips, and even holds live virtual events—to share information related to accessing needed services, and also to hold cultural celebrations like Mother’s Day and Dia de los Muertos. Diana is far from the only member of the community who has reached out via Facebook in desperation and found connection to what she needed.
“We are here to help the lives of the Latinx community members, because it’s easier when they have to access health care, but [we also want to make it easier] for the hospitals and medical staff to build those connections,” said Zapater. “We need to work all together and make the lives of these families that have less access to health or lower income or other barriers, like language or culture, a little bit better.”
Acknowledgments
The author is the managing editor of this publication. The article has been reviewed by guest editor Adam J. Zolotor, Editor-in-Chief Peter J. Morris, and the subjects.
Lissette Saca provided consecutive interpretation for the interview with Diana Ramirez.
- ©2022 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.
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