05/19/05 — Hospital tries to improve care, accessiblity for Latino patients

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Hospital tries to improve care, accessiblity for Latino patients

By Bonnie Edwards
Published in News on May 19, 2005 1:45 PM

KENANSVILLE -- Imagine having a heart attack. You are in pain and know something is wrong; and you have to get to a hospital.

Once you get there, however, you can't tell the healthcare workers what's wrong with you because you do not speak their language.

Now, imagine the terrifying mass of hospital forms and charges, also all in a language you don't understand.

Those and other barriers are what Duplin General Hospital is trying to eliminate with its new Hispanic outreach program. Director Alex Asbun says the initiative is designed to teach hospital personnel how to relate to the county's 15 percent Latino population, and to make those residents more comfortable with using the healthcare system.

The differences begin with culture, Asbun said. When a Latino gets sick, he turns first to his family, usually the dominant female figure. Privacy is also an issue, he added. Some Latinos will go to a folk healer rather than make the trip to the hospital and answer what they fear will be embarrassing questions about their health.

So, part of Asbun's job is to approach the independent Latino community and convince the people to count on Duplin General Hospital.

"The key is to have them see us as a friendly place and not as the unknown," he said.

And although they are welcoming, Asbun has to deal with cultural issues within the community as well. The Hispanic community is made up of people who come from many different countries, and each culture has its own way of approaching health issues.

And then there is the independence, Asbun said. When Hispanics arrive in the county, they tend to form their own little communities within the community, banding together socially as well as in their day-to-day existence.

"You'd be surprised how the community has managed to live on its own," he said. "You probably work with someone who speaks Spanish. If you go out to eat, you go to a Hispanic restaurant."

Shopping is done at a local, Hispanic-owned store rather than a large supermarket, he added.

Taking care of their own, and seeking the comfort of interaction with people of similar background and culture are not limited to the Hispanic community, Asbun said. Anyone who moves into a new community has to deal with the adjustments that go along with learning a new place.

"Even within the same country, there can be different cultures depending on which region you come from," Asbun said.

Located in the county with one of the largest Hispanic populations in the state, Duplin Hospital officials realized over the years they weren't doing the job they needed to in addressing the needs of Latino residents. Hospital Vice President Rebecca Nesbitt said putting in a translation service was not enough, Duplin General needed a more comprehensive approach to providing the care the Hispanic community needed.

The hospital applied for a foundation grant and acquired the money to start Asbun's program. He became the hospital's director of Latino health care access and started his program in April 2003.

But educating the Hispanic community about what Duplin General had to offer was not his only job. Hospital employees needed some help, too.

First on the agenda was learning Spanish.

Some hospital employees were hesitant at first, Asbun said. But after a while, Spanish classes were full, and employees were trying out their new skills.

Learning and appreciating cultural differences took a little longer.

"Our employees didn't have an understanding of the cultural difference," Ms. Nesbitt said. The doctors and the staff didn't understand why a man would bring 20 family members with him to the doctor's office."

But all that is changing, Nesbitt and Asbun said.

Now, employees are enjoying their cultural exchange. Last year, they participated in a festival complete with Spanish bingo. The hospital cooks also prepared several traditional Hispanic dishes from recipes gathered from hospital employees from Colombia, Mexico and Brazil. Some employees even traveled overseas and will share their experiences later this summer.

The work to get Hispanic residents more comfortable with seeking healthcare continues as well.

Each month, pregnant Hispanic women are given tours of the hospital so they can meet the staff before coming in to have their babies. Asbun collaborates with the health department and other organizations that refer people to him.

Those tours are important service to the hospital's clientele, he said. At Duplin General, 49 percent of newborns this past year were Hispanic.

Asbun said he hopes to work himself out of a job. His goal is to make the community so comfortable with seeking care and the hospital so self-sufficient with training and maintaining a bilingual staff that he can move on to the next project. Part of his plan is to help Latinos get financial support for education to go into healthcare careers and come to work at Duplin General.

It is the stories, cards and phone calls he gets from those he serves that keep him focused on his goal.

One of those memories is of a man from Oaxaca, Mexico, who worked in Duplin County for nearly 20 years but did not speak English.

One day, he came to the hospital suffering from a stroke.

"He was helpless," Asbun said. "He had no one to tend to him."

The hospital staff mobilized and got the man not only the care he needed, but assisted him in getting home.

"A member of the community opened her home to tend to him while we did the paperwork to get him back home," Asbun said. "The hospital donated the first round of medications. The Mexican Consul helped us arrange the flight back home."

Asbun said he knew the hard work was worthwhile when he got a call from the man from home saying he was doing fine.

"I consider myself lucky to get to do something I like and feel lucky one more person got the help they needed," he said. "And I get a pay check."

He said he is enjoying his time in Duplin County, saying the diversity is one of the community's treasures.

"We have an extra richness we take for granted," he said.